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Permit CITY TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00439 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/26/2007 PARCEL: 2 S 112 B D -062 00 SITE ADDRESS: 14798 SW 76TH AVE ZONING: R -7 SUBDIVISION: PROSPECT MEADOWS LOT: 005 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: 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 • LEGACY HOMES INC 17581 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: LEGACY PLUMBING 8985 SW HAZELVERN WAY PORTLAND, OR 97223 REQUIRED ITEMS AND REPORTS • Contact # : PRI 503 -816 -8887 FAX 503- 297 -4587 Reg #: LIC 159281 PLM 26 -517PB • 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: /6z4/C .A...) Permittee Signature: 7 ` Ca. /-e/Vl 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. 53/25/2007 11:11 5036317283 LEGACY HOMES /TMR PAGE 03104 k--- • 1 . hOl2 ot�t�lt� USE, ()NIA ', Plumbing Permit Application ' b ' c' p P ennit No.. City of Tigard d . • `Date y th y cRG /o 7 B � DO af �.'�'� a 13125 SW 'Hall Blvd.; Tigard, OR 97223 • ; u Revi ® Phone: 50 3 . 639 . 4171 Fax: 50 3.598.1960 2 � r � II [;:telBy: Other P • it No.: �� TIGAR1� inspection Line: 503.639 -4175 Date Ready/ay: J A 8I See Page 1 for Internet: www.tigard r � - or.gov i ` N•t(f ^. • - hod: ' - Sup, mental lntbrmation TYPE : OF WO • ei _ r , ;�>� SC�IEDiTL•� .. . ❑ D emolition 11 t g 1 3 ��� i s Fors , .dal information use checklist l�'ew construction Description Qty. Ea. Total ❑ Addition /alteration/replaoetnent ❑ Other: New 1- 2- family dwellings (includes 100 i1 for each utility connection) - CATEt ORY OF CONSTRUCTION SFR (1) bath 249.20 " and 2- family dwelling ❑ Commercial/industrial SF1Z (2) bath 350.00 SFR (3) bath 3 ❑ Accessory building ❑ Multi-family Each additional bath/kitchen 45.00 ❑ Master builder ❑ other: Fire sprinkler ( sq. R) Page 2 JOR SITE INFORMATION AND LOCATION Site utilities Job site address: 1 _ __ ..'�i"''i . , . Catch basin or area drain 16.60 City /State/ZIP: , " . r, v- , 0g. -9 / �jp�g G a-. Dryweli, leach line, or trench drain 16.60 Footing drain (no- l inear ft.: , ) Page Suite/bldg. /apt. no -: Project n : Pf' ^ � Illi A Manufactured home utilities 110.00 • Cross street/directions to job site: • Manholes 16.60 • Rain drain connector 16.60 Sanitary sewer (no. linear ft.: .) Page 2 • Storm sewer (no. linear ft: _^.) Page 2 Water service (no. linear R.: ) Page 2 Subdivision: Lot no.: 3 Fixture or item Tax map /parcel no.: 2. 5 1 2.. t3 Q Absorption valve • ' : ' .DESGR IC , • • iPOI . v OFVk!ORIC , o reverter -:•.. $acltfl w p 1 S.. l , .. —f— . — l ,, ^ Backwater valve MIMI 16.60 Clothes washer 16 -60 5 1 i'LQO-1 -- Q 4 ©i C. Dishwasher 16.60 1 01 51 T- G . 0 00 1) 16.60 D founta E2'.P ROPERTY U 13'NER • : ::. • 4 0 T1✓NAN,T 16.60 . I ' _ Ejectors/sump Nam °: _ r ■ .w A . Expansion tank I6.60 1 Address: — n � ! Fixture /sewer cap — . 16.60 A Floor drair . 111111 /floor sink/hub 16.60 City /State /ZIP :OC �- � 9.-1 oy9 16.60 �/ Fax: Garbage disposal Phone: (S 03 C ?, 2 '] �, g ' Gn 3 1 i a Hose bib M 16.60 ' . .. . E ,APPLICANT ' .• • • ; ' . . ❑ .CONTACT PERSON roe maker 16.60 . . .- Business name: Interceptor /grease trap 16.60 " Medical gas (value: $ ) Page 2 Contact name: � � .; ' <� • - 16.60 Primer - Address: 16.60 Roof drain (commercial) City/State/ZIP: - . - . - - Sink/basin/lavato), 16.60 Phone: ($ 5 1 ' - Fax:,: ( ) Tub /shower /shower pan 16 -60 A lb E -mail: v . C. +. Lt ° P • C. 1 2 ^ `P a -cat-- Urinal Mill 16.60 iCO NTRA L7;OR Water closet 16 - 60 •, , Water heater 16.60 Business name: • : � a c. _� Other; Address: ear,- Subtotal City/State/ZIP: " . • •,, v ; ..„ .... Minimum permit fee; $72.50 Phone: 6 0, l . .7,.- •. Fax: ( ) • Residential baalcflow minimum .ermit fee: $36.25 i. Plan review (25% of permit fee) CCB Lie.: k . 3 • r I� . no �� " • � a .: . S tate surcharge (8% of permit fee) / Authorized signature: , — �o TOTAL - PERMIT FEE . " 11 This permit application expires if a permit is not obtained within • [Tint name: /--•-• .. _ Date 180 days after it has been accepted as complete, *Fee methodology set by Tri- County Building Industry Service Board. I; \Huildine¢[mitAPLM- P¢rmitppp.dOG O6 /26/D6 440 46laT(10/02(CONINVEB)