Permit d+
VpH CITY OF TIGARD J 0 7 PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00134
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/6/2007
PARCEL: 1 S 125DA -07700
SITE ADDRESS: 09245 SW 69TH AVE ZONING: R - 4.5
SUBDIVISION: KINGS VIEW LOT: 076 JURISDICTION: TIG
PROJECT: TOMASOVIC
Project Description: 1 clothes washer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 1 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: ft
Owner: FEES
TOMASOVIC, ROBERT S AND
DENISE B Description Date Amount
9245 SW 69TH AVE [PLUMB] Permit Fee 4/6/2007 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 4/6/2007 $5.80
Phone : 503- 293 -6241 Total $78.30
Contractor:
ANCTIL PLUMBING INC
16900 SW MERLO RD
BEAVERTON, OR 97008 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -642 -7323
FAX 503- 642 -7755
Reg #: LIC 24184
PLM 26 -162PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: c Permittee Signature: Call 503.639.4175 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
APR -5 -2007 01:13P FROM:ANCTIL PLUMBING 5036427755 TO:5035981960 P.1
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Plumbin Permit A iication 101t III 1 1(1 1 �I (1\11
City of T i g a r d GE, , E q L7 O1 • 1:22:Y , . . ) /3
13125 SW Hall Blvd., Tigard, OR S'r - � �
Ran Review
Phone: 503.639.4171 Fax: 503.5911.19966QQ -. 4 200] D „ t � T Other Permit No.:
24- Hour Inspection Line: 503.639.4 _a L j. 1 L i J Date Ready/Br. : run' 0 See Page 2 fa
Internet: www.ligsrd- or.gov of p Nod ed/Melhod Supplemental lafaneatlea
x [[ T7 t' r d ': FEE •j$G71 ®U1.6 cag gad - ;
❑ New construction ❑ Demolition For spedalInformolion use checklist
��/► Description I Qty. L Ea. I Total
�Xd dition /alteration/replacemem ❑ Other: New 1.2- family dwellings (includes 100 ft for each utility connection)
e.'704;°a ,,; ' t v t CATEGORY OF'CONSRLICCUON +l� ;mx:1'Z :..r
j • SFR (1) bath 24920
and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
Q Accessory building ❑ Multi - family
SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
• ..4 .,c;. �;�:v.,,�, wr,, l -. ,• � :: ; Site utilities
Fire sprinkler( sq. ft.) Page 2
t• c SOB SITE INFoRMXTION ,AND Va t1CAT10N • ∎ •
Job site address: _ I 2.45 SW 4914 AVE basin or area drain 16.60
City/StaterZ(P: Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: '-To m A gOvj (_ Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross strcet/dircctions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: 1 Page 2
Tax trap /parcel no.: Flslrre or Item
Absorption valve 16.60
DESCRIPTION OF ,WORK • µ. 4 :. 7 I4 f .: • 4 Back flow preventer Page t
RE - (3-or 1( I If --. j F'rj _ Backwater valve 16.60
LA) IT AI ft c Lk . O Clothes washer • ( 16.60 „(4.6.e.
Dishwasher 16.60
Drinking fountain 16.60
ROPERTY OWNER • I ..era,:::, ;i . 4,:0 TENANT .
Ejectors/sump 16.60
Name: -T GM A- SO t/ Ex pansion lank 16.60
Address: Fixture/sewer cap 16.60
City/State/ZIP: Floor drain/floor sink /hub 16.60
Phone :51i )�� •J - &a y ( Fax: ( ) Garbage disposal 16.60
❑ APPLICANT • ' ' " . ❑ CONTACT PERSON ' 1 . Nose bib 16.60
Ice maker 16.60
Business name: Interceptor /grease trap 16.60
Contact name: Medical gas (value: S ) Page 2
Address: Prima 16.60
City /State/ZIP: Roof drain (commercial) 16.60
Shik/basinAavatory 16.60
Phone: ( ) f Fax: : ( )
Tub/showa /shows pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
r
Business name: i ) C t) (- _Yj ✓Yf9 i e � ✓ . 7 ,: -it/C Water heater 16.60
I M
Address: (p)ac) sw exto g/p Other
City/State/ZIP: A\49412•40- o g 9 ,off Subtotal
(J 2� �?j Minimum permit fee: 36.20 -
Phone: ) (Jib/ 4-3 7 F ax: ( (...4 (...4 ReResidential beckllow minimum permit fee: $ ( T ' 36.23
CCB Lic.: 2)4 ` 554'' Plumbing Lic. no • 2.Gr 1 f' Plan review (25% of permit fee)
State surcharge (8% of permit fee) 5. 80
Authorized signature: f � �
TOTAL PERMIT FEE .30
Print name: $ ;I •, t I Date:14j 41 I
This permit application expires II' a permit V rot obtained within
180 days after It has been accepted as complete.
•Fee methodology set by Tri -County Building Industry Service Board.
I. %Building.PamiuwLM•PamitApp doe 12/30'OS 440-4616T1I0/02ROM/wrn)
ppi CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00134
DATE ISSUED: 4/6/2007
TIGAItp 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S125DA - 07700
SITE ADDRESS: 09245 SW 69TH AVE ZONING: R -4.5
SUBDIVISION: KINGS VIEW LOT: 076 JURISDICTION: TIG
PROJECT: TOMASOVIC
Project Description: 1 clothes washer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 1 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: ft
Owner: FEES
TOMASOVIC, ROBERT S AND Description Date Amount
DENISE B
9245 SW 69TH AVE [PLUMB] Permit Fee 4/6/2007 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 4/6/2007 $5.80
Phone : 503- 293 -6241 Total $78.30
1D
Contractor: l i
ANCTIL PLUMBING INC i
16900 SW MERLO RD REQUIRED ITEMS AND REPORTS
BEAVERTON, OR 97008 0
0
1
•
• Contact # : PRI 503- 642 -7323 _ 8
503- 642 - 7755,7 -jj R,' ; ;4 . (0
Reg #: LIC 24184 k i V /6
PLM 26162PB
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.
Permittee Signature: r 0.11.41. ,.-{_ eL —
Issued By: Cti
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.
-
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for PLM2007 -00134 REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description PASS Date By ✓ Code I Inspection Description I PASS Date I By
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 J
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 piping
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 Sprinlder 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: X 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 1 ' 345 Culvert/catch basin
4110
405 Fill Excavation 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing X 399 Plumbing final 1
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: i
499 Final inspection 599 Final inspection J
I:\ Building \Fonns \InspCard- AOP- Blankdoc 02/02/07
CITY OF TIGARD . � •
BUILDING DIVISION • PERMIT #: PLM2007 -00134
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/6/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 r� "'IL.
INSPECTION WORKSHEET FOR DATE: 4/912007 TIME: 7:01 AM PAGE: 50
SITE ADDRESS: 09245 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: KINGS VIEW LOT #: 076 TYPE OF USE:
PROJECT NAME: TOMASOVIC
DESCRIPTION: I clothes washer.
OWNER: TOMASOVIC, ROBERT S AND, PHONE #: 503-293 -6241
CONTRACTOR: ANCTIL PLUMBING INC PHONE #: 503 - 6417323
Inspection Request Scheduled For: Date: 4/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 046171 -01 503- 642 -7323 Y
Corrections /Comments/ Instructions:
•
gr PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: V1+4...i‘ V �`'t— Date: ( 0J07) Phone #: (503) 718-