Permit CITY TIGARD PLUMBING PERMIT
• DEVELOPMENT SERVICES PERMIT #: PLM2006 -00042
DATE ISSUED: 1 06
— 6 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 5110
PARCEL: 2S110DD -00109
SITE ADDRESS: 11025 SW SUMMERFIELD DR 6 ZONING: R -25
SUBDIVISION: SUMMERFIELD APARTMENTS LOT: 013 JURISDICTION: TIG
Project Description: Unit 6, install washer
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 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: ft
DISHWASHERS:. RAIN DRAIN: ft
Owner: FEES
SUMMERFIELD ASSOCIATES, LLC Description Date Amount
% HSC REAL ESTATE
1500 SW 1ST SUITE 1020 [HRPLM] Hourly Plumb 1/31/2006 $14.38
PORTLAND, OR 97201 [HRTAX] Hourly 8% Sti 1/31/2006 $1.25
Phone : 503 - 546 - 5712 Total $15.63
Contractor:
RAY'S PLUMBING
15200 NE CAPLES SUITE C REQUIRED ITEMS AND REPORTS
BRUSH PRAIRIE, WA 98606
Contact # : PRI 360 - 892 - 8700
FAX 360 - 892 -9644
Reg #: LIC 33217
PLM 37 -149PB
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 - 246-6 or 1- 800 - 332 -2344.
Issued By: APP g)1 Permittee Signature: l . CLt0.1
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.
01/23/2006 1 4 : 52 5036243681 TIGARD BUILDING DEPT PAGE 02/03
.,,,,.. 6 ,,,
Building Fixtures C i‘i ,r___ ljj: :
Plumbin Peri_L_2plit A - ica ion - 1(,1( ow< I:
131 SW Hall
Receives] # O MININAMMAgil
City of Tigar 1 jAN 6 20 25 B.. Ti 2 - M
gard, OR 97223 " Flan Review
Phone: 503.639.4171 Fax: 503.598.19_6.0_ ... __, _ i •- •-.,.. . ,..: Other Permit No,;
24- Hour Impaction Lino; 503.639.417(dry Of Tif_ 14_ IL . -. Date Ready/ST tu ' 21 See Pagel - tor
interne: rNw.ci.tigard.or.us ,. r 1 . & t • oinx Notified/WM*4 /4c _ Supplemental NI
;t1; .... :,
,;::77.47,:'S":11KI',7:7.:1'; ., #W,;....,: ...
For 'eclat information asa checklist
• ['New construction El Demolition
Description f Qty. 1 La. I Total
1.3 Addition/alteration/replacement 12 WASEtat.- 14 Newt- 2 dwellings (includm 10011 for each utility connection)
SFR (llbath 249.20
121 1- and 2-family dwelling 0 Commerciallindustrial SFR (2) bath 350.00
ID Accessory building 13‘Iti-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
1:1 Master builder 0 Other:
' Fire sprinkler L...... L...... sq ft.) Page 2
'; .':'''': : ;::.:4 € : ; t7:7 sit u tiliti es
Job site address nos 64 ,,, c o.,-- p g 4- 4, Catch basin orates drain 16.60
City/State/ZIP: -r op., Dryweil. leach line, or trench drain t6.60
- Footing drain (no. linear ft: _____) Page 2
Suiteibldgfapt. no.: Project nameSbo Lijkifr*gt... ,--•
Manufactured home utilities 110.00
Cress streeUdirccticais to job site:11k42AAgyiu ,T)
Manholes 16.60
Rain drain connector 16.60
&miter/ scum (no. linear ft; ) Page 2
Storm sewer (no. linear ft.: ___,) Page 2
Subdivision: 1 Lot no. • Water service (no, linear R.; ) Page 2
Fixture or item
Tax map/parcel no.:
Absorption valve 16.60
..... , = •''.;:(% ..';::.•',1'..:' .4: "-....: - ..,........:: •
-..!. , • ... :.., : . nil. •:... • • - .4 .. • • • -, . V r, •, Zfr••• . .• ', , '.. Ts :, . ' ' ; A ' Back flow preventer Page 2
0.
O- 1.-1-Doe--..; O • Badcwater valve . 16.60
Clothes washer / 16.60
Dishwasher 16.60
Drinking fountain 16.60
.
Ejcctwslsump 16.60
Name: U i et* - 1 4 6a3c-4 Arri-F. - 5 Li-c- Expansion tank 16.60
Address: 42 i . P - c5A flinEE- i5Cs9 ....4-2c1.)-2.-C) Fixturciscwar alp 16.60
City/StaterZIP:1rza. 0 I De__- 6 172.0 1 Floor dmin/floor ainit/hnb 16.60
Phone: (50 5le - 5 7 2_ I Fax: 603)646 '530 1 Garbagi: disposal 16.60
16,60
1 1 .....■•':;_:;...'i:,::: T. '.':7... :'::. 4. titglik01...;1: Rose bib
. ' Ice maker -1 16.60
Business name: sy_yD c i xi c... ___
_ Intaccrodgrease trap 16.60
Contact name: CA-ON-0 c„...) .ts-tr.-...aft„, Medical gas (vahic: $ ) Page 2
Address: i 5 q0 11.6 104 A tie Primer 16.60
City/State/ZIP: PA 0 -62E-Ft e... (..1../A 6712)64--2-- Roof drain (commercial)
16.60
k
Phone: 660) 546 -16., 2,...5 j FaX: : (34,15)) 5 & - j 6 Sin/banin/lavatory
.-;, - 16.60
Tub/shower/shower pan 16.60
E-mail: Chad el<5(<4Guareicon._ coo., Urinal 16.60
'' '..•':'' '=.': • • . • ----. Warlosct 16.60
i
Business name: P,P) ...1 PLAJ:%- 1 •4 ) Ci• Water heater 16.60
Other: talirr 4 11,15 L..
Address: I 5 20 ma- cia 2 5:... CT C.-- - '
City/Sate/ZIP: 12 _,..., s 0 . pi24:\.. i e vi... A et 6,0, Subtotal
Minimum pennit fee: $72.50 36
Phone; (3C,rf. gq 2,- S70 0 Fax: ( eci 1 - ciG41- Residential hackflow minimum pmnit fee: $3625 / 4
CCI3 Lie.: - 5-3 2 i Plumbing Lic. no.: - Ct "; Plan (CAM (25% of permit fec)
Authorized signet
State surcharge (8% of permit fee) /4 AS°
re i -
TOTALPERIVIIT FEE
Print name: d _ , t/ i , Date: / ET9 This permit application expires if a permit is not obtained within
- 180 days after It has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board,
jAI:luitcrmeermitalPLNIF-PermitAvo.doc 06/05 I% .....----
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CITY OF TIGARD . , -
BUILDING• DIVISION PERMIT #: PLM2006.00042
13125 SW Hall Blvd., Tigard, OR 97223 Alk DATE ISSUED: 1/3I/2UO
Phone: (503) 639 -4171 II
Inspection Requests (24 Hrs.): (503) 639 -4175 P
INSPECTION WORKSHEET FOR DATE: 2/14/2006 TIME: 2:22PM PAGE: 76
SITE ADDRESS: 11025 SW SUMMEPFIEL) DR 6 CLASS OF WORK:
SUBDIVISION: s U MME_R1:IELD APAR1 MLN I'S LOT #: U13 TYPE OF USE:
PROJECT NAME: tiUMMERFIF.LD AP'ARTME'NTS
DESCRIPTION: Unit 6, install Washer
OWNER: SUMMERF ASSOCIATES, LLC, PHONE #: 503-M6 5712
CONTRACTOR: RAY'S PLUMBING PHONE #: 360 - 802 -(3700
Inspection Request Scheduled For: Date: 7/ 14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3)0 Plumbing rough -in 026825.07 503-310.7187 N
Corrections /Comments /Instructions:
k \itish
C
/
p4S` ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION
III ADDITIONAL FEES ASSESSED
Inspector: 1 " `'L Date: v ( Phone #: (503) 718- yr 4y