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Permit CITY OF TIGARD PLUMBING PERMIT :4 COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00082 DATE ISSUED: 6/15/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S 135AC -02500 SITE ADDRESS: 10890 SW 95TH AVE ZONING: R - SUBDIVISION: LONGSTAFF CONDOMINIUMS LOT: 019 JURISDICTION: TIG PROJECT: LONGSTAFF CONDOMINIUMS Project Description: Site utilities.other's 7 rain drain connectors,& 13 manholes CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: 5 FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: 570 ft WATER CLOSETS: WATER LINE: 1,076 ft DISHWASHERS: RAIN DRAIN: 790 ft Owner: FEES CASE TERRA LLC 9200 SW NIMBUS AVE Description Date Amount BEAVERTON, OR 97008 [PLUMB] Permit Fee 6/15/2007 $2,199.00 [PLMPLN] Plan Review 6/15/2007 $549.75 [TAX] 8% State Surcha 6/15/2007 $175.92 Phone : 503- 452 -9003 Total $2,924.67 Contractor: L & H EXCAVATION 12685 NW NEWELL FOREST GROVE, OR 97116 REQUIRED ITEMS AND REPORTS Contact # : PRI na Reg #: LIC 175537 PLM 359PB 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: 11 / Al Permittee Signature: / 4PA 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. Iot /(- -IT /ES Plumbing Permit Applicatio> i -2 - FOR OFFICE USE ONLY City of Tigard Receiv 6 Permit N : u 13125 SW Hall Blvd., Tigard, OR 97223 L Date : Z?") 11 � �� �� Phone: 503.639.4171 Fax: 503.598.196 LC-0 ) p0 Re e: ew -'� Other Permit No.: Inspection Line: 503.639.4175 TIGARD (�i= V 1 / ut - 1ltar�l NotiDate Pl an R DateeadyB 6 y: p Juris: H Su See ppleme ntal In Pa ge2for formation Internet: www.tigard-or.gov fi Me TYPE OF WORK f iDi'NG ©fVtIVN , � /J'��i " _ (Vew construction ❑ Demolition f : r 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 (I) bath 249.20 (a1- 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: /OSe9 O S'w 5 1 l+ A1/6"" Catch basin or area drain 3. 16.60 79 City /State /ZIP: - 774 A P o O4_ g 7 j, Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: l Project name: Lon, s & Footing drain (no. linear ft.: ) Page 2 c. rygFY n+�o - /ti��1MS Manufactured home utilities 1 10.00 Cross street/directions to job site: 51.,v (,„.,,, t. s r4FF �� Manholes f '2, 16.60 ,225:-.7 Rain drain connector _�© -7 16.60 ��b , , 2� Sanitary sewer (no. linear f d R) f;:, Page 2 87 Storm sewer (no. linear ft.: 117 Page 2 79 �" i' Subdivision: Lot no.: Water service (no. linear ft.: 4 /ogl Page 2 / 0 ` Fixture or item ` Tax map /parcel no.: / S kJ 3s AC_ , 1 . /Mr ZSw, L/L, SO , urivo Absorption valve 16.60 y DESCRIPTION OF WORK Backflow preventer Page 2 Y/Lw t^Tfz STvt - i4 wvio (/-ri (... /. I - )EI i i,.,cu (, rDt 11.. Backwater valve 16.60 S b IA.`nA- , Stq..+' Vck..7 (n -ATl� T -p�,` Clothes washer 16.60 � ` v ti�� T Dishwasher 16.60 t - ` Y"l C 1'�v“NV- iv4 L. CAw P 124) - s x . 1 t PROPERTY OWNER ❑ TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: C3 WS).4 r en,vt, (..(.L Expansion tank 16.60 Address: q 1,4_,/:, sw N ' s Ave Fixture /sewer cap 16.60 City /State /ZIP: (29am \ j‘,,,, A -jp,J cDik Cl i (KjS Floor drain /floor sink/hub 16.60 Phone: (505) Li S L - $at5, Fax: (5o3) X15 Z- e-.)0".43 Garbage disposal 16.60 ❑ APPLICANT 621, CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: jgt„» A Qp„Aimwv--x...‘ � Ou�'L w lez &'r r Interceptor /grease trap 16.60 Contact name: A. T ( • �th5 A * t4 P C Medical gas (value: $ ) Page 2 Address: e l - 2A,O 5‘ ■ VIN , (1U5 AV Primer 16.60 City /State /ZIP: v , - � 011 COS Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone:(50S) tIsa__ 8003 1 Fax: :(su3)`t52. Bo► Tub /shower /shower pan 16.60 E -mail: w c.c. @_ G,1 .0..vy W . (,qvu�, Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: 7 : 4. `j- 4 - 4 J , - Water heater 16.60 Address: / tR 0 S� ti j Other: City /State /ZIP: . Zvt r^-/' / Lr 7 //� Subtotal �9 � �-��Q Minimum permit fee: $72.50 Phone: ( ) )� Fax: ( ) / �j ?i Residential backflow minimum permit fee: $36.25 CCB Lic.: f 76. 3 Plumbing Li��1 I ( � // fjj Plan review (25% of permit fee) :J tiq, 93 l Q 11))3/./.. - `M y � ✓ � ^ State surcharge (8% of permit fee) L /,"1� . q ,L Authorized signature: ` V Re, TOTAL PERMIT FEE Print name: ___1_ Date: I�r4 This permit application expires if a permit is not obtain_ 180 days after it has been accepted as complete. *Fee methodology set y Tri- County Buil ' g Industry Service Board. I: \ Building \Permits\PLM- PermitApp.doc 06/26/06 440- 4616T(10/02/COM/WEB) Ni Q ^� ' ��� ��' / ' CITY ���� ����������� ' ~-� = ��m m w OF m o���m�m�� ._ � � ummp . BUILDING DIVISION PER K�|T#: PLM2007-00082 13125SVV Hall B�d,T�a�.ORQ7223 DATE ISSUED: 8/15/2.007 Phono:(503)63O-4171 Inspection Requests (24 Hrs.): (503) 839~4175 _./14,..":11411..',', � INSPECTION WORKSHEET FOR DATE: 6/22/2007 TIME: 7:03AM PAGE: 45 SITE ADDRESS: 10B9D SW9S[MAVE CLASS OF WORK: SUBDIVISION: LONGSTAFF CONDOMINIUMS LOT #: 019 TYPE OF USE: PROJECT NAME: LANGS[AFFC0NQOk4|N|UK8S DESCRIPTION: Siieuti|itimy.m&hm/s 7 ruin drain xo^nectmrs.& 13 manholes OWNER: CASE TERRA LLC, PHONE #: 503-462'9005 CONTRACTOR: L & 11 EXCAVATION PHONE #: na Inspection Request Scheduled For: Date: 6/23y2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 0onbomnwwvmr 050768-01 503'793-0340 N Corrections/ .^nnnnento/|netruod*no: ` ' / 4--)) r. � �� . ^� ��A ~- ~~� ^� .�,_ ' 0 ' - -^-'_ o- ^ � ~~ n� � ' ~~��■- ri PASS 1 PARTIAL APPROVAL 7 CANCEL 1 NO ACCESS FAIL CALL FOR INSPECTION 1 | ADDITIONAL FEES ASSESSED �� Inspector: i/- UOa�e� � Phone #: (503) 718- 21(11-1/