Loading...
Permit si • -s, III CITY OF.TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00552 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/14/2007 PARCEL: 1S134CD-08500 SITE ADDRESS: 11865 SW SUMMER CREST DR ZONING: R-4.5 SUBDIVISION: BURLWOOD NO.4 LOT: 035 JURISDICTION: TIG PROJECT: SAJA Project Description: Replace 45ft of water service. • CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: . WATER LINE: 45 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES SAJA, EDWARD J ROSE M 11865 SW SUMMERCREST DR Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 12/14/2007 $72.50 [TAX] 8% State Surcha 12/14/2007 $5.80 Phone : • 503 -590 -3848 . Total $78.30 Contractor: ARS LLC PO BOX 20698 PORTLAND, OR 97294 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 235 -8784 FAX 503- 491 -2932 Reg #: LIC 127325 PLM 34 -168PB • This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: . ,II . _ . # . Permittee Signature: �►y w r Y z , Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • 0 -.‘ ' .DIti.CEIVED • Plumbing Permit App icaTinn 3 2001 FOR OFFICE, USE ONLY 111 City of Tigard � �i ONCID t Review � Pcnnit No 14 - 00,65 1 a 13125 SW Hall Blvd.. Tignrd,f[ Phone; 503,639.4171 Fa.: [�1L1JI�y� � '�[9f1: '7�� Deter Other Permit No.: T 1 C A R D inspection Line: 503.639,417"~ Date Ready /By: la . • El See Page 2 for -- Internet; www.tignrd- or.gov Notified /Method; Su plcmentnl Information TV% t • OF WORK, : • ; • • . • r" :...: , t.tt. ';'SCHIZDmmLE 1:1 New construction ❑ Demolition M~- For s 'octal in ormntion use checklist, _ _ -- Descri tion En. fatal __ CR Addition /altcruti ace ment ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection) CA'1 EGOR'Y O1:' CONSTRC)C: TION . .. • .. , . . • SFR (l) bath 249.20 ® I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350,00 [I Accessory building ❑Malti- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: - - Him sprinkler( sq. ft.) Page 2 .1OIk SITE :INFORMATION AND .LOCATION . Site utilities - ~✓ Job site address: 11865 SW SUMMER CREST DR Catch basin or area drain 16.60 City /Sthtc /ZIP: TIGARD OREGON 97223 Drywcll, leach line, or trench drain M 16.60 Suite/bldg. /apt. no.: Project name: SA Footing drain (no. linear ft ^) Pa 2 Manufactured home utilities 110.00 Cross street /directions to job site: SW 121 AV Manholes 16.60 MAP- 655 -C3 TOMAS GUIDE MAP Rain drain connector 16.60 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no, linear ft.: Page 2 Subdivision: I of no.: Water service (no. linear ft. 4 ) Page 2 Fixture or item Tux map /parcel no.: Absorption valve . I6,60 D119CRIr.PTION •QT+' Iv .90N , : ; .: Back flow preventer Page 2 • REPLACEMENT 45 VT WATER SERVICE Backwater valve 16,60 Clothes washer 16.60 Dishwasher 16.60 • • - • - • . • - Drinking fountain I6.(d) Ig PROPERTY OWNER • .All TE. .. f . . - _ - -- - -_ -- Ejectors /sump 16.60 Name: EDWARD SAM -'- °._ ,_ ... " . _ , V ,,, - „, Expansion tank 16,6(1 Address: 11865 SW SLIMMER CREST DR Fixture/sewer cap 16.60 City /State /ZIP; TIGARD , OREGON 97223 Floor drain /floor sink /hub 16.60 Phone: (503)590 -3848 Fax: ( ) Garbage disposal 16.60 _ � , Hose bib 16.6(1 0 APPLICANT © CONTACT'P'1CR$ON ' ' " ' ' Ice maker 1 6.60 Business name: ARS dba JACK HOWK PLUMBING & DRAIN Intcrccptnr /grcasctrap 16.60 Contact name: DAWN JACKSON Medical gas (value: $ ) Page 2 Address: P.O. BOX 20698 Primer " - 1 6.60 City/State/ZIP: 97294 Roof drain (commercial) 16.60 - Phone: (503) 235 -8784 I Fax: : (503) 491 -2932 Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 . CONTRACTOR . . . • •• .. : Water closet 16.60 • Business name: ARS dba JACK HOWK PLUMBING & DRAIN _Water heater 16.60 Address: P.O. BOX 20698 Other: -" City /State/ZIP: PORTLAND OREGON 97294 _ Subtotal Minimum permit fcc: $72.50 71 511 Phone: (503) 235 -8784 Fax: (503) 491 -2932 _ Residential hackflow minimum permit fee: $36.25 CCR lie.: 12732$. -- -- Plumbing Lie. no.: 34-168 P � Plan review (25% of permit fee) _ C_. State surcharge (8% of permit fcc) 5.80 Aulhorired signature: t TOTAL PERMIT FEE 78.30 Print name: DAWN JACKS Date: 12/13/07 This permit application expires if a permit k not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Serviee Board. tAno0di " 116n6m6 440- 461ST(111/(17JCOMnvr-.R) CITY OF TIGARD � ,,t, . BUILDING DIVISION PERMIT #: pLM2007_00552 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/14/2007 Phone: (503) 639-4171 t ; Inspection Requests (24 Hrs.): (503) 639 -4175 �'! �.. INSPECTION WORKSHEET FOR DATE: 12/17/2007 TIME: 7 :01AM PAGE: 40 SITE ADDRESS: 11865 SW SUMMER CREST DR CLASS OF WORK: SUBDIVISION: DURl WOOD NO LOT #: 035 TYPE OF USE: PROJECT NAME: SAJA DESCRIPTION: Replace 45ft of water service. OWNER: SAJA, EDWARD J ROSE M, PHONE #: 503 - 590 -3848 CONTRACTOR: ARS LLC PHONE #: 503`235 -0764 Inspection Request Scheduled For: Date: 12t1712007 Pour Time: . Code # Inspection Description Confirm # Contact # Message . 330 Water service 061626 -01 503 235 -8784 Y P I Ivd Corrections/Comments/Instructions: 0 vok (oA I-6V g PV- "1 eIt-oche co �e0. ce. Care. c 4, LA ( chi PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Cno ‘'1'1\M-1 1 \ 6 - i. Date: I a n 1 D Phone #: (503) 718-