Permit 0 CITY OF TIGARD ' • PLUMBING PERMIT
1
`- °: . COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00023
.,i GnD` 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/24/2007
T
PARCEL: 1 S 134DA -06300
SITE ADDRESS: 10747 SW NORTH DAKOTA ST ZONING: R -4.5
SUBDIVISION: PP1991 -107 LOT: 003 JURISDICTION: TIG
Project Description: Kitchen remodel, other fixture is an ice maker.
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: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
JACK WHITNEY
10747 SW NORTH DAKOTA ST Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 1/24/2007 $72.50
[TAX] 8% State Surcharl 1/24/2007 $5.80
Phone : Total $78.30
•
Contractor:
CASCADE MECHANICAL SYSTEMS INC 3
PO BOX 399
ESTACADA, OR 97023 • REQUIRED ITEMS AND REPORTS 0
C
Contact # : PRI 503- 630 -4492 $
0
FAX 503 -630 -5510 E � � - 0 v
Reg #: LIC 127012
`PLM 3 -324PB r t I j , I b
W
•
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 b calling 503.246.6699 or 1.800.332.2344.
Issu By: � W12(1i /�l Permittee Signature: Aid _,,� ���
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.
INSPECTQR'S SIGNATURES ARE NOT
Inspections Required for: 6..--
, _ c:00 a3 REQUIRED ON GREEN INSPECTION CARD.
✓ Code 1 Inspection Description 1 PASS Date 1 By I ✓ Code 1 Inspection Description 1 PASS Date 1 By 7
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground/slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading/footing _ 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit _
225 Post/beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piling _
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post/beam plumbing
995 Misc. inspection: < 320 Plumbing rough -in
998 Alarm final 322 Shower pan _
999 Sprinkler final 330 Water service
335 Rain drain
340 Storm drain
_ SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls •
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I:\Building\lnspection Cards\Forms\AOP- InspCard- Blank.doc 12/09/2005
Pr CITY OF TIt3ARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00023
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/24/2007
PARCEL: 1S134DA-06300
SITE ADDRESS: 10747 SW NORTH DAKOTA ST ZONING: R - 4.5
SUBDIVISION: PP1991 - 107 LOT: 003 JURISDICTION: TIG
Project Description: Kitchen remodel, other fixture is an ice maker.
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: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
JACK WHITNEY
10747 SW NORTH DAKOTA ST Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fcc 1/24/2007 $72.50
[TAX] 8% State Surchari 1/24/2007 $5.80
Phone : Total $78.30
Contractor:
CASCADE MECHANICAL SYSTEMS INC
PO BOX 399
ESTACADA, OR 97023 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -630 -4492
FAX 503 -630 -5510
Reg #: LIC 127012
PLM 3 -324PB
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 b calling 503.246.6699 or 1.800.332.2344.
i
Issu = . By: ; • � 1� ■ __1 . 7 Permittee Sig ature: /J � V/reg .
Call 503.639.4175 by 7:00 a.m. for an inspection that bu mess 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. •
Jan 24 07 10:45a Cascade Mech Sstems, Inc 503 - 630 -5510 p.1
Plumbing Permit Applicatiou L L
) FOR OFFICE SE O LI .
�
City of Tigard t � D / ei 4 9 7 / t rte.: I � �/ ? -D
13125 SW Hall Blvd., Tigard, OR 97223 - �j�j Fr Y "l` QC t� J
Plan Phone: 503.639.4171 Fax: 503.598.1960 ",,,,r,. "1 Date/By: new
,
24- Hour Inspection Line: 503.639.4175 ^^ {{�� / �� l Y O her permit No.:
, (110 1 �_ _ -, Dale Ready/By. ® See Page 2 for
Internet: www.ci.tigard.or.us
Notified/Method: � Sa pplemamllnf o rmat i ou
TYPE OF O ' i WI _
FEE* SCHEDULE
❑ New construction ��� , e „. ow For special information use checklist.
10. A-. Description I Qty. I Ea ( Total
❑ Addition/alteration/replacement - If Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder ❑Other Each additional bath/Ititchen 45.00
Fire sprinkler ( sq. R) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: /o7 it 7 S eti /t-' Oar_ /40/4e. Si - Catch basin or area drain 16.60
City /StatefLlP: /'� Drywell, leach line, or trench drain 16.60
Suite/bldg./apt. no.: I Project name: WI/ / rA\ ti y Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site:
Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear R: ) Page 2
Storm sewer (no. linear R: ) Page 2
Subdivision: l Lot no.: Water service (no. linear ft.: ) Page 2
Tax map /parcel no.:
Fixture or item
Absorption valve J 16.60
DESCRIPTION OF WORK 13acldlow preventer Page 2
A .Aciudt -- i 1.eaj Backwater valve 16.60
Clothes washer 16.60
Dishwasher i 16.60
❑ PROPERTY OWNER • TENANT Drinking fountain 16.60
I El 16.60
Name: 1A c--V 1 )D�f- il ft. Y I I
Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City/State/ZIP: Floor drain/floor sink/hub , 16.60
Phone: ( ) I Fax: ( ) Garbage disposal 16.60
0 APPLICANT ❑ CONTACT PERSON Hose bib - 16.60
Business name: //'�� QS�'4? T ? eJ s [
Case Ice maker / 16.60
j� S
Interceptor /grease trap 16.60
Contact name: � G N < S Medical gas (value $ ) Page 2
Address: FO 1?e>C• 3 7 i9 Primer 16.60
City/ State/ZIP: � S ( cte . c.c 4 Roof drain (commercial) 16.60
Phone: // ^� , _ ,, (/� _ Sink/basin/lavatory / 16.60
( ) V �/ • " L Fax: ) G 3 0 5-0 Tub/shower/shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: 5l ,Q-d/1 e _ n rp f � /f Water heater 16.60
Address: V' , �� 1 Other.
City/State/ZIP: Subtotal
Minimum permit fee: $72.50
Phone: ( ) Fax:
( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: 127 Plumbing Lic. no.: 3 - 2 Plan review (25% of permit fee)
5//::(;%9 State surcharge (8% of permit fee)
Authorized signature:
�-. TOTAL PERMIT FEE
Print name: 3-n D ate: /LO This permit application expires if a permit is not obtained within
L 180 days after it has been accepted as complete.
*Fee mcthodoloev set by Tri -County Building Industry Service Board.