Permit w
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CITY TIGARD PLUMBING PERMIT
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i� DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00154
��I DATE ISSUED: 4/25/2006
= -�` 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 104BC - 06800
SITE ADDRESS: 14203 SW WALNUT LN ZONING: R -
SUBDIVISION: BAILEY WOODS LOT: 004 JURISDICTION: TIG
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Project Description: Backflow preventer for irrigation.
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
Owner: FEES
JAMES NAM IKI
14203 SW WALNUT LN Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 4/25/2006 $36.25
[TAX] 8% State Surcha 4/25/2006 $2.90
Phone : Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 692 -5945
FAX 503- 692 -0768
Reg #: LIC 7804
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: "� a t•��'� Permittee Signature: { C\310,
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.
_� Imo, i' .. ,
Building Fixtures � i�_ - �, , , 1� . ' "_ i
Plumbing Permit Application FOR OFFICE USE ONLY . . •
City of Tigard LJ.� r
Received - —� Pr rvt Nn. �A �� • 13125 SW Hall Blvd., 'Tigard, OR 97223 1`I��L a�� Y
Plan Review
Phone: 503.639.4171 Fax. 503.598.191 . i:i \Y \u a /.;;.•. +I , , I Date/By: Other Permit No:
24- Hour Inspection Line: 503.639.4175 n I I I ' rA it f
Internet: www.ci.ti ard.or 1> >,r f ?fT r - - -'., , , , Date Ready/By: ur /J See Page 2 fnr
g 1 Notified/Method: �U Supplemental Infonnatinn
`` TYPE OR .yVORIC FEE* "SCHEDW F,; .
T New construction ❑ Demolition For special information use checklist.
Description t Fa. 7 "I Dial _
Ell Addition/alteration /replacement El Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
' ! •' • .._ • CATEGORY • ; OF ,CONSlRGC'TION' • , ; SFR (I) bath 249.20 •
�h- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
1:7 Accessory building 111 Multi-family SFR (3) bath 399 00 •
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler L_ sq. ft.) Page 2
3013• SITE INYrORMATION : k r D ,LOCATION ' Site utilities
lob site address: / L j.. j -",„0 ad Q , r ra#1, Catch basin or area drain 15.60
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City/State/ZIP: 9a/2. /.( / 7?-4)-3 Drywell, leach line, or wench drain 16 60
= I V Y % ` ,��� Footing drain (no. linear R.: ) Page 2
Suite/bldg./apt. no.: P ro j ect name: i &M / A- J � --
Manufactured home utilities 110 00
Cross street/directions to job site -
Manholes 16 60
(L) /L}G e.l).0 1Y' - ° Rain dram connector 16.60
Sanitary sewer (no. linear ft.: ) ' Page 2
Storrn sewer (no. linear ft.: ) Page 3
Water service (no. linear ft. ) Page 2
Subdivision: Lot no.: -
(Jr, r/ Fixture or item
Tax map /parcel no.: L Ef ,✓
Absorption valve 16.60 •
DESCREPT[ N OF' WORK `_ Bacicflow preventer / Page 2 c ..` - / ,
L < .:. r'1/ ' ` _- 2 t • /*//- { - i + : I - - • • , j Backwater valve _ 16.60 •
Clothes washer 16.60
Dishwasher I 16.60
Drinking fountain 16.60
' W
•PROPERTY..- ONER.. 4;1 .
E j —
ectors /sump 16.60
Name: (:),/-, • /;% . , ' , - . --y :nom. - T_-, t• LrlY1 m 1 /1,19 - 7 ES LLc.Expansion tank 16.60
Address: L/, _; , -. •. / ,- c L ` (.) c i ( Fixture/sewer cap 16.60
City /State/ZIP: L t'- ,' t. • r' .; (. : (.1 f 7/2 ; `:, Floor drain /floor sink/hub 16 60 i
Phone: ( ) — Fax: ( ) Garbage disposal 16 60 • . .r APPLICANT 'CONTACT :•PERSON• , . Hose bib
H b - 16 60
• Ice maker i 16.60
Business name: ._/ 1 - ; - % ' , , ( ._ : . '-'!! ) "1 L - f'? Interceptor /grease trap 16 60 I • Contact name: `_ ' \ • • . - L : Medical gas (value: $ ) Page 2
Address: / ) .j (: ( (1. F YLt!_,, I (:r i kr) Primer ' 6 60
Ci /Statcl7.IP: J J ' �/ Roof drain (commercial) 16.60
tY j!1d 1 d 0, ( h' . i �'
Phone: ("-_-.,/,',.-;) • -.. ' - -• .. Fax :: (L,,, j) _ C • -.,',.•,... 1 , Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal ! 6.50
' CONTRACI'OIt.•: • •' Water closet 16.60
Business namc:� _ , ' '...--/. /' /,' :7", ,r --,- Water heater 16 60
Address: •. • ?'/ i i /t / Other: I
/State /ZIP: '-�j _ Subtotal
City/State/ZIP: tY / �L �Ci: } ��^� J L� �0 62 y Minimum permit fee• 172.50 _
Phone: CjL - 3 ) j� � eOL f < i Fax: 6 (419 4- D`7( g. Residential backflow minimum permit fee: $36.25 34. - o Z�
CCI3 Lic.: 7 g-L) Li _ - J Plumbing Lic. no.: Plan review (25% of permit fee)
/
/ State surcharge (8% of permit fee) p2 , 50
Authorized si pa TOTAL PERMIT FEE 39, /s-
Print
— — ' 1
name' r , 3 > �� ' T DatL/ - o:�p - U CA � This permit application expires if a hermit is not obtained :thin
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Seev .:c Po:n
i•\Bui :diagV'c, mit +'.l'L\t l'• Panai. \II,.1., 12 / :610 -16 I6T110 (02:Cn4VWSB)
1 89L0- 269 -COS u ego :L0 90 S2 -+dd
CITY OF TIGARD
BUILDING DIVISION PERMIT #: IPI_ ; t0s'; -00 ;%4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26:2t)0%=%
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/31/2006 TIME: 7:07AMMi PAGE: 20
SITE ADDRESS: 14203 SW WALNUT LN CLASS OF WORK:
SUBDIVISION: BAILEY WOODS LOT #: 004 TYPE OF USE:
PROJECT NAME: NAMIKI
DESCRIPTION: €_3; r;E lo;js ptc:vc n ea for scri ati�rt.
OWNER: NAMIKI, .JAMES PHONE #:
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503. 692- ::394'.:.)
Inspection Request Scheduled For: Date: 5/31/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
.19 Plumbing `ire tl 030855-01 503 -692-5946
Corrections /Comments /Instructions:
/
i
4 PASS 1 PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
1 FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / � 7 Date: Phone #: (503) 718- __..