Permit A C TY O TIGARD PLUMBING PERMIT
A DEVELOPMENT SERVICES PERMIT #: PLM2005 -00041
A!: 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/2/2005
SITE ADDRESS: 07913 SW LEISER LN PARCEL: 2S112BD-05100
SUBDIVISION: LEISER PARK ZONING: R -4.5
BLOCK: LOT: 015 JURISDICTION: TIG
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
Remarks: Installation of backflow device.
FEES
Owner:
Description Date Amount
LEGEND HOMES
12755 SW 69TH AVE #100 [PLUMB] Permit Fee 2/2/2005 $36.25
PORTLAND, OR 97223 [TAX] 8% State Surcharl 2/2/2005 $2.90
Total $39.15
Phone : 503 620 - 8080
Contractor:
GREEN EARTH LANDSCAPING
22600 NW MEIER RD.
HILLSBORO, OR 97124 REQUIRED INSPECTIONS
Phone : RP /backflow preventer
Plumbing final
Reg #: LIC 7817
PLM ALL PHASE PLUS
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR
952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)
246 -6699.
Issued By: Permittee Signature: 1:e t \r .{)
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
?/02/2005 12:29 5036470468 GREEN EARTH LANDSCAP PAGE 09
�t cElvfirt OF TIGARD X001
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FEB a 2 2005
iot• a „,,a ,. 'ter,' „, . 9n,, try h- R't t
GT OF TIGA' ■
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P.nnittvo,. i,D UU Aid
• i$ W Blvd., 97723
BUILDING DIV .10� --� _
Pb mc 303.639A171 Pmt: 503598.1960 ,x i.,# OmarPendt'No=
a` Haar rtrapacelm, lark so3.639A17! L`,L`' ' a� la rata Pugs 3 rot
Inter= wirmai.dgard w w P 7
f � s4P1�.>s Irdonastlaa
1
V 3' r rte, u
t5 N w coCIUciloa Q Demolition r �_ .:',,, , .. rj'S EL Total
0 Addis om/altm+ ep 0 Mom No. Ii- 2-temlly dwo111tsp (includes 100 fl. tar each utility oameodon)
S t r u+►a..�� .,a+lr. -• S 1 bo h 24920
^^ ]y.�w. V��•VI,))++l�Cr,, F'�. "`7. t,�•��:�•� „ �I II +IIµµ' PR b��p/ to .00
SFR r .4R ��:�Iw lf14!:11 l v � r/1�L.�.f�L�rw• ►�i � :. 3�'.wwA)1� X30
1r.. 1- and 2- foldb' ❑ �tria1 390.00 IIM
0 Aetieascuy brdldiug C7 ,m m►
ill -esn v) bath eaab whildona bsOr/Mmhee 45.00
❑ Neater b+d1dsr ❑ Other: Ago tamer (-,-L IN, n) Page 2
w, =�. +'$ 1Ns�t. "� Gi� 11 iwaKAncY4t `, 81te ulWtles
iY.►i
Job die address: i9/ 3 J 'iii/ - e g- Catolt basin or stmt ante r 16.60
Cty/ tahs+Z1P• , Or . ? 2 Drywall, lamb hire, or trench drain - 16.60 -
FOOdn8 drain Om. linear R: __..) > _
project tsaotr. Maaufhcntree b utilities 110.00
Cross atraet/diramtlooa m jab silo Manhelee 1 6.60
tar 111111 Main drama coaneetor 16.60
/ Sanitary sower (no. now ft.: ,,._) - 1 'a 's 2
Storm rawer (no. Mast f!: _�
rte= .
I Water service (no, linear lt.: r ! a
sbbdirlaioa 1.�. A �' L � l '
Mara or from _ no.:
� m,wTo :l..a •f 1. �I.; , .,. , � Bad:flla Absorption 1640 Page 2
A� d�� �� , �! •,I •. r t • .. }1y ••:. � .e � prorertat' � p� 2
. t v et e ' /Z Backwater rave 16.60
�� / )sue y
Goalies washer 16.60
.� 16.60
Dishwasher
,*Ri rTi, r,ia - pl n � � � Drink1n <fOUOtAia 11" �� �, +���� r ..: ( � .f43• d `.;d 10 16.60 MEI
-
L'ISPtflfi i Itirv.;: +0 *a .. i
� / 1
F�qt ann tank 16.60 II
• f� tot) ~ (p % f � tot q' t/ Q 0 Ftxttudsewler cap 16.60
Roar drain/lioar s ub 16.60
t'!9 L/ ._l l / t t3stbmgedieposal 16.60
» o3) (/240 Ir0 Fax: 3) . "
s'-r E flss bib 16,60
iw ; F1f�41$:.� " "�I6G' ' % -.''` 1' ee maker 16.60
..., . N1!/ IIr/!i(i► ref r , /L
liill mil 16.60 I=
Contact mom i , Madioal Sias (v Iuc: $ ) J P$ 2
Address: 0 D /V iet) ti � gp • Primer MN 1 6.60
-
C1pr/3tyteiL1P: ` , p✓19 P/, - 1(Z. Z �
Roof drain (aorrorafnt) � -
16.60
Thom ( 3 ) GCor7 Fax: l ) 6 17Q&/( 8 Sink/basln/laratory 16.60
Tub/showetlst+ower twat 16.60
Trtlsail: Wind 16.60 IIIIIIII
�{{ • {{i�`` nt ^) mr:t i� • M 1. , r. a I
�lil����ll[H �:i4�i�;uij:�ili .• +pn ;'( t ��i
F I S '^ WasaCloea mg 16.60
WatQ bow MI 16.60
t`• J' Other: SubtotalCity/Sato/OP:
�D (07 F ax: , 8 Minimum permit ire: 572-5' a
, � a3) , r ( ) 6 � -v ti t ' Residential bsoldlow mtinimum • • : t DE 536.2!
COB Litt.: - 7 Q / "j i Ph robing l ea. no.: i7 0 7 Plan review (2576 of permit les) ±: -.
Aml,urizmi ( / State curt arse OM of permit M) ' it 0
/ /�!' 'TOTAL Pfi F& =r within
_ G P:/ /
I Mr Thum A,( ?4! Thar permit spplteotiou expires if a pert Ss not obtained in
-- 180 days afar 1t has been accepted am complex&
'Fan m duedology set by THlounty Building industry $ctvlce Board.
am MI 444‘16.41010300000W45)