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Permit CITY TIGARD PLUMBING PERMIT ± DEVELOPMENT SERVICES PERMIT #: PLM2003 - 00344 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/15/03 SITE ADDRESS: 13555 SW 124TH AVE PARCEL: 2S103CC 05500 SUBDIVISION: WHISTLER'S WALK ZONING: R - 4.5 • BLOCK: LOT: 002 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: Install irrigation backflow device. FEES Owner: Description Date Amount DON MORISSETTE HOMES 4230 GALEWOOD ST [PLUMB] Permit Fee 7/15/03 $36.25 STE 100 [TAX] 8% State Tax 7/15/03 $2.90 LAKE OSWEGO, OR 97035 Total $39.15 Phone : 503- 387 -7538 Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD. TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone RP /Backflow Preventer hone : 503 692 5945 Final Inspection Reg #: PLM 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. Issued By: Permittee Signature: a j2 /,/ (4 actr/1 ,,, Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day Jul 14 03 06:35a dam edmonds 503 - 632 -0768 p.2 Plumbing Permit Applica OII FOR OFFICE USE ONLY - Received Plumbing V a R CEO L � DateB : /5 03 l3 :I L(1l aPJO�� -7.)- City of Tigard , l� Planning Approval Permit No. Sewer Permit Na.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 JUL 14 2003 Dat /B Permit No.: Phone: 503-639-4171 Fax: 3n03 - T " f t AR '' � Post- Review Land Use Internet: www.ci.tigard_or.us vlTv ~ "•:.,. i Ei1 Date/B J �tt' ( Case No.: P g q � 1i �741Vi - -' I I Contact Sufis.: ® See Page 2 for 24 -hour Inspection Request: tllibt+# Name/Method: i / (- 7 Su !mental Information. TYPE :OF WORK" FEE* SCREDULE (for special Information use checklist) ew construction ❑ Demolition Description j Qty. j Fce(ea.) j Total Addition/alteration /replacement ❑ Other: New 1- & 2-family dwellings C:ATEGORY'OF CONSTRUCTION - (includes 100 R., for each utility connection) dwelling SFR (1) bath 249.20 1 & 2 -Famil Y g ❑ Commercial/Industrial SFR (2) bath 350.00 ❑Accessory Building 0 Multi- Family SFR (3) bath 399.00 ❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCATION '_ Fire sprinkler - sq. ft.: Page 2 Joh site address: /3X5,5 ,,,5,i, / _ }) A"UC ' Site Utilities Suite #: j Bltd- /Apt. #: Catch basin/area drain _ 16.60 Pro eet Name' Drywell /leach line/trench drain 16.60 Z : WiiiSt' /crs Waite LO � - Footing drain (no. linear ft_) Page 2 Cross street/Directions to job site: Manufactured home utilities 110.00 °Su_ A.) / �r ' t:- Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.) _ Page 2 Subdivision:Wh is -iv t,ca CiC_ I Lot # : � Storm sewer (no. linear ft.) Page 2 Tax map /parcel #: �• E Water service (no. linear ft.) i Page 2 _DESCRIPTION OF WORK Fixture or Ite Absorption valve 16.60 _L+. a s e_ . Vii f 9 G 07'L_ Backflow reventer P / Page 2 X • S 80-C4C {77 -r6C.) C -LJ(L C, Backwater valve 16.60 Clothes washer 16.60 Dishwasher _ 16.60 I►� OPERTY OWNER Drinking fountain 16.60 ¢i 1 �< " . Ejectors/sump 16.60 Name: Dry) m4 - s ct : /'-, e_ Expansion tank 16.60 Address: L i e , )30 SW Get 6e-C.0 6e-C. C'C -C. •, ye-a- Fixture/sewer cap 16.60 City /State /Zip: / ..k e_ 6Sevc D k ci, 7.03'y Floor drainlfloorsink /hub 16.60 Phone: Fax: Garbage disposal - 16.60 M. Hose bib 16.60 • PPLICANT _ ' CONTACT Ice maker 16.60 Name: & / /e"n �'.S/par-r -G'Zt Interceptor /grease trap _ 16.60 Address: /.) -D-Db S LU f 1 l g/(311 L 12D Medical gas - value: $ Page 2 _ City /State/Zip �u�c,� -j ©/._ 7vVo Primer 16.60 Roof drain (commercial) 16.60 Phone: Cog,), - 51 YE I Fax :Sb3 toga - /)74> Sink/basin/lavatory 16.60 E -mail: Tub /shower /shower pan . 16.60 - CONTRACTOR Urinal 16.60 Business Name: [(rllt/S (-cif or-e 41-Y) „.. Water closet - 16.60 Address: /6„. 4-LL) Ph L ,SiO -?,y kb Water heater 16.60 City /State/Zip: r Lc a / y � Df - 'q' /t 6,..) Other. Phone$63 tpcl - 6 i$ Fax: S63 (o - Q ? ( � ,Cf Plumbing Permit•Fees* CCB Lic. #: , 7 e , Plumb. Lic - #: Subtotal S Authorized Minimum Permit Fee $72.50 $ Signature; ->6 .,L )Date:'7-Pi - C3 Residential Backflow Minimum Fe b. plc - S Plan Review (25% of Permit Fee) S t�f Iei ,cea_yr--cU State Surcharge (8% of Permit Fee) $ , TO (Please print name) TOTAL PERMIT FEE $ 2. _ C S Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with Isometric or 180 days after it has been accepted as complete. riser diagram for plan review. *Fee methodology set by Tri- County Building Industry Service Board.