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Permit CITY TIGARD PLUMBING PERMIT _ 40 DEVELOPMENT SERVICES PERMIT #: P /23/20 06 -00502 .�.DATE ISSUED: 10 � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 10/23/2006 PARCEL: 1S134DB-09400 SITE ADDRESS: 11113 SW 113TH TERR ZONING: R -4.5 SUBDIVISION: STONECHASE LOT: 018 JURISDICTION: TIG Project Description: Residential backflow 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 GERRITZ BIGGI CUSTOM HOMES Description Date Amount 11113 SW 113 TERRACE TIGARD, OR 97224 [TAX] 8% State Surcharl 10/23/200E $2.90 [PLUMB] Permit Fee I0/23/200E $36.25 Phone : 503 - 619 - 4668 Total $39.15 503 - 526 - 2084 Contractor: MARK BROWN LANDSCAPING PO BOX 744 REQUIRED ITEMS AND REPORTS VANCOUVER, WA 98666 -0744 Contact # : FAX 360 - 993 -5993 PRI 503- 234 -2667 Reg #: LIC 5192 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 . or 1- 00- 332 -2344. p\ i Issued By (? __AJV\JQ - Permittee Sig nature._ --- .. 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. , i h yr 005 ©V L0 3 Plumbing Permit Application Foj ,OFFICE USE O\1,1' City of Tigard ReceivY /L7 , t b J � Plan Review Permit No.: '/ M (5��p�"' 13125 SW Hall Blvd., Tigard, OR 97223 DateB �fJ (j ( " Other Permit No.: Phone: 503.639.4171 Fax: 503.598.1960 AmI � Date/By: Hour Inspection Line: 503.639.4175 ?•• I� r ep Date Ready/By: r ' ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: u /. Supplemental Information - FEE. �D R':�;; a.:. TYPE OF. WORK' �ai,< ,�a ^'''r i'i For special information use checklist [ew construction ❑ Demolition Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection) CATEGORY' OF CONSTRUCTION;, ,gig r;G, z;(A =`:' ', &. SFR (1) bath 249.20 I- and 2-family dwelling SFR (2) bath 350.00 y g ❑ CommerciaUindustrial ( ) ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION;,;:; Site utilities Job site address: 1 i 11 ) 1 ) 1' fewykeit Catch basin or area drain 16.60 City/State /ZIP: I L f!l Ov R7� L( Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: 1 I Project name: ' n( �I h` ,,S . , Footing drain (no. linear ft.: Page 2 %.5/5, Manufactured home utilities 110.00 Cross street/directions to job site: Nor-/h J� f� 0. 9 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: ne _ has e-- I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 T - :DESCRIPTION OF WORK,, ..._ "; .: ' ",., < Backflow preventer / Page 2 • 3 A ,, 5 O D Z 2tr-1 &f 70 l .i3 &r U] ( .f'l Backwater valve 16.60 Clothes washer 16.60 . Dishwasher 16.60 Drinking fountain 16.60 ❑ PROPERTY OWNER , ❑. TENANT. ti , p Ejectors/sump 16.60 Name: ( ur�'f _, cD/ r J - kfy j )� LAC- Expansion tank 16.60 Address: � � � `,�� vei n " / d f., -h Fixture/sewer cap 16.60 City/State /ZIP: , e Er 7Un 62' Q 70Q� y Floor drain/floor sink/hub 16.60 Phone: ( J ` E i &g-___ , 7 & Fax: ,...) G Z �� Garbage disposal 16.60 ,..:.- ....... ..., Hose bib 16.60 ID APPLICANT, . i: ❑:%'CONTACT1P 0 ,,., '- �/� //`j" Ice maker 16.60 �� Business name: ri V_J/ � , �, ,A.15 (,! l� Interceptor /grease trap 16.60 � (. Contact name: I Medical gas (value: $ ) Page 2 Address: 455 G ) � or� /Ad Primer 16.60 City /State /ZIP / / Roof drain (commercial) 16.60 �u� �� n � 70L-- 1 /' /� </ I Fax: ( /- j Sink /basin /lavato 16.60 Phone:,y9 ) tL _ ` �lQ d - 5 h - ?t ry - . Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 .: CONTRAJ ; ' ..'L ;'; .�;i' ; ;Vi,:o. : ; ., .... _., Water closet 16.60 Business name: m �� 6/ 2 0 ,, i C.� „ _,� /, ( - Water heater 16.60 P.O.- O � �/ Address: "� 'IV Other: / /- Subtotal City/State /ZIP: ∎ VAnO(Jev wf p / 81 4'4'_O7L/L� / Minimum permit fee: $72.50 / -1" � Phone:* O- ) ,47 Fax:3 (e - O , g 9 3 _599 3 Residential backflow minimum permit fee: $36.25 O CCB Lie.: / Plumbing Lic. no.: Plan review (25% of permit fee) ` State surcharge (8% of permit fee) (. 901 Authorized signature: / I TOTAL PERMIT FEE ! , / 5 Print name: and y /L /� ,/ /J/17 )il Dat JO Q -O This permit application expires if a permit is not obtained within J C�/�' - 180 days after it has been accepted as complete. *Fee methodoloev set by Tri- County Buiidine Industry Service Board CITY OF TIGARD BUILDING DIVISION ,t.- PERMIT #: PLM200G -00602 13125 SW Hall Blvd., Tigard, OR 97223 .. DATE ISSUED: 10/23/2006 Phone: (503) 639 -4171 /Adu� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/14/2006 TIME: 7:02AM PAGE: 51 SITE ADDRESS: 11113 SW 113TH TERR CLASS OF WORK: SUBDIVISION: STONECHASE LOT #: 018 TYPE OF USE: PROJECT NAME: STONECHASE DESCRIPTION: Rklick4-#M fekteoiliwt, topifLrgatiuo ' n; OWNER: GERRITZ BIGGI CUSTOM HOMES, PHONE #: 563 -619 -4668 CONTRACTOR: WWI tr elhaL.I'dES, PHONE #: 60 <20 Inspection Request Scheduled For: Date: 12/14/2006 Pour Time: Code # Inspection Description 'Confirm # Contact # Message 399 Plumbing final 04105543 503.718 -2433 �l Corrections /Comments /Instructions: J r r • -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL I ] CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 `6 Date: i v Phone #: (503) 718 - L