Permit 1, v CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00327
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/25/2007
PARCEL: 2S 104BA -07100
SITE ADDRESS: 14055 SW NORTHVIEW DR ZONING: R -12
SUBDIVISION: CASTLE HILL NO. 2 LOT: 104 JURISDICTION: TIG
PROJECT: SHAMLOO
Project Description: Install backflow preventer.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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
PHIL SHAMLOO
8623 SW AMICUS TERR Description Date Amount
BEAVERTON, OR 97007 [PLUMB] Permit Fee 7/25/2007 $36.25
[TAX] 8% State Surcha 7/25/2007 $2.90
Phone : 503 -577 -8677 Total $39.15
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # :
Reg #:
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 B . Permittee Signature: 2 k( hoy)
•
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.
- 07/24/07 TUE 14:52•FAX 503 8600 ' CARL H ARONSON AGENT X1002
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Plumbing Permit AppinA"z Lion f !, . ,•;,,,,=)•,•:, '', ': ` ` fi • lrt]2 c . 1 1 U t 1' 1 , i l iN l . .r ., . n " v,
C of Tigard ' JUL 2 3 2001 Reothea Permit No.: ma Uaassv: 2 193- P(.M 200 6032
1- 12sSW1ia 11HMI,.Tigard,A 723
k,a Re v iew• •
Pht±ne 503.6,;9.4171 Fes: 12. b0 �' Other Pamir No,: .
Inspection line: 511;5.639.4175.
<I' I� ∎A 1 - t' 3 i 1 R ITAd fay! Jdr4: RI See Page 2 far
Internet: wwtv.ligarti -orgt ■ r , k . !,; , , I I V'(h&d'Methnl: • - 110 s�ole> atat Ihrormadon
TYPE OF WORK FEE* SCHEDULE
❑ New construction 13 Demolition For,rtidal inJorraa/ion rrae eherldisc _
Description I Qty. 1 Es. 1 Total
❑ Addition/ahctation/rt:placcment ® Other: New 1- dyad lin I s
_ 1• - (includes 100 R. Ibi each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) hath ' 24920
I - and 2 family dwelling ❑ Commercial /industrial SFR (3) bath ~ `35000
❑ Accessory building ❑ Multi- family SFR (3) bath 3'19.00
ces
❑Master builder Other Each additional battik itchcn • 45.00
- Fire sprinkler ( ..:,q. tt_) . . .Page 2 L
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 14055 SW Nvrtbview Dr. Catch basin or urea dr tin ' 16.60
Ci ty/Statc/ZI P: Tigard, Oman 97223 Drywell hatch line, of trench drain _ i 6.6U
Fooling drain (no. briar lt. :_ _) Page 2
Suite/bldgfapt, no.: Project rum e: Sprinkler System - Manufactured home Militia 1 10.00
Cross street/directions to job site: Barrows In walnut to North•iew - • -
Manholes .16.60
' , Rain drain connector - 16.60 '
. Sanitary s co t e r (no: l i t t e a r IL: „ ) Page 2
Storm sewer (no. line: a (1.: i ) Page 2
Subdivision: CASTLE HILL 02 I Lol no.: 104 Water :nice (no. linmr f.: ) Page, a
— — Tax reap /pawl no.: R204134_5 Fixture or item _ •
-
. Absorption valve 16.60
DESC[iIPFIOr: OF WORK Back flow preventer I Pap 2
Sprinkler System backwater valve 16.60
t
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER ] . ❑ TENANT Drinking fountain 16.60
Fjectors/sump 16,6
Name: Phil Shatnloo Iigmnsion tank 16.60
• -
Address: $623 SW Amicus'fer. FixnurJscwercap 16.60
City /Slate/ZIP: Beaverton. OR 97007 Flom. drain/finer sinh/huh . ' 16.60
Phone: (503)5774677 \ Fax: (503- )590 -7606 Garbage disposal , ' 16.60
® APPLICANT ❑ CONTACT PERSON
^� Hose bib' 16.60
Ice maker • 16.6n
Business name: lnttxceptor/grcasc trap • 16,60
Contact norm= _ Medical gas (value: 5 '.) Page 2
Address: Primer 16.60
City/State/ZIP: Rnnfdrain (nommen 16.60
Phone:( Y Fax )
Sink/hasin/lavalory 16.60
• Tuhishov.er /shower ion 16.60
E -mail: Urinal • 16.60
COYTRAI.TOR Watcrcloeet _ 16.60
Business name: --- =
' Water hatter _ 16.60 •
Address: Othcr _ - --
City/Slatc/ZIP: Subtotal
Minimum permit fee-. 372.50 • 3 6 25
Phone: ( ) Fax: ( ) Residential kick flow minimum permit fee::. 53635
. CCB Lit.: Plumbing Lie. no,: I'Ian review (25% ofpermit fee)
Authorized signature: - �; .. r'' ; r�� Suite surcharge AL PERMIT fee) Z •q�
_ n'' < TOTAL PERMiT FEE: 7 .-;;;', .1-
I Print name: ,./: /'r
i d” j j +• . e 1 Doc: 7 M�r y 1 This pperm!!! appibsatlon expires Ira permit IS not ettained hhtn . 15.
- 180 day' al it has been accepted is complete. 3q
I =Fun methodology v et,by Tri- County Building Industry Service Board.
131bittdlor .re,ikkrs,M- PcrmliAppAuC %WIG% 410- 16i6ri Iaftni OM:
. , „• - -
,,,,„,,,,4,.,s.- CITY OF'•TIOARD
,: ,. PLUMBING PERMIT
. PERMIT #: PLM2007 -00327
���..' ;�• COMMUNI DEVE
* "`'..• - , 1: -. DATE ISSUED: 7/25/2007
T ,tGARp' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S104BA - 07100
SITE ADDRESS: 14055 SW NORTHVIEW DR ZONING: R -12
SUBDIVISION: CASTLE HILL NO. 2 LOT: 104 JURISDICTION: TIG
PROJECT: SHAMLOO
Project Description: Install backflow preventer.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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
PHIL SHAMLOO
8623 SW AMICUS TERR Description Date Amount
BEAVERTON, OR 97007 [PLUMB] Permit Fee 7/25/2007 $36.25
[TAX] 8% State Surcha 7/25/2007 $2.90
Phone : 503 -577 -8677 Total $39.15
Contractor:
OWNER I
REQUIRED ITEMS AND REPORTS
I
Contact # : ,,;..r�ras4- Ais...e.x.ww.w.:. gi.k.. „, O
r �[ ® W
Reg #: _� . � EXPIRED - )42 J
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.
a
c> 1
y.
Issued By-----___:. sl j r 4.0? Permittee Signature: �/ tiZ• ( '
�..- 1
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 sits 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 QLIA --00321- REQUIRED ON GREEN INSPECTION CARD.
I ✓ Code I Inspection Description I PASS Date I By I I ✓ Code I Inspection Description I PASS Date I By I
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 _ 1
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 ______[__J
285 Drywall nailing 610 Gas line _ I
287 Suspended ceiling 615 Mechanical rough -in
29 inspection: _Misc. uupectio _ 620 Hydronic piping
- .899 MFG- Structure final _ 625 Duct w ,____
k 498 - Grading final 630 - Fire damper
• 299 . Final erection 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 urderslab
915 Fire alarm rough -in _ 310 Crawl drain
920 Suppression trip test _ 315 Post/beam plumbing
995 Misc. inspection:
X v
320 Plumbing rough -in
998 Alarm final
999 S rinlder final — 322 Shower pan
• j
y� 330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
' 405 ^ Excavation I 345 Culvert /catch basin I
410 Fill 350 Septic tank • I
415 Grading 395 Misc. inspection: _
205 Footing X 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer 1
498 Gradu g final 595 Misc. inspection: ____,
499 Final uup; cao. 1 599 Final inspection __ _
I: \Building\ Forms \InspC ud- AOP- Blankdoc 02/02/07
CITY OF TIGARD eu-iii3O01- 66;27
BUILDING DIVISION - PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED:
Phone: (503) 639 -4171 1
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_! 1 1 ..
INSPECTION WORKSHEET FOR DATE: 9 2� 0 • TIME: / , c, r -
1./ PAGE:
SITE ADDRESS: I 1 0 5S in U, v) "' [[["'��� : D , CLASS OF
OF WORK:
RK:
SUBDIVISION:
PROJECT NAME:
DESCRIPTION:
OWNER: NS PHONE #:
CONTRA • -: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
"g CD& v(i, - cl m) -F(,►,v.Q
Corrections /Comments /Instructions:
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASS SED
Inspector: /C/` Date: L0/ 0 Phone #: (503) 718