Permit a v
CITY OF TICARD PLUMBING PERMIT
.4 .'" COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00565
TIGARD DATE ISSUED: 12/26/2007
TtcA
13 125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S135CC-00300
SITE ADDRESS: 11600 SW TIEDEMAN AVE ZONING: R
SUBDIVISION: PAYS PARTITION LOT: JURISDICTION: TIG
PROJECT: PAYS PARTITION
Project Description: Private line work for sanitary, storm and water.
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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: 100 ft
WATER CLOSETS: WATER LINE: 90 ft
DISHWASHERS: RAIN DRAIN: 100 ft
Owner: FEES
TODD PAYS
20097 SW CORRINE ST Description Date Amount
BEAVERTON, OR 97007 [PLUMB] Permit Fee 12/26/2007 $165.00
[TAX] 8% State Surchar€ 12/26/2007 $13.20
Phone : 503- 352 -9838 Total $178.20
Contractor:
TROY ELLIOTT PLUMBING
NO BOX 1958
REQUIRED ITEMS AND REPORTS
NORTH PLAINS, OR 97133
Contact # : PRI 503- 309 -5750
Reg #: LIC 152130
PLM 34 -402PB
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.
Thos- • es are - - h in OAR 2- 0001 -0010 through OAR 952 -0001 -0100. You may obtain copies of these rules or direct questions to OUNC
by Iling 503.246.6699 • ,1 0.3 .2344.
sued By:k Permittee Signature: _
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.
k
Plumbing Permit Application FOR OFFICE USE ONLY
City of Tigard Received /n c L 0? . / Permit No.: , Ao(q
� ,f ,�J
a 13125 SW Hall Blvd., Tigard, OR 97223 Date/By % Ol
Plaan n R Re eview Other Permit No.:
Phone: 503.639.4171 Fax: 503.598.1960 Other
TIGARD Inspection Line: 503.639 Date Ready/By: J+ RI See Page 2 for
Internet: www.tigard or.gov Notified/Method: ! f K e Supplemental Information
TYPE OF WORK FEE* SCHEDULE
'
® New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
® I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 11600 SW Tiedeman Avenue Catch basin or area drain 16.60
City /State /ZIP: Tigard ,)Aqy pq v 45)Z Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: i Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW Tigard Street
Manholes 16.60
SE corner of SW Tiedeman Aveenue and SW Tigard Street Rain drain connector 16.60
Sanitary sewer (no. linear ft.: 100) I Page 2 55
Storm sewer (no. linear ft.: 100) 2 Page 2 55
Subdivision: N/A I Lot no.: Water service (no. linear ft.: 90) 1 Page 2 55
Fixture or item
Tax map /parcel no.: TI S R1 W, Sect 35CC, TL 3090
Absorption valve 16.60
DESCRIPTION OF WORK Back Flow preventer Page 2
Install storm drain pipe, waterline pipe and sanitary sewer pipe on private Backwater valve 16.60
v)
property. Clothes washer 16.60
l Dishwasher 16.60
� � PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: Todd Pays
Expansion tank 16.60
t o Address: 20097 SW Corrine Street Fixture /sewer cap 16.60
a City /State /ZIP: Beaverton, OR 97007 Floor drain/floor sink/hub 16.60
Phone: (503)352 -9838 Fax: (503)214 -8500 Garbage disposal 16.60
® APPLICANT ® CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Pays Custom Homes, Inc
Interceptor /grease trap 16.60
Contact name: Todd Pays _ Medical gas (value: $ ) Page 2
Address: 2..o&fl sf4 nDC((flk, S4.1.49(,-f Primer 16.60
City /State /ZIP: ¶ 32�'�" f n 062- 91 O ,, 1 Roof drain (commercial) 16.60
P Sink/basin/lavatory 16.60
A Phone: (s03) 3 3 � ? 3 Fax: : (5b2) 24 It g r4 O
Tub /shower /shower pan 16.60
E -mail: &VT, kW C. /� ► U r" G�
(� Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: 73-W7 L W/ 40 /1 fi i) Water heater 16.60
Address: 16655 SW Ivy Glenn Street Other:
City /State /ZIP: Beaverton, OR 97007 Subtotal 165
Minimum permit fee: $72.50 Oa
Phone: (503) 848-7300 Fax: (503) 356-6300 Residential backflow minimum permit fee: $36.25 //pS'
CCB Lic.: /(pO W 7 Plumbing Lic. no.: 3y. yUL P�j
Plan review (25% of permit fee) -t®�
w State surcharge (8% of permit fee) /
Authorized signature: Z 4(r
TOTAL PERMIT FEE !7g•
Print name: T a , , Date: 12/19/07 This permit application expires if a permit is not obtained within
)J 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
I:\Building\Permits\PLM- PermitApp.doc 06/26/06 440-4616T( I 0 /02/COM/WEB)
CITY OF TIGARD r
BUILDING DIVISION PERMIT #: PLM2007- 00565
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1212GG12001
Phone: (503) 639 -4171 V
Inspection Requests (24 Hrs.): (503) 639 -4175 1 ��
INSPECTION WORKSHEET FOR DATE: 1/16/2008 TIME: 7:02AM PAGE: 30
. SITE ADDRESS: 11600 SW TIEDEMAN AVE CLASS OF WORK:
SUBDIVISION: PAYS PARTITION LOT #: TYPE OF USE:
PROJECT NAME: PAYS PARTITION
DESCRIPTION: Private line work for sanitary, storm and water.
OWNER: PAYS, TODD PHONE #: 503- 352 -9838
CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: 503 - 309.5750
Inspection Request Scheduled For: Date: 1/15/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 5 e wt.." 063231 - 01 503 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ‘14.A.—S) \ \C\-- Date: I 161 On Phone #: (503) 718-
CITY OF TIGARD _
,. 44
BUILDING DIVISION PERMIT #: PLM2007- 00566
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/26/2007
Phone: (503) 639 -4171 �Ml'
Inspection Requests (24 Hrs.): (503) 639 -4175 _ ..
INSPECTION WORKSHEET FOR DATE: 1/17/2008 TIME: 7 :00AM PAGE: 7
SITE ADDRESS: 1'1600 SWTIEDEMAN AVE CLASS OF WORK:
SUBDIVISION: PAYS PARTITION LOT #: TYPE OF USE:
PROJECT NAME: PAYS PARTITION
DESCRIPTION: Private linework for sanitary, storm and water.
OWNER: PAYS, TODD PHONE #: 503.352 -9838
CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: 503 - 309-5750
Inspection Request Scheduled For: Date: 1117/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
39f Misc. inspection 063444 -01 503 - 936-2577 Y
Corrections /Comments/ Instructions:
1 ow-4 - i a, \ —2 s'' ' -t '' 3 0 3 LA Sa.- 4---.... g7 ...-ten
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Ln/t —,J i 1 1 5 \^"'K, Date: 1 1 V) / 1/0 $' Phone #: (503) 718-
CITY OF TIGARD ,,
BUILDING DIVISION PERMIT #: PLM2007 -00505
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/26/2007
Phone: (503) 639 -4171 *so
Inspection Requests (24 Hrs.): (503) 639 -4175 _. W `'L ...
INSPECTION WORKSHEET FOR DATE: 1/18/2008 TIME: 7:02AM PAGE: 25
SITE ADDRESS: 11COO SW TIEDEMAN AVE CLASS OF WORK:
SUBDIVISION: PAYS PARTITION LOT #: TYPE OF USE:
PROJECT NAME: PAYS PARTITION
DESCRIPTION: Private line work for sanitary, storm and water.
OWNER: PAYS, TODD PHONE #: 503- 352 -9838
CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: 503 - 309-5750
Inspection Request Scheduled For: Date: 1/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
505 Sanitary sewer 063521 -01 503 - 936-2577 Y
Corrections /Comments /Instructions:
Li 11 3 03 (j FA/ G F, 6 g4 Q C To P✓o ip-e/ LA tee,..
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: fl vi..A-J \U -- -- Date: ) J MI OTC Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00505
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/26/2007
Phone: (503) 639 -4171 4g4 r r�,
I
Inspection Requests (24 Hrs.): (503) 639 -4175 .J F_ L.
INSPECTION WORKSHEET FOR DATE: 1/23/2008 TIME: 7 : 00Am PAGE: 19
SITE ADDRESS: •1 SW TIEDEMAN AVE CLASS OF WORK:
SUBDIVISION: PAYS PARTITION LOT #: TYPE OF USE:
PROJECT NAME: PAYS PARTITION
DESCRIPTION: Private line work for sanitary, storm and water.
OWNER: PAYS, TODD PHONE #: 503-352-9838
CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: 503 303.5mo
Inspection Request Scheduled For: Date: 1/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
330 Water service 063732 -01 603-936 -2577 Y
Corrections /Comments/ Instructions:
I y `.s, i~ Lc D e VC s 00 to Pv0 u m-rte ,,,.
1..1 u - Vvc.--�i 1 -e, �"r - A pe viivt.if. A ►.t,,re.-A/t h Co vt
❑ PASS IX PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( V t.iv / /li Date: 1 1 3 ( Q2) Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 00 G5
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/26/2007
Phone: (503) 639 -4171 �"° ''Yr l
Inspection Requests (24 Hrs.): (503) 639 -4175 , F '' (—
INSPECTION WORK FOR DATE: 1/24/2008 TIME: 7:02AM PAGE: 52
SITE ADDRESS: 11600 SWTIEDEMAN AVE CLASS OF WORK:
SUBDIVISION: PAYS PARTITION LOT #: TYPE OF USE:
PROJECT NAME: PAYS: PARTITI0N
DESCRIPTION: Private line work for sanitary, storm and water.
OWNER: PAYS, TODD PHONE #: 03.352-9838
CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: 503 - 309 -5750
Inspection Request Scheduled For: Date: 11 ?4/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 06383401 503936 -2577 N
Corrections /Comments /Instructions:
S 0.,./i 4-m ai {,,..J ✓ S v L___- .��‘.m/ d-- Li '' S 2 ✓./172.4_,..- ( i po i ,
S LEI TO rPv, u v,t., . [ way 00 -ri-d - p-t c e itA- )
/ Ai, -\-'o a A x P q.,,,-,,,_-‘1:- T►., ►{.,, bv(--- ee ,Aly . wA...c,.) Q 6„ Lu". w.e a
i -ru ,
cav- ,, C L t t t 9l J
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr641.li -- Date: 0 71j \0 Phone #: (503) 718-