Permit ,, ; CITY OF TIGARD PLUMBING PERMIT
' -° CO MMUNITY DEVELOPMENT PERMIT #: PLM2007 00438
,TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/26/2007
PARCEL: 2S112BD -06000
SITE ADDRESS: 14752 SW 76TH AVE ZONING: R -7
SUBDIVISION: PROSPECT MEADOWS LOT: 003 JURISDICTION: TIG
PROJECT: PROSPECT MEADOWS
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: OTR 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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
LEGACY HOMES INC
17825 S FIELDSTONE LN Description Date Amount
OREGON CITY, OR 97045 [PLUMB] Permit Fee 9/26/2007 $36.25
[TAX] 8% State Surcha 9/26/2007 $2.90
Phone : 503 -544 -6783 Total $39.15
Contractor:
LEGEND PLUMBING
PO BOX 23338
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 624 -0582 ,
FAX 503- 624 -0582
Reg #: LIC 163964
PLM 34 -470PB
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 : -�_ ,�,__ _ _ Adt_ A _,. ` Permittee Signature: 61 a c e d?
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.
NW. 07 11:11 5036317283 70 t LEGACY HOMES /TMR PAGE 02/04 k \I ‘‘,7 • 1 '
t �
Plumbing Permit . pplica o n I•Oli OFFICI. USE ONL,
City of Tigard SOP 2 5 2001 j., � Received Permit No,:
�
a 13125 SW Hall Blvd., Tiger 972 1 1 i�� Pl ev iea 6 / Orin Permit No.:
p 1B �
k A
Phone: 503.639.4171 F 0 _ , , ;A
T I G A K i Inspection Line: 503.639.4 frD ` 1 �`V 'Date heady/By: rur: 1il See Page 2 fa• Notified/Method: Supplemeo Dana
t PE •t . �V41!tK
Seely
,New construction 0 Demolition Fot speed urforaiatlon use checklist
Description Qty- l Ea. I Total
0 Addition/alteration/replacement ❑ Other New 1 -2- family dwellings (includes 100 R. for each utility. connection)
' CATSGOR'l(..O "' CON§11#/eflON . • ..:; ° ..; SFR (1) bath 24920
]-1- and 2-family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
SFR (3) bath 399.00
O Accessory building ❑ Multi- family
- Each additional batb/kitchen 45.00
0 Master builder 0 Other: Fire sprinkler ( sq. ft) Page 2
- JOB, S1TE INFORMAi1O1!i AND...LOCATION° Site utilities _ .
Job site addres - ( !.� 1'o t h Catch basin or area drain 16.60 ,
City/State/ZIP: 0.,- t • Drywell, leach line, or trench drain 16.60
./a n0.: Pro'ect name: Footing drain (no. linear ft.: �) Page 2
Suite/bldg./apt. S DL ] 'a ►� ,r • • 4 a
Manufac aired home utilities • • 110.00
Cross street/directions to job site: - Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear R: _) Page 2 . .
Stor n. sewer (no: linear it: ,_) Page 2
Subdivision: I Lot no.: Water service (no. linear R: _ Page 2
Fixture or item
Tax map /parcel n0:: Z 5 i 7, r • ,ill • Absorption valve 16.60
.. , .. .. ..:;. lDE,.sCR AN.:<t)F`
;.. ..... ]3ackflow proven ter •
l , ∎ I. • ■ • W Backwater valve 16,60
5 W 2 c C 1 _ Q Q O cp Clothes washer 16.60
Dishwasher 16.60
57 2—C) PC) "2 ' 0 (:)� � tain
,4 Lpko�E3;t ri..0 NN}uR , , : r:.1:11 IENAhiT .. . _
Drinking fou 16.
Epetors/sump 16.60 .
Name: 1...p R ,U <n .. A Expansion tank 16.60
Address: S '2r, . .5 . Vi AdQ 4.. fixtnre/sewercap 16.60
City/State/ZIP: - C Floor drain/13oor sink/hub w 16.60
Phone: ( p s p� a -� C ( S Q (Q 3 [ - r� Garbage disposal Ho 16.60 • ` AI7LICA1V1 1 0 CO14TACT PERSON' se t
. . . — ice maker 16.60
Business name: _ interceptor/grease trap 16.60
Contact name: sr 9, a H l 1 P -^(..." _ Medical gas (value: $ ) Page 2 .
Address: Primer 16.60,
. Roof drain (commercial) 16.60
City/State/ZIP:
- _ - Sink/basin/lavatory ,
Phone: (6 o9 5 -.. Fax:: ( ) Tub /shower /shower pan 16.60
E-mail: b (....L0 ...11;:› <S V-42-1C . _ Urinal 16.60
CONTRA,C OR' . water closet
1660
: ...:,: � �Lmb; Wa h 16.60
Business name: -
Address: l Other:
} �� S k.-)� -1, 4 1 . ('1 Subtotal
City /State/ZIP :71 . •I Net1 (7 P._ cc? as Ll _ Minimum permit fee: $72.50
Phone. (S ,.,9 a - Pte ( ) Residential backflow minimurit ermit fee: $36 -�
Platt review (25% of permit foe)
CCB Lic.: \ 1e 3 0l. Plumbing Lic. no.:
7o P .
State surcharge (8% of permit tbe) /
Authorized signature: TOTAL PERMIT FEE _/. J
I G5 J07 This permit application expires if a permit is not obtained within
C Print novae:
, 1 i o i
D "/ 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
IA Buildinvermi ;611'x.m•PermitApp.doe 06/26/06 44046r6T(IO/02icomnvta)