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Permit ��'':± 1 CITY TIGARD PLUMBING PERMIT C OMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00118 " °' ' . .., DATE ISSUED: 3/21/2008 g1.49 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 '�'? " "'' PARCEL: 2S104AD - 03802 SITE ADDRESS: 12630 SW WALNUT ST ZONING: R - 4.5 SUBDIVISION: WALNUT CROSSING SUBDIVISION LOT: JURISDICTION: TIG PROJECT: CASA TERRA Project Description: Connecting existing house to utility services. (t Mr a c5 i">✓') 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: 100 ft WATER CLOSETS: WATER LINE: 100 ft DISHWASHERS: RAIN DRAIN: 100 ft Owner: FEES CASA TERRA LLC. PO BOX 1082 Description Date Amount CLACKAMAS, OR 97015 [PLUMB] Permit Fee 3/21/2008 $165.00 [TAX] 12% State Surch 3/21/2008 $19.80 Phone : Total $184.80 Contractor: TROY ELLIOTT PLUMBING PO BOX 1958 NORTH PLAINS, OR 97133 REQUIRED ITEMS AND REPORTS Contact # : PRI 503 -309 -5750 Reg #: LIC 152130 PLM 34 -402PB 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 direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. „ ))7,,...) Issue By: K „ f/ t Permittee Signature: � Gam - 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. • / 0 4 § r, K fvt.f_.),k- .ki Plumbing Permit Application Building Fixtures fe 10 FOR OFFICE USE ONLY Cl of Ti and CONI n R eceived / n 13125 SW Hall Blvd., Tigard, OR 9 �� ` �„� '� w 111 g Op Date/By: N O Permit No.: �/ • +�j `. i y) //r Phone: 503.639.4171 Fax: 503.5981960. p P� t P1 By eW Other Permit No.: • Inspection Line: 503.639.4175 �v` 0( T I G A R D , ® 4 to Ready/By: Juris: El See Page 2 for Internet: www.tigard or.gov $ �� Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE [New construction ❑ Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total ❑ Addition/alteration/replacement ❑ 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 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler (_ sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: /263 0 S li'; 1 f A ` % ;T' Catch basin or area drain 16.60 City /State /ZIP: ■ i (, ) 0. (l '', `.. / / <� Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: AO! :- i ; ;- , . Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: MO) Page 2 5 ` • ate . Storm sewer (no. linear ft.: /(&) Page 2 55. GO Subdivision: I Lot no.: - Water service (no. linear ft.: /p)) Page 2 5 s7J Fixture or item V, Tax map /parcel no.: -o , :, • N, Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 j I_ (. V / C2 E / / // fe'• (. ! it t ;' (/ Li- ( % i / lr) Backwater valve 16.60 c,N. (led/it e 7 .Y / < -T/ JC No, 6 [, T 0 T/ L / 7--/ „fidr efe/ - Clothes washer 16.60 Dishwasher 16.60 �LGBC�T�� GA- tltC��j Drinking fountain 16.60 j PROPERTY OWNER I ❑ TENANT Ejectors /sump 16.60 Name: CA kJ Pr L LC Expansion tank 16.60 Address: eO G a>, (O �)..„ Fixture /sewer cap 16.60 City /State /ZIP: C___lcAr k4 tertA., dre-- 6 1 - 7 Ul 5- Floor drain/floor sink/hub 16.60 I Phone: (s) , ) ` Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 J Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) Fax:: ( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 _ CONTRACTOR Water closet 16.60 i 4 Business name: - 6 r ) LL/ p 7� i u N ` 1 IVY, Water heater 16.60 Address: PQ X / 1 L q Other: City /State /ZIP: /2T71 / 0S < Q 7 /3 Subtotal Minimum permit fee: $72.50 a Phone: (6( 3) c5o9 ...s� 7 5p F Residential backflow minimum permit fee: $36.25 ) (P5' CB /5 "�, 3d r'- Plumbing n9 a'el-4/4PI) Plan review (25% of permit fee) .6- -_ State surcharge (12% of permit fee) )9, Authorized signature: TOTAL PERMIT FEE / gy, 0 Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. 1:\ Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(10 /O2/COM/WEB) Mar 27 08 07:50a 503 -466 -4703 p.2 CITY OF TGGA �1 COMMUNITY DEVELOPMENT t ECEWED A,' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 MAR 2 8 2008 Plumbing Signature ®G D S IOIV IMPORTANT PERMIT NOTICE TROY ELLIOTT PLUMBING PO BOX 1958 NORTH PLAINS, OR 97133 Permit #: PLM2008 - 00118 Date Issued: 3/21/2008 Parcel: 2 S 104A D -0 38 02 Site Address: 12630 SW WALNUT ST Subdivision: WALNUT CROSSING SUBDIVISION Lot: Jurisdiction: R Zoning: TIG Project Name: CASA TERRA Description: Connecting existing house to utility services. Your company has been indicated as the plumbing contractor for the permit referenced above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work. Please mail the fo • i of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681. If you have any questions please call 503.718.2433. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: CASA TERRA LLC. TROY ELLIOTT PLUMBING PO BOX 1082 PO BOX 1958 CLACKAMAS, OR 97015 NORTH PLAINS, OR 97133 Phone #: Phone #: 503 - 309 - 5750 Reg #: LAC 152130 PLM 34 -402PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X S;- mature .f authorized Plumber Name (pr ed) CITY OF TIGARD:, BUILDING DIVISION PERMIT #: PLM2008.00118 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2000 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/2/2000 TIME: 7:00AM PAGE: 24 SITE ADDRESS: 12630 SW WALNUT ST CLASS OF WORK: SUBDIVISION: WALNUT CROSSING SUBDIVISION LOT #: TYPE OF USE: PROJECT NAME: CASA TERRA DESCRIPTION: Connecting existing house to utility services. (Relocated services) OWNER: CASA TERRA LLC., PHONE #: CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: 503 - 309 -5750 Inspection Request Scheduled For: Date: 5/2/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 069260 -01 503 -936 -2577 Y +✓ti. (. Corrections /Comments /Instructions: P ,r4 (,.,rc. L-k w c . „ .1 \LJ.. A.roi 474 Capt. ch-) PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (31- Date: SIZW) Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2008 -00118 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2001 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/1/200B TIME: 7:00AM PAGE: 27 SITE ADDRESS: 12630 SW WALNUT ST CLASS OF WORK: SUBDIVISION: WALNUT CROSSING SUBDIVISION LOT #: TYPE OF USE: PROJECT NAME: CASA TERRA DESCRIPTION: Connecting existing house to utility services. (Relocated services) OWNER: CASA TERRA LLC., PHONE #: CONTRACTOR. TROY ELLIOTT PLUMBING PHONE #: 503. 300 - 5750 Inspection Request Scheduled For: Date: 5/1/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 063161101 503 -936 -2577 N Corrections/Comments/Instructions: 14 S g Pig ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: lip ► \Ivh.,,,f \N Date: 4 4 ( ) I ) Oil Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION Akb PERMIT #: P1.M 00B -00118 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/21/2000 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/8/2009 TIME: 7:00AM PAGE: 20 SITE ADDRESS: 12630 SW WALNUT ST CLASS OF WORK: SUBDIVISION: WALNUT CROSSING SUBDIVISION LOT #: TYPE OF USE: PROJECT NAME: CASA TERRA DESCRIPTION: Connecting existing house to utility services. (Relocated services) OWNER: CASA TERRA LLC., PHONE #: CONTRACTOR: TROY ELI. I OTT PLUMBING PHONE #: 503 309 Inspection Request Scheduled For: Date: 4 /8/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 340 Storm drain 068033-02 503.936-2577 N Corrections /Comments /Instructions: • V , PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CRAV► ■ Date: y 1e 0T. Phone #: (503) 718- CITY OF TIGARD , BUILDING DIVISION PERMIT #: PI_.Ivi2008.00118 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: :3121/2008 Phone: (503) 639 -4171 !� Inspection Requests (24 Hrs.): (503) 639 -4175 ,' °'I �.. INSPECTION WORKSHEET FOR DATE: 4/9/2008 TIME: 7:00AM PAGE: 21 SITE ADDRESS: 12630 SW WALNUT ST CLASS OF WORK: SUBDIVISION: WALNUT CROSSING SUBDIVISION LOT #: TYPE OF USE: PROJECT NAME: CASA TERRA DESCRIPTION: Connecting existing house to utility services. (Roloc: ted services) OWNER: CASA TERRA LLC., PHONE #: CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: 503 Inspection Request Scheduled For: Date: 4/8/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 Sanitary sewer 068033-01 503 -936 -2577 N Corrections /Comments/ Instructions: • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CT0 V'M. -.i\ \t■ Date: y k I Z Phone #: (503) 718- CITY OF TIGARD, r= BUILDING DIVISION PERMIT #: Pi..M2006•00 i 1e 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/200U Phone: (503) 639 -4171 je Inspection Requests (24 Hrs.): (503) 639 -4175 "- INSPECTION WORKSHEET FOR DATE: 4/7/2006 TIME: 7:01AM PAGE: 25 SITE ADDRESS: 12630 SW WALNUT ST CLASS OF WORK: SUBDIVISION: WALNUT CROSSING SUBDIVISION LOT #: TYPE OF USE: PROJECT NAME: CASA TERRA DESCRIPTION: Connecting existing house to utility services. (Relocated services) OWNER: CASA TERRA LLC., PHONE #: CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: 603 - 309 - 5760 Inspection Request Scheduled For: Date: 4%//2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 3366 Rttiertirnin 067970 -01 503.036-2577 Y Corrections /Comments /Instructions: S OVVS L1 KiW-t/ S43 v 4 TL u Sr' SUS 3y0 tpov • rtOW ❑ PARTIAL APPROVAL [ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CO) \S\--, Date: y I 04` . Phone #: (503) 718-