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Permit CITY TIGARD PLUMBING PERMIT 1 41 1' DEVELOPMENT SERVICES PERMIT #: PLM2005 - 00241 W 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/3/2005 PARCEL: 2S112CD-13700 SITE ADDRESS: 07826 SW ALDER ST ZONING: R -12 SUBDIVISION: HAMBACH GROVE LOT: 035 JURISDICTION: TIG Project Description: Installation of backflow device. 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 LEGEND HOMES 12755 SW 69TH Description Date Amount SUITE 100 [PLUMB] Permit Fee 6/3/2005 $36.25 PORTLAND, OR 97223 [TAX] 8% State Surcha 6/3/2005 $2.90 Phone : 503- 620 -8080 Total $39.15 Contractor: MARTIN SANDERS GROUNDS MAINTEN PO BOX 307 NORTH PLAINS, OR 97113 REQUIRED ITEMS AND REPORTS Phone : 503- 647 -5567 Reg #: LIC 5742 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: 2774 lIl� Permittee Signature: eiTT 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. Jun 02 05 12:53p Martin Sander 503 -647 -9151 p.4 c Plumbing Permit A .. .. V ® r ° r - i ' 1 c' 4, •4 1 PemdtTb 3 � 125 SW Full Blvd. Tigard, OR 97213 nn � [ r �� �� S d � y/ P}toeat 503639A171 Fax:50354E.196D�U� 0 LOOJ Radar OtbesPeracie a..: 24 }lair tr ao Liam 503.6394175 11 Thee Reedrio ® doe rate 2 for Internet wwa .d.epra.arne (� TY OF T I GA -.: Nodd . Swer+rs.e.nr r.ru ari.. �" r '•'T;•., 'a• - •:a: 1 -.d' 'v . .4. ti• - '. -V- - - . . - .•'" + '- X2•:1' . ..' LY wl ' Far ++s+ :4 New s r -. Qty- Ex- Total Q Adds - NYem 1- 1 -4sely dwelling (Maud=100 ft_ the each utility cottneerion) x _� :sr $ 2 930 � gaattE 1 3/'.'�'�°�r;' :.�. i • . ._ - ''• BERG) bath „i r , ....� ... :r:: Asti : t� l2sa.- � •i a�3�t - ` ,- - - - -• _ �_-- z I- m o d Z- y dwelling © SFR (*bath . 350-00 • ❑ Accessory binldiog 0 Mutri-fatally SFR (3) bath 39400 Each additional bath/kitchen 4540 0 Master par btn7dc a Other: lire sprinkler (� as ft.) Pagc 2 War.ffel,i17:4 Site medalist Job site address: 7 ♦ s ((.r%' 3 j,1 I � S Cara, basin or area drain 16.60 i n / V "� re:// -22_2_ Gty/SatralP: ; l a tr / l ci leach ch line, or a drain 16.60 SuitdbldB tno-: `! I Plojecrnmtac H ( 2 /21 :&5- / 0 Footingdrain(no - linear IL:__,) Page Manuf muted home utilities 110.00 Cross strectidhoctions to job sit= h(seoholes 16.60 Rai* drain cotxnctor 16.60 SanhIaly sewer (no. Knorr f1 -: _••_ _) Pane 2 Storrs sewer (no. liner ft.: ) Page 2 Subdivkion: PM' F il4i t-C -H• c 2 S* / IvG"- I 1 -°' "°-: 5 $ Water =vice (no. tines R.: ) 1•3 6c 2 Flours or Item Tex Odpipateel 00.1 �r� : +t -: :; `=I - e+dmowprevmoa ke5 idp�sfici / Pam .25, r4 1 V f, 146,. J 61- ' / /Q--+e% 6 T7 .1.>7%) .1.>7%) Bactewrsar vat. , 16.60 Clothes washer 16.60 Dishwasher 16.60 ��$' et. r a ° .:V 41144 t- t•�• . , ,.- Dtialeing fountain 16.60 �: ���� . ._ .. k`�� �, Z. a � - t } _ >rj eetaraizwrep 16.60 Nam= L ( T � /,/_43 t ?; - 5 , Expansion tattle 16.60 Address: / Z 7 S S 5 G� / 77-i ✓ G� , " ` - FWatdsewer c p 16.60 Oty/State IP: r z 5 � q --1 '2 Floor 1640 tiJ p dicey Phone: CS z) (v 2-0 - •C U KO Frac ( b' 59 Z� g - OD . 16.60 ,y�{. �.{ ,y7.r - r- =.�•:�*• • 11:1-. - - Hale bill 16.60 us walker 16.60 B» lit nag MG(..r +\,\n S ei - rCc)1/44;2_. (" t O vr, d S 4' &>A 1. • 6,mrcptortarema O 1640 Co6ncT - ri :1 h'� -- Medical was (value: S ) Pate Address: (P U f52.? J. C.- Primer City/StatdZMP: &) 7-' -.1-(• e L s I Cam_ 9 - 71 � s ) 16 -60 I J � 16 -60 Phone (S i- j) 6749 7 - ,�S 1� • 7 Farr : (5()') 47 LP -' ( 7 JS 1 Tub/ahowet/shower pan 16.60 E -mail: 'Urinal 16.60 ~ z3:7 't -__ LRrr`2 ... (.3 % - a:� 3 "= : <= 't::�l • i' WaKtcloSCt 1660 / . f , Easiness Mom - 71 -1 t cec/7�6 Nc�? ds• H% W ater heater 16.60 Address: t). `� - �� -7 Other: ' Sabtasal 30 , - z S Cit K.) J 'c-1 P LoL VI g / 0 97/ � 33 Minimum permit fee: S72-50 Qi Phc ( jG3) Y S o 7 - S .7 Fu ( ) �v `f? - ! l'S/ itts deaUSl 1>aclmoa• minimum fee: S36.25 tic. rra.: • Pam review (25% ofpetmit fee) ^ COB Lft : • .5 7 -� Z P L "08 State surcharge (11% ofp rmit fee) -/- Authorized Signatin= z/'7) 01 - / "/ � ,„-- I her= 6-- / - /, TOTAL PERMIT FF3 �3 j , / S Print Dame: 4.-- rich~ �C< /?/" " 6' I This p e ads appfic+eion awes ire peraa c is war {Leopard wtcsin ISO days arter it has bozo summed as compitta- *Fe=methodology set by Tri- County Building Industry Service Saud. isl6.,1s, asa 1zms 444wesauvrorcorerwsat