Permit g:r . R
rf 71 ry „ CITY OF * PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2006 -00595
T 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/19/2006
PARCEL: 1 S125DB -01700
SITE ADDRESS: 07140 SW TAYLORS FERRY RD ZONING: R - 4.5
SUBDIVISION: SHADY DELL LOT: 017 JURISDICTION: TIG
Project Description: Replace 80' of rain drains.
CLASS OF WORK: OTR 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: ft ,
DISHWASHERS: RAIN DRAIN: 80 ft
Owner: FEES
CHAD PLUSH
7140 SW TAYLORS FERRY RD Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 12/19/200€ $72.50
[TAX] 8% State Surcha 12/19/200€ $5.80
Phone : Total $78.30
Contractor:
PIPELINE PLUMBING .
PO BOX V - 108
333 S STATE ST REQUIRED ITEMS AND REPORTS
LAKE OSWEGO, OR 97034
Contact # : PRI 503- 624 -1906
FAX 503- 624 -1926
Reg #: LIC 158260
PLM 3 -510PB
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: �a Permittee Signature: _.e r, ,�.D
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.
Dec 19 06 09:44a PIPELINE PLUMBING (503) 624 -1926 p.1
f/ t1
Plumbing Permit Application si �t [5� 6L� = . { FOR O Fl Ic E USE r.ONl i,:
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III . City of Tigard p t o yd:a /9 o6 � �-/ 1` P N ,h�OG 00 ' S�
0 13125 SW Hall Blvd., Tigard OR 97223 2006 ran Review / [� U
Phone: 503.639.4171 Fax: 503.598. p Other Permit No.:
T 1 G
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: lu;;:/ ®
\ RI) see Paget far
Internet: crww.ti and -or. ov
8 g 1 1 fllglt* 1I11 QI fU Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
Q New construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
Q Addition/alteration/repIacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 24920
21 I- and 2- family dwelling ❑ Commercialiindustrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Masier builder Each additional bath/kitchen 45.00
❑ O ther:
Fire sprinkler ( sq. ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: .9 1t1u �w i ' .,. 1 u r L � Y i r l�t 1 2x� Catch basin or area drain 16.60
City/State/ZIP: I ti f, {t't � t ( #f � , C. '� - I • Drywell, leach line, or trench drain 16.60
Suite/bldg.iapt. no.: Project name:
1 1 Footing drain (no. linear ft: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
-� 1
�l' it.),-Le rl W l "a Cl, r s(\ T Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lol no. ; Water service (no. linear ft.: ) Page 2
' Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION O F WORK J Ga Backtlow preventer Page 2
I ?•I� Ll C e o 4 - k {� (l Backwater valve 16.60
(l0 - Clothes washer 16 60
Dishwasher 16.60
,8" PROPERTY OWNER CD TENANT Drinking Fountain 16.60
(� Ejectors/sump 16.60
Name: ( :01 (A [ .i �'1 Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City /State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ..-E PERSON Hose bib 16.60
p Ice maker 16.60
Business name: 1 tp :61.1 e e I l.\.i,, hth Cj Interceptor /grease trap 16.60
Contact name: t 1,.t I C i:_er i j Medical gas (value: S ) Page 2
Address: 3 j 2 S} - P(LK 'I- J E Primer 16.60
City/State/ZIP: LcLdu 0 .J e ct.O (,)(L. q - 63C/ Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
45(23S) Phone: �) ",)'..4 - 1 {i Ok, "Fax :: (t j) ti)) I e 4, 0 Tub/shower/shower pan 16,60
l �%
E mai Urinal 16.60
CONTRA TOR Water closet 16.60
Business name: Water beater 16.60
Address: l A.il) e Other:
City/State /ZIP: Subtotal
Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential backtow mininturrt permit fee: $36.25
CCB Lic.: J 5 B31.zQ , Plumbing Lic, no.: i E 57 - it Plan review (25n/ of pemut fee)
Authorized sio afore: State surcharge (8% of permit fee)
\ {1
c k, TOTAL PERMIT FEE
Print name: ♦ Date: ' This permit application expires if a permit is not obtained within
ll� .i 1T( �)I�, i � �� f `` I� 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industy Service Board.
I''. BuifdingPcrmirsAPLA [- PermitApp.doc 06/26106 440- 4616"[(10 /02JCOM/WEB)
CITY OF TIGARD ... - -
BUILDING DIVISION - PERMIT #: PLM2006-00595
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1211912006
Phone: (503) 639-4171 40 0 1 4011 it
Inspection Requests (24 Hrs.): (503) 639-4175 A- AL.
INSPECTION WORKSHEET FOR DATE: 12121/2006 TIME: 7:00AM PAGE: 57
SITE ADDRESS: 07140 SWTAYLORS FERRY RD CLASS OF WORK:
SUBDIVISION: SHADY DELL LOT #: 017 TYPE OF USE:
PROJECT NAME: pwsH
DESCRIPTION: R ay o f ra d ra i ns.
OWNER: PLUSH, CFIAD PHONE #:
CONTRACTOR: PIPELINE PLUMBING PHONE #: 503
Inspection Request Scheduled For: Date: •12/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Me ag- ) (IAA
336: Rain drain 041395-01 503-624-1906 Y
Corrections/Comments/Instructions:
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I I PASS PARTIAL APPROVAL 7 CANCEL NO ACCESS
*FAI 6 I I CALL FOR INSPECTION
7 ADDITIONAL FEES ASSESSED
, •
Inspector: Date:E__i_
1 i 25 Phone #: (503) 718-2/
1
,.,
CITY OF TIGARD ..
BUILDING DIVISION PERMIT #: PLt 200E f #Qraf35
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/19/2006
Phone: (503) 639-4171 , ue�gp,��ij'(li -
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/22/2006 TIME: 7:00AM PAGE: 15
SITE ADDRESS: 07140 SWTAYLORS FERRY RD CLASS OF WORK:
SUBDIVISION: SHADY DELL LOT #: 017 TYPE OF USE:
PROJECT NAME: PLUSH
DESCRIPTION: Replace 80` of rain d
OWNER: PLUSH, CHAD PHONE #:
CONTRACTOR: PIPELINE PLUMBING PHONE #: 503 - 624.1306
b
Inspection Request Scheduled For: Date: 1:2212006 Pour Time:
Code # Inspection Description Confirm # Contact # Me age ev
335 Rain drain 041469 -01 503.624 -1906 �' 'l
Corrections /Comments /Instructions:
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li( A. A._ kre z.ek, i (
6 A
U /V--Cr - -- '‘ €A ----- Cn/Q-V (ZZ.: ("</--,- 1
„ . 614 Ai) It " d. it' C S * 11 K}c L-0-4--Rr
I I PASS PARTIAL APPROVAL CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION _Ti ADDITIONAL FEES ASSESSED
1 ZI
Inspector: Date Phone #: (503) 718 2 '
y
CITY OF TIGARD . -
BUILDING DIVISION PERMIT #: P( 006.0 595
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 17119/2006
Phone: (503) 639 -4171 ! 411101
Inspection Requests (24 Hrs.): (503) 639 -4175 -1!+ i.,
INSPECTION WORKSHEET FOR DATE: 1/3/2007 TIME: 7 :07Ai PAGE: 15
SITE ADDRESS: 07140 SW T AYLORS FERRY RD CLASS OF WORK:
SUBDIVISION: SHADY DELL LOT #: 017' TYPE OF USE:
PROJECT NAME: PLUSH
DESCRIPTION: Replace . 0 i_f "t "tr . dr [► ; n � /
2ln _� O 9- -3
OWNER: PLLISI°I, CHAD �j 7 g 2 S�1 A- - PHONE #:
CONTRACTOR: PIPELINE PLUMBING G I-4- PHONE #: 503 - 624 -1906 I P
Inspection Request Scheduled For: Date: 1/312007 ocl (p Pour Time: Q A �S'
Code # Inspection Description Confirm # ontact #' Mz -age V 399 Plumbing final 041740-01 503 -710 -2 `.6 ' Y _ �1\\"5
Corrections /Comments /Instructions:
----• •2— Zr r -----
1
(--
PASS 1 I P i - TIAL APPROV n CANCEL n NO ACCESS
FAIL ' A ' " C. 1 CTI n ADDITIONAL FEES ASSESSED
Inspector: Date 3 v Phone #: (503) 718=