Permit II q CITY OF TIGARD ---7_,.-09 PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00316
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/19/2007
PARCEL: 2S 111 CC -14600
SITE ADDRESS: 10155 SW HIGHLAND DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.4 LOT: 197 JURISDICTION: TIG
PROJECT: MICHELS
Project Description: Install new ice maker line.
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: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
GLADYS MICHELS
10155 SW HIGHLAND DR. Description Date Amount
[PLUMB] Permit Fee 7/19/2007 $72.50
[TAX] 8% State Surcha 7/19/2007 $5.80
Phone : NA Total $78.30
Contractor:
CHRISTIAN PLUMBING INC
DBA CROWN PLUMBING
5429 SE FRANCIS REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97206
Contact # : PR1 503- 771 -9449
FAX 503- 771 -9454
Reg #: LIC 42671
PLM 34 -70pb
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 c y: j, / /j/ / // Permittee Signature: ...c,2„..-
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.
07/17/2007 10:47 5037719454 CROWN PLUMBING PAGE 02/02
Plumbing Permit Application _, . E'
City of Tigard Received
JUL 1 7 2007 Dnf y: , q,
] 3125 SW Hall Blvd.. Tigard, OR 97223 �""" N0 ' N/1 ��7 -ao3
DIVISION Phone: 503.639.4171 Fax; 503.598.196(. , : - • PIP .
inspection <lon Line: 503,639.4175 '�+��� t �'� ° I i7l�: t® n ue/t1y: Other Permit No.:
T I i s ;� i. I?
Internet: www.tigard- or BUILDING i I I ! N o 1 R cady/ 9 y: ]aria: ®5x Pope l ref
No tipad /Method: Supplemental Information
TYPE OF WORIi; ....:: ':
• FrEE .SQIED .. "'' •
❑ New construction ❑ Demolition For special frr,/ormarinn use checklist
El Additirm /alteratitm /t+eplatxmcnt Description I Qty. 1�� Total
❑ Other: New 1- 2- family dwellings (includes 10011. for each utility connection)
. CATEGORY OF CONSTRUCTION ::: ;..:: • '' SFR (1) bath 249.20
® 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
1:1 Accessory building ❑ Multi - family SFR (3) bath 399.00
❑Master builder Each additional bath/kitchen • 49.00
❑ Other:
_ Fire sprinkler ( sq. ft) Page 2
JOB SITE INFORMATION •A1ti1D L,OCI�TTON . . site utilities
Job site address: 10155 SW HIGHLAND DRIVE _ Catch basin or area drain 16.60
City/State/ZIP: TTGARD, OR 97224 Drywcll, leach line, or trench drain 16.60
_
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: _ ) Page 2
• Cross streel/directitms to job site: Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear f.; i ) Page 2
Stomi sewer (no. linear ft.: �) Page 2
Subdivision: I Lot no.: Water service (no. linear R: ,_) Page 2
Tax map /parcel no.: Fixture or item
_Absorption valve l 16.60
• DESCRIPTION O. F•' ORK .. 9acktlow preventer Page 2
INTALL NEW ICE MAKER LINE Backwater valve 16.60
Clothes washer 16.60 _
Dishwasher 16.60
• ti PROPERTY OWNER Drinking fountain 16.60
:. :-�b: Alva .
Name: c�.l ( AA
Ejectors/sump 16.60
t � 1 n jv Expansion tank 16.60
Address:
FixtWle/sewer cap 16.60
-
,
City/State/ZIP: TIGARD, OR 97223 Floor drain/floor sink/hub 16.60 -
Phone: ( ) F ax: ( ) Garbage disposal 16.60
• I •AePI!LICANT .. 1 VO N 'Alt 'VERSOi'u.:. . Hose bib 16,60
Business name: CHRISTIAN PLUMBING, INC. DBA CROWN PLUMBING �' Ice maker 1 16.60
Interceptor /grease trap 16.60
Contact name: DENNIS UNDERWOOD Medical gas (value: $ ) Page 2
Address: 5429 SE FRANCIS STREET Primer 16.60
City /State/ZIP: PORTLAND, OR 97206 Roof drain (commercial) 16.60
(503) 771.9449 I F Sink/basiMavarory 16.60
Phone:
( ) ax:: (503) 771 -9454
E -mail:
Tub /shower /shower pan 16,60
Urinal 16.60
•
CONTRACTOR • Water closet 16.60
Business name: CHRISTIAN PLUMBING, IN DBA CROWN PLUMBING Water heater 16.60
Address: 5429 SE FRANCIS STREET Other:
City /Statc/P:i,P: PORTLAND, OR 97206 Subtotal
Minimum permit fee: $72.50 72,50
Phone: (503) 771 -9449 Fax: (503) 771 -9 Residential backllow minimum permit fee: $3625
CCB Lic.: 42671 n Plumbing Li .. 34 -70PB Plan review (25% of permit fee)
Authotired signature: Qv State surcharge (VA of permit fee) 5.80
` TOTAL PERMIT FEE 78.30
Print name: DENNIS UNDERWOOD Date: 07/17/07 I This permit application expiras If a permit is not obtained within
180 days after it has been accepted as complete.
*Fcc methodology set by Tri- County Building Industry Service Board.
1: U3uildirIAPermltalPl .M- PamitAo°.doc 06/26/x5 440
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C ITY OF T I GARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00316
DATE ISSUED: 7/19/2007
T t CARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S111 CC -14600
SITE ADDRESS: 10155 SW HIGHLAND DR ZONING: R -
SUBDIVISION: SUMMERFIELD NO.4 LOT: 197 JURISDICTION: TIG
PROJECT: MICHELS
Project Description: Install new ice maker line.
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: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
GLADYS MICHELS Description Date Amount
10155 SW HIGHLAND DR.
• [PLUMB] Permit Fee 7/19/2007 $72.50
[TAX] 8% State Surcha 7/19/2007 $5.80
Phone : NA Total $78.30
a n
Contractor:
CHRISTIAN PLUMBING INC i
DBA CROWN PLUMBING REQUIRED ITEMS AND REPORTS
5429 SE FRANCIS 0
PORTLAND, OR 97206 CI
Contact # : PRI 503- 771 -9449 } $
FAX 503 - 771 -9454 ‘ EXPIRED_, ,;, Q
Reg #: LIC 42671 ! W
PLM 34 -70pb • 'a _ 0 le /0 a • `.
•
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 r. y: .1 A , l/ / 7 (' Permiftee Signature:.,_ �� 0 !I C4 ;(/ CSI1
: / r
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 NO` `
Inspections Required for. it M - - i^A-1 ( REQUIRED ON GREEN INSPECTION CARD.
✓ Code [g7 Inspection Description -- I PASS Date r' . Code ( Inspection Description __ TPA SS Date j By
BUP - Buildin: Permit ELC - Electrical Permit
mg 405 Excavation 1 I 1 Underground/slab cover • •
410 Fill 1 110 Temporary electrical service
- 415 Grading 1 115 Electrical service .
205 Footing 120 Electrical rough -in
MI 805 MFG-Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover 't
_ 215 Footing drain _ _ 135 Low voltage
220 Slab 140 Sign installation • •
r 310. Crawl drain 145 A/C or heating unit circuit ^ I
- 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
21 55 - Wu- proofing basement walls — 135 Low voltage
260 Tilt -up panel . 195 Misc. inspection:
265 Masonry 199 Electrical final
F 270 Reinforcing steel (rebar)
275 Framing
r 810 MFG- Stn.:cture set -uj __ _ — MEC - Mechanical Permit
280 Insulation 1----
605 Post/beam mechanical I —=_-__]
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 _ I
498 I Gnarly final •
__ • _ 630 Fire damper
L� 299 Final inspection - 635 Smoke detector shutdown
640 Exhaust hood _ •
695 Misc. inspection:
699 I Mechanical final _ I
BUP - Fire Protection System Permit
905 7 Sprinkler underfloor, /slab PLM - Plumbing Permit
•
910 Sprinkler rough in _ 305 Plumbing underslab l
915 Fire alarm rough-in • 310 Crawl drain •
_ 920 Suppression trip test 315 Post/beam plumbing f
995 Misc. inspection: _ X 320 Plumbing rough in
998 ■larm final — 322 Shower pan — — 1
1 I 999 Sprinkler final — _ -- 330 Water service
•
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer 1
405 Excavation I _ 345 Culvert/catch basin I _ •
. 1 410 Fill • _ _ I 350 Septic tank !
415 Grading 395 Misc. inspection:
205 Footing — j 399 Plumbing final - y
210 Foundation walls
215 Footing drain
420 • Sprinkler supply lines SWR - Sewer Permit _
495 Ivlisc. inspection: j _ 505 I Sanitary sewer
498 . Grading final 595 Misc. inspection: ---- x 499 Final inspection 599 Final inspection 1 '
I: \Building \Forms \InspCard- AOP- Blankdoc 02/02/07