Permit CITY TIGARD PLUMBING PERMIT
i I DEVELOPMENT SERVICES PERMIT #: PLM2006 -00342
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/13/2006
PARCEL: 2S 104BA -04200
SITE ADDRESS: 12474 SW 141ST PL ZONING: R -12
SUBDIVISION: CASTLE HILL #2 LOT: 075 JURISDICTION: TIG
Project Description: Backflow preventer for irrigation.
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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
NOEL SILVERMAN
22934 8TH ST Description Date . Amount
SANTA CLARITA, CA 91321 [PLUMB] Permit Fee 7/13/2006 $36.25
[TAX] 8% State Surcha 7/13/2006 $2.90
Phone : 661- 259 -7828 Total $39.15
Contractor:
FOREST LANDSCAPE, INC
40437 NW VERBOORT RD
FOREST GROVE, OR 97116 REQUIRED ITEMS AND REPORTS
Contact # : FAX 503- 359 -1908
PRI 503- 357 -3808
Reg #: PLM 8253
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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: -7 ti��� 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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Plumbing Permit Ann - `s' ' -i l'(.)R ol"FI(l 1'P l)"1.1
2006
City of Tigard ��L 1� �f / /�
Blvd., Tigard OR 97223 F<t►, x / ' / V � *� xo:: ! ``��
Phone: 503.639.4171 Fax: 503.598.1960 Y pF (IGA Plan Review // �� �� 459„Z 13125 SW Hall Blv
24 -Hour Inspection Line: 503.639.4175 -' 1NG 01v ,, ' .
Date R e 178aaaPaaaraitNa.:
Internet: w0. W.CLtigerdOC.aas 8`J1LD r � ate Resdy/6
Notifed/Meth >, Sae Page 2 ro[
Notified/Method: Supplemental
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;: J : ^ r .. jj r : ! ''t h mow. ..: .
4z .. Y;:� . �A iS.'..t t/.X.. � ..f ♦ . x3. ^ ��'3. •t>
, ,.,.. � u. rn:. 'Lr... � <d sir '�� S " + "r
♦_ L.gra ♦ . � `fi::`' ,. 5: Sfl: x . .5!`� 5`<. ^. .ti' nE J tT - :
, ''' . -. , -.,.•
❑ Demolition For s,u
special naf6vrxaders sae dreamt
;9 Addition/alteration/replacement 0 Other Description r• I Es_ ) Total
New l 2 � ?; ` < -,,, - sxi �y . a . : , dwellings (includes 100 ft for each utility connection
<;;; ;? ,ii:... "��':,� .r: f �.;.'.' [ 24920
-... . �,.., , ,3sa{4tz. ::. yK ^• : -3! i �, . +� ;'; '`;; - : .a.: SFR ( bath
�1- and 2- family dwelling 0 Commercial/industrial ` SFR (2) bath
13 Accessory building 350.00
❑ M SFR (3) bath 1 ° 399,00
❑ Master builder ❑ Other: Each additional bathlkil[]ren 45.00
7:1":4'" s;+; "t+,!: c_ i .�` • ftA•,i �? t -' j '�° rsxc;' . Fire spridcler ( s4 ft.) Page
i;`:.i • Yr k4:N ,1 { G . `CS b r n' -r 'tfg..`A�`4{° !,:fAl - I Q-
•"�+ �..xrsU'rj Tx '�� -. ''9• � °; a�^4.0 Site utilities
' 6 P;0 � =- t .4 L.1 S t om 14131 })1 Catch basin or area drain
I 16.60
City/State/ZIP: - op_ q T 22, Drywall, leach line, or trees drain I 16.60
Suite/bldg./apt no.: U Project name: q Footing dram (no, linear 11.: ) Page 2
Cross street/directions to job site: Manufactured home utilities 1 10.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (na linear It: ) Page 2
Subdivision: j Lot no.: Water service (no. linear ft: ) Page 2
Tax tnep /parcel no.:
'Wars or Item
& ig ' - :-. 4' :i �'�'Y Vi:,!. { �i 4 .`;i';t;4 U s' 6 llT. M �;' �':: '�� .fizTrgtl( �. ti '�.` "2^' 'ui 4:: ' .
J : al ti 1 w a E 4 tr a .r v ,< 2 131 AbamPtiea valve
t 16.60
:a .. x , " t`4 11 i b`a`` i ,-: v.:y :;'r f t f ,,y .� go Haarlem, + P age 2 3 1
• rri 5a, -, ca Y - t (/•t (.(. l Gc ' C- ckwater valve 1 Page l l/
2.
16.60
Clothes washer 16.60
'tY:i !ir 5 "rt Q " b s' ,... •„ ` Dishwasher 16.60
gSt,;G @ ar . FA V '�,,, < : '',.'.',4i", 5 ' ':Y.i'' !._':: -,,, R Mfr 4:'_ zit ,77: x".�r.,..... > ... � , r; ..;
-.i ,.' 'f,'r.x ' .1 . 5 :x w s '- y *. ^ir• -' { : . p . , ,.� l farmtain
f , ,,.:,,�, :wt � • x• z: - « a x``i;'is;4b ' L6.6D
Name: Noe) c 1 \ Vern-run E ectnea/s 16.60
Ejectors/sump
Address: 9.2 "I P)4 .k-1.. 3 - F Expansion tuneewer c 16.60
G� �' JJ Fixture/sewer cap 16.60 - City/State/ZIP: ' � 1 i i i (_ 1 ', .'u Floor drnin/Roor sink/hub
Phone: ( ,1) c,J -• . up. Fax: ( ) G ars 16.60
-` t:. Garbage disposal 16.60
..-,.,'.,,.e ' ; `"i:th'!" -a~. Wt:k"„aa:2`•d ". • i i'�? :y `y '�} - .'1 s 1 i' -t!sP T7+ w9 , • • •- Hose bib
I � ry t4 i 1 3 n < � l',: � �� sv s :* r i` : , ; , 16.60
name: Fore. �l ( ,C c r..t �� T � C Ice molar 16.60
Business ca
reenact name: \' �^ ,p Cc. 1 • Intercepter/grease trap 16.60
` ` e A ` � Medical gas (value: S ) Page 2
Address: OA P) N �J Ve' Y hr • is 16 Primer •
16.60
City/State/ZIP: F \ e o / UrC' S C rc� Y I I ( rl Roof cln in (commercial) 16.60
_ rte) - :Mu Fax: :*NA - y - Q Sink/basin/lavatory vatory 16.60
E -mail:
„....r, �� , Tub/shower/showerpaa 16.60
?;1 s; .r>Y , �i`F ' ,; $
i 4�`I` . %.•YF'24'a'S�s 3tr , - _ r _ Urinal
s. .•ktk1Y a .a:�1 e , y�� iK }V3 ar, 16,60
f � � s 4yv ti 2Y ti PI" ,'! 1V
Business name: 'FcA -.e,�� l �l . ` Wafer closer 16.60
C J
Address: ( A 04 ?) --+ (� I r - t I jC , ���1�� Doc, Water 16.60
Cit3' C t. sc 1'�t V ' ( .J p Q C� /0 CP'
�t� Subtotal
�p 11 -4 Fax: (, )1 3 fZ )9 (`4 Residential backflovr minimum P�?t fee, 172:50
Phone
(�[�� ��, rJ 536.25
�" ' (C. X53 Plumbing l ic. no.: Plan review (25% ofpermit fee)
Authorized signature: State surcharge (g% of t fee) � 0,t0�
Print name: AXl r � SG I . C C(. V . Yl ••Q (7( 11. f Date -3 2,1DG, ,m. Perm application e Ifa a PERMIT FEE 31
1tiD days after it has been accepted B nst n e.
tY Building P�
*Fee methodology set by Tri -Coun p� d Qe complete.
Industry Service Board.
E d XEJ3 13C213SH1 dH WdLE :is 9002 2T T nr
CITY OF TIGARD
, -- -
BUILDING DIVISION
Ad PERMIT #: PLM2006-00342
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/13/2006
Phone: (503) 639-4171 i ..„„fo o l i i i iik
Inspection Requests (24 Hrs.): (503) 639-4175 ...........W . n"
• INSPECTION WORKSHEET FOR DATE: 91 TIME: 7:02AM PAGE: 46
SITE ADDRESS: 12474 SW 141ST PL CLASS OF WORK:
SUBDIVISION: CASTLE HILL #2 LOT #: 075 TYPE OF USE:
PROJECT NAME: SILVERMAN
DESCRIPTION: Backflow preventer for irrigation.
OWNER: SILVERMAN, NOEL PHONE #: 661-259-7820
CONTRACTOR: FOREST LANDSCAPE, INC PHONE #: 503-357-3808
Inspection Request Scheduled For: Date: 9121/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 036956-01 503-357-3808 N
Corrections/Comments/Instructions: /
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PASS PARTIAL APPROVAL fl CANCEL fl NO ACCESS
I I FAIL EI CALL FOR INSPECTION 1 I ADDITIONAL FEES ASSESSED
Inspector: (14 1 . `e,./ Date: / fr ; Phone #: (503) 718- -2