Permit CITY OF TIGARD
PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00454
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/5/2006
PARCEL: 25111 BA -00901
SITE ADDRESS: 14270 SW 100TH AVE ZONING: R -3.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 025 JURISDICTION: TIG
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
SHELLEY SMITH
14270 SW 100TH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 10/5/2006 $36.25
[TAX] 8% State Surcha 10/5/2006 $2.90
Phone : Total $39.15
Contractor:
ASPEN CREEK LANDSCAPING INC.
610 S. CENTER ST
NEWBERG, OR 503 - 538 -26 REQUIRED ITEMS AND REPORTS
Contact # : FAX 503 -538 -0136
PRI 503 -538 -2636
Reg #: PLM 7859
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: J Permittee Signature: ;
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.
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OCT -04 -2006 08:50 AM ASPEN' C,R+E- � ' K 1= A APING 5035380136 P. 02 vi,
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jumbi4 tt� Permit ADD1 ca ,�, 1 ;
- T ) - g ll s. I d Received Permit Na.:
City o>p'�i�tard Ti T u k. : Date/B :/ �'� � .. �� 1.f _`4 y
13125 SW Hall Blvd., Tigard, OR 97223 �` 1� r r ?. r P sn Review
Phone: 503.639.4171 Fax: 503.598,1960 , - V ' lltygy; Other Permit No.:
24- Hour Inspection Line: 503,639.4175 a f! •i i
. Date Ready/By: hurl; 111 See Page 2 for
Internet www.ci.tigard.or.us Notified/Method: r Su • .lementai information
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[] New construction 0 Demolition For apodat information use checklist
Description 1 qty. 1 Ea. I Total
❑ Addition/alteration/replacement ® Other: Spriuker System New 1- 2- family dwellings (includes 100 ft. for each utility connection)
A vM- I I Y L 1 f A{ 1 1 h� N %'" 'TG �'! BY.A' 141 Y
. iR 1f�'fNY, i I 1 _
m M1 r1 1�'f� ; k i ; .�i � . 17 t ,die r�� � 1 7: l<'.:i'aw�e. , ,f at . 1 , ,�.. �acr��,'�'e.. ;. ; j'� SFR (1) bath 249.20
I, 3u ,1W,44
0 1- and 2- flunily dwelling ❑ Conunerclal/industrial SFR (2) bath 350.00
-
13 Accessory building C1 Multi- tbmily SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder 0 Other Fire sprinlder ( T - sq. ft.) I Page 2
, ' , I ^ p���f'V. i Y 1i•rl'. Nir \Ny r1 Iva 1 1'+*'>✓ ��: i, � lI 1 {
,';., E � t,0„ 'r'r;4: M -'" si ry 7actc s lca3 Yes .fmtgoe9.� atria ' `e l �' ; :, ` . - ; t: Site 110110es
Job site address: 14270 SW 100th Ave Catch basin or area drain 16.60
City /State/ZIP: Portland OR 97223 Drywall, leach line, or trench drain 16.60
Suite/bldg./apt, no.: I Prtleot name: Then, Smith Residence Footing drain (no. linear It: ) Page 2
Ma nutitctured home utilities 110.00
Cross street/directions to job site: SW McDonald St Manholes 16.60
Rain drain connector 16,60
Sanitary sewer (no. linear ft.: Page 2
Stone sewer (no. linear ft.: ) Page 2
Subdivision: [ Lot no,: Water service (no. linear ft.: ) Page 2
Fixture or Item
Tax map/parcel no.: Absorption valve I 16.60
t , < ,' I , auYre ' ?" tTY`i.R,t itF {, ,v{a t "*4 , �T An r Ta"yI ,t1 +1+ + _
d' 4 s fi I , t a r o t ? t: ( i �;w- "'2A ti:� p
, 0 „,,,l�+k��4't • ,.st ukxa ?t, ,AL i,.. Moiil., ,,A W u..W4 ,.,a% It Backflowpreventet Paget I
Irrigation installation with landseaping B Cc L(C FI d lru Backwater valve 16,60
Clothes washer 16,60
- - — - Dishwasher 16,60
ar 11��+£ to i x # a yt m ,"7,77,4,111.411.” { t ., x,, I v� r ur +c�7 Y� , 74 i ,, ' r Drinking fountain 16.60
1 t'6 1.. • . 1 S y dfilkxl� . � L ro r l,.., • - .t � 141, 1i vf il6 'NAN 0 '—W ∎ I k X 31 ip Ejectors/sump 16.60
Name: Smith Expansion tank 16.60 -
Address: Finn /sewer cap 16:60
—
City /State/ZVP:Floor drain/floor sink/hub 16.60
F ax
Phone: ( ) . (( ) - Garbage disposal 16 -60
A . . • 'v v..+ ,41 1 l rni fir J i' "`n Traa' x ttYr�•mr�t,T� r v i Ir ' ;'' Hose bib 16.60
i, �;I'4 '''',4 .,t47,' t I ,ic b�":s'u � u , rkn,, �' N41"> h( Tr�XS ,f:'i',�Li:+:'xa7.1e:�VG17"a , Ice mew 16.60
Business name: Aspen Creek Landscaping Inc interceptor/grease trap 16.60
Contact name: Gene Pima Medical gas (value: $ ) Page 2
Address: 610 S Center St _ Primer 16,60
City /State/ZIP: Newberg OR 97132 Roof drain (commercial) 16.60
-
Phone: (503) 538 -2636 j Fax: : (503) 538 -0136 Sink/basin/lavatory 16,60
Tub/shower/shower pan 16.60
E-mail: off ee®aepencreeklandaeaping.eom Urinal 16.60
P7C T . aartiq .. ;. , 1 ..x' I , A. ^.`, c t A : * S • { A ,, r r 5 r " b` 1 �rl t it • ly op it ..- lr p . x i,t 1: 1, t ' al ve Ih n R Art,; ,. .: A , Way closet 16.60
.� t � i A:. ., � d � nx Y l.1 .. . �i, a�v �� r �'�i � " ��
Business name: Water heater 16.60
Address: Other -
- Subtotal
City/State/ZIP;
- Minimum permit tbe: $72.50
Phone: ( ) Fax: ( ) _ Residential backflow minimum permit fee: $36.25
CCB Lie.: Plumbing Lie. no.: Plan review (25% of permit foe)
-
. State surcharge (894 of permit fee)
Authorized signature 4
�- TOTAL PERMIT FEE .3 1
pri name: 6, , 'Pi ir s Date: I D . d This permit application expires If a permit is not obtained within
-�,P 180 days after It has been accepted as complete.
*Fee methodology set by TN-County Building Industry Service Board .
i;lBulldinplPnm i PLM•PeratApP dal OePo9 440-46161110atICDMAVU3)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLIvI2006-00454
13125 SW Hall Blvd., Tigard, OR 97223
&ARO( DATE ISSUED: 10/5/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 10/17/2006 TIME: 7:04AM PAGE: 95
SITE ADDRESS: 14270 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 025 TYPE OF USE:
PROJECT NAME: SMITH
DESCRIPTION: Backflow praventer for irrigation.
OWNER: SMITH, SHELLEY PHONE #:
CONTRACTOR: ASPEN CREEK LANDSCAPING INC. PHONE #: 503-538-2636
Inspection Request Scheduled For: Date: 10/17/2006 Pour Time:.
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 038281-01 503-672-5657
' Corrections/Comments/Instructions:
*–PA PARTIAL APPROVAL .-‘Pfl CANCEL pi NO ACCESS
FAIL El CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: 17\f Date:— IP I Phone #: (503) 718-
_ _ .