Permit �•
CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00414
..��I DATE ISSUED: 9/8/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S125DD -05100
SITE ADDRESS: 09770 SW VENTURA CT ZONING: R - 4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT: 059 JURISDICTION: TIG
Project Description: Repair 70' of water line.
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: 70 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
RONALD CAMERON
9770 SW VENTURA CT Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 9/8/2006 $72.50
[TAX] 8% State Surcha 9/8/2006 $5.80
Phone : Total $78.30
Contractor:
LOVETT EXCAVATING INC
2925 SW HARTLEY DR
GRESHAM, OR 97080 REQUIRED ITEMS AND REPORTS
Contact # : FAX 503- 288 -1630
PRI 503 -504 -2847
Reg #: LIC 125507
PLM 26 -773PB
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: "2 ') Permittee Signature: Sl
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.
09/07/2006 11:43 5032881630 PAGE 01/02
z
' A lumbin Permit A lieatig iv ED QE® vOI' t-tl'S'1'(.'.E lisp, oN5A
City of Tigard Ft Uaty q '-1-61- '-1-61- Pcrmlt NoO Q f
"COV /
13125 SW Hall blvd „ 'Tigard, OR 97223 r Plan Review
Phone: 503.639,4171 Fax: 503598.1960 SEp 0 7 20 °T„°7 1-_.r�l, { \ Pion Other Permit No
24- Hour Inspection Line: 503,639.4175 e! 1 '� { Date RrnAy/R '
y, ”' ® gee page 2 for
Internet: www.ci.tigard or us CITY OF TIG '"~'" Notificd/Metlxul: Supplemcntn1 Information
G DfVlSl
_ t • • TYPE t tw 1L" • f DTJEIs • _ .■
QNcwconstruction ❑ Demolition For 'pedal information use cheeklfa
Description J Q. I Ea. I Total
Egf Addition/altcraticm /rcplocement ❑ Other: _ New 1- 2- family dwellings (includes 1 q0 ft, for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249,20
1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350,00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
es
Each additional bath/kitchen 45.00
❑ Master builder Q Other:
Fire sprinkler ( so. ft.) Page 2
. JOB SITE INFORMATION AND LOCATION Site utilities •
Job Site address: cm 0 5th Ventura Catch basin or area drain 1 6.60
City /State/ZIP: T % , D q" 2 :2- Drywall, leach lint, or trench drain 16.60
Suite/bldg. /apt. no.: �/ 1 Project name: Footing drain (no. linear R : ) Page 2
Manufactured home utilities 1 10.00
Cross street/directions to job site:
Manholm 16,60
_ Y- �.-a+T4 Rain drain connecter 16.60
Sanitary sewer (no. linear ft: ) Page 2
Storm sewer (no. linear It; ) Page 2
Subdivision: I Lot no.: Water service (no, linear ft.:jO I Page 2
Fixture or item
Tax map /parcel no.:
A hsorpt;on valve 16,60 •
DFSCfl1PTION OF WORK Backflow preventer Page 2
— ID I Wailvf__Setuice, �� r Backwater valve 16,60
"''"��'' Clothes washer 1 6,60
Dishwasher 16.60
Drinking fountain 16,60
0 PROPERTY OWNER I El TENAIt T • Ejcctors/sump 16.60
Narnc: 16.60
Expansion tank
Address: Fixture/sewer cap 16.60
City /State/Z_IP: Ploor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16 60
• ❑ APPLICANT ❑ CONTA+IvT "•!PERSON Hose bib 16•60
Ice maker 16.60
Business name: Interceptor /grease trap 16,60
Contact name: Medical gas (value. $ ) Page 2
Address: Primer 16.60
City /State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax: : ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: _ Urinal 16.60
CONTRACTOR Water cloact 16.60
Business name: L r / Water heater 16.60
Address: _ J r `� s ! Other: I .�
Subtotal
City/Statc/Z1P: G , „ • r • "la •O
f M inimum permit fcc :72
Phone: (003) 5O -- , a Fox: ( ) a � � -� „,... Residential backflow minimum permit fec: $ ,.
CCB Lie.: / 0 Plumbing Lie. no.: a6- .313 Plan review (25%ofpermit Fee)
State surcharge (8% of permit Fee)
Authorized signature: .ice . M I t TOTAL PERMIT FE1? d
Print name: {na K� ( r d Date: d 1'1 I2,0M0 This permit application expires if a permit is not obtained wit
tun days after it has been accepted as complete.
*Fcc methodology set by Trl -County Building industry Service Hoard,
1 :Maul ldlnecrmitoPLM- Pormit \pt+.do or/n; 441M61ST(10/02/COM/W1313) -
•
' CITY IGARD
BUILDING DIVISION PERMIT #: PLM2006- 004114
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 902006
Phone: (503) 639 -4171 Vit Inspection Requests (24 Hrs.): (503) 639 -4175 ..:--.
INSPECTION WORKSHEET FOR DATE: 9/11/2006 TIME: 7:00AM PAGE: 71
SITE ADDRESS: 09770 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 059 TYPE OF USE:
PROJECT NAME: CAMERON
DESCRIPTION: Repair 70' of water line.
OWNER: CAMERON, RONALD PHONE #:
CONTRACTOR. LOVETT EXCAVATING INC PHONE #: 503 - 504 - 2847
Inspection Request Scheduled For: Date: 9/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 036263 -01 503 - 504 -2847 N
Corrections /Comments/ Instructions:
Ff...)C
n -1,11 p__ d Cd—J ./ bl
L.. a _OIPIM!
up
-a /IV -•• `V
. Ai
,......
46' /
I.
.._ -A •vm r • ,
Do
• ,, I -7:
. .
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ C; L FO• INSPECTION ❑ ADDITIO AL ES ASSESSED irn 3
Inspector:
bli , ! Date: V - \�
> Phone #: (503) 718 -