Permit . , .4 o C ITY OF TIGARD PLUMBING PERMIT
..,.. ° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00141
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/8/2008
PARCEL: 2S 102CA -00928
SITE ADDRESS: 13300 SW VILLAGE GLENN DR ZONING: R-4.5
SUBDIVISION: VILLAGE GLENN LOT: 028 JURISDICTION: TIG
PROJECT: LIDINGTON
Project Description: Installing 600 ft. 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: 600 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
STEFAN LIDINGTON Description Date Amount
13300 SW VILLAGE GLENN DR
TIGARD, OR 97223 [PLUMB] Permit Fee 4/8/2008 $287.00
[TAX] 12% State Surch 4/8/2008 $34.44
Phone : 503 -544 -9838 Total $321.44
Contractor:
RELIANT PLUMBING & MECHANICAL
11575 SW PACIFIC HWY STE 219
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 246 -1201
FAX 503- 246 -1205
Reg #: LIC 169844
PLM PB 117
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: �jf �_ Permittee Signature: Gy 1G7
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.
� 477 PAGE 02/03
' 1[ nu n
mbing Permit Application FOR OFFICE list': ONI.1
City O£ Tigard C L Received Dares 13125 SW Hall Blvd., Tigard, O 9 L� Permit No„ 401 _
' 0 ' Phone: 503 639.4171 Fax: 503.598. (SQL 2008 Plan Rcvlaw •
Other Permit No,: (
www,tigard -or gnv
inspection Line; 503.639.4175 Aats Re
• I I (: A R O DA1 R cn /
Internet: C/ �ppg g - GPM
dy By. cu R► See Page 2 for
�,� �y 'S.vY tl �t ®' p � , �q Q Ned God/method. 3npplementnt lnftmm�tion
_ . , pt o1?, :V kit O +'��1;J'6 hait')`Y/, 9,",1;' ";I : :I :!'; : ; ;, . � �,,- �! :! � � �� ,,,� ; �,,n ,
❑ New construction ❑ Demolition For special information use checklist
Description ) Qty I lsa i Total
Jperjdition/nItentionh-cptaceme ❑ Other:
New 1 - 2- family dwellings (includes 100 fl, for cach utility correction)
CAIiGCJRi ^(J w iF ;;! SFR (1) bath 24920
and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
-
CI Accessory building 0 Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
CI Master builder 0 Other:
: : ;1078 ' Sit �'�]�TrC 1V1' 'M`01V lam' ,;,,�I�''� ' Fire sprinkler ( sq. ft.) Page 2
D . luC� C'rk;"1I;1� Site utilities
C+., -�
Job site address: Catch basin or area drain
'' �V, 2.• V y e l, Y ". 16.60
City/State /ZiP:'V'i %C'Lc.,0\ CS e Qq a 3 Drywell, leach line, or trench drain 16 60
_
Manufactured home utiliiics 110.00
Suite/bldgJapt, no.: -- Project name' z. �, /1 J Footing drain (no linear ft.: ) Page 2
Cross street/directions to job site:
Z: U, J /V
-- Manholes 16 60
Rain drain connector I6.60
Sanitary sewer (no. linear ft„ _) Page 2
Storm sewer (no. linear ft.: _) Page 2
Subdivision: Lot no.: Water service (no. linear ft . 5pifgl Page 2
Tax map /parcel no.: Fixture or item
Absorption valve 16.60
6 Backilnw presenter Page 2
"y, M.+ P Backwater valve 16.60
1 Clothes wtelhcr 16.60
—
Dishwasher 1660
-4FPROPElitir C 00 :li; ,•. Drinking fountain 16.60
Namc: �� �� " ` • Ejectors /sump 16.60
`� ` Yl
-
Expansion tank 16.60
Address: s . 49. ., : � fi - NBC p c. e 4 Fixture/sewer cap 16.60
City /State/Z1 : " • a Q r . 9 Floor drain/floor sink/hub 16.60
Phnnc:SLi 4 _' ' 9 ss 8- Fax: ( WC* 4 , k Garbage disposal 16.60
[, APPLICANT C , 1Tosc bib 16.60
; , 1:1 ;(* tit ii i , s+ 'lv
Business ramie: w .. (cc maker 16.60
Contact name: — Interceptor /grease trap 16.60
Medical gas (value: $ ) Page 2
Address: Primer 1(60
City/State /7_iP: Roof drain (commercial) 16.60
Phone: ( ) tax:. ( )
' Sink/basin/lavatory 1660
E-mail: Tub /shower /shower pan 16.60
' , 'C6 L ttii; ,, ., Urinal 16.60
;��;!'''';�'i;'' Water
Business me: ' 16.60
na
�� ^ # a a a . ., 4 - • • Water heater ] 6.60
Address: , 15'7 3 . (e Other:
City /StatcfZfP'r ' t • - - Subtotal z,$'7, 0 0
— Minimum permit fee: $72.50
Phone: _ c r Fax: (j 24 1 � Residential 1,ackflcrw minimum permit fee $36.25
CC9 Lic.: �' Plumbing Lie. no.: to Plan review (25% of permit fee) t Aulhnri?cd signature: �
-
State surcharac (8% of permit fee) �� '
_ TOTAL PERMIT FEE b
Print name:
Ate ' � �. - Date:/-) --7 _ This permit application expires if a permit is not nbtnine within
180 days after it has been accepted as complete_
*Pee methodology set by Tri- County Building industry Service Board,
l,\ Hull (IisiOremrt •\PLM•PcrmilApp 06/26/06 \L
440- 4616T(10 /02 /COM/Wl?Al V 1
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: PLM2008 -00141
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4 /8 /; ?O08
Phone: (503) 639 -4171 Ake I�I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4111/2008 TIME: 7:01AM PAGE: 32
SITE ADDRESS: 13300 SW VILLAGE GLENN DR CLASS OF WORK:
SUBDIVISION: VILLAGE GLENN LOT #: 028 TYPE OF USE:
PROJECT NAME: LIDINGTON
DESCRIPTION: Installing 600 ft. of water, service.
OWNER: LIDING1 ON, STEFAN PHONE #: f03
CONTRACTOR: RELIANT PLUMBING & MECHANICAL PHONE #: 503
Inspection Request Scheduled For: Date: 4/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 068221 -01 503.516-9915 N
Corre /Comments /Instructions: Q A ('�
L" • ✓ ; G c 1, ����a \ ✓t1V� d \� I{�21..� ��� J2 /L fLC,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspectorcb Date: 4 1AN 1 0 Phone #: (503) 718-