Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00124
fi�rl �l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/7/2006
PARCEL: 1S136DD-00900
SITE ADDRESS: 06830 SW ATLANTA ST ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 002 JURISDICTION: TIG
Project Description: Commercial backflow prevention device for irrigation.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: B 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
MALCOLM & SHARON ESLINGER LLC Description Date Amount
11575 SW PACIFIC HWY
PMB 160 [PLUMB] Permit Fee 4/7/2006 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 4/7/2006 $5.80
Phone : 503 620 - 9515 Total $78.30
Contractor:
ALL OREGON LANDSCAPE INC
8575 SW SOROENTO RD REQUIRED ITEMS AND REPORTS
BEAVERTON, OR 97008
Contact # : PRI 503- 646 -6426
FAX 503- 625 -9668
Reg #: LIC 6667
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 -0 in hrough OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 3-246-6.1! • 1 i 00- 332 -2344.
Issu By: �� Permittee Signat -. � •" ,l •� , � ��
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.
Apr 06 06 03:45p R11 Oregon Landscaping 5036259668 p.1
4
Plumbing Per A icaation FOR OFFICE USE ONL1' .
City of Tigard R 6 2046 D /By: G 46 1 ' l.� p - X(
Pcnnit No.:
13125 SW Hall Blvd, Tigard, Otsxt77223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / ,. Date/By:
Other Permit No.:
24 Hour Inspection Line: 503.639 4 pf TIGARD � '�'j , Date
Internet: www.ci.tigardor.us GI I' mrviS1ON •"`"" ' D t - 7 E( $eePage2
.. - .t : ' V P1AICI Notiird/ 4ethod: pp
Sule men ta l Info rmatlon
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*New construction 1=1 Demolition For special information use check list
Descripti
[11 Addition/alteration/replacement ❑ Other: on
1 Qty. 1 Ea- 1 Total
New 1- 2- family dwellings (includes 100 It for each utility connection)
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A,1 N1t� QX?a�fl �:. � : .:.::.:; : ,:: : ::.�.
.......................:........:...........................,. ..................:....,...:... SFR I bash
>. . :: i' :.:. :.�:iS» >.:.....:.. O 249.20
1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building El Multi-family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
Firesprinkler : R
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lob site address: ie 1 J O � �' (� r J r - ` Catch basin or area drain 16.60
City /State/ZIP: 1 ,- ,--,&. G AZ G1-'4 i.
Drywell, leach Iine, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no, linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no -_ Water service (no. linear ft.: ) Page 2
Tax map/parcel no.: Future or Item
Ahso ti valy
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on e
16.60
Aq .t S .: _'_> s04 � r , < [::? ::::;::tit: ?�
Backtlow preventer Page 2 11.1 li l l 0
I V) 514-G 1 1 t ✓i (i Si? i-N 0 1C-t �S Backwater valve 16.60
J Clothes washer 16.60
Dishwasher 16.60
1r72T..:. OlYI4 #�
Dri
nlun fountain
16.60
Name: t S1,U10 ' e � , Gt v j' 1 4•._ ' Ejectors/sump
Expansion ta 16.60
pa 16.60
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Address: i l Fj �� S i/ V MC; (• C, 1 / "l t.✓ Fixture/sewer cap 16.60
City /State/ZIP: ' i /'�j Gtr-� / 0 C) -22 3' FloordraWlloor sink/hub 16.60 •
Phone: (STS )G L .- Sl Fax (g./3 )6. zo -C»q •}j Garbage disposal 16.60
AR
H
ose
bib
1
6.60
Business name: ::: •: Ice maker 16.60
�' J vi (( Sr + � t �� i l Interceptor /grease trap 16.60
Contact name: t
i.rnDi Medical gas (value: $ ) Page 2
Address: ( 3- i,) C. at / P. Primer 16.60
City /State/ZIP: S ✓ alt o e 9 L( Roof drain (commercial) 16.60
Phone: (t J3) C'Li(s L/ Z Fax:: (c(J3) C,2.5 ''66, Sink /basin/lavator 16.60
E-mail. vv Tub /shower /shower pan 16.60
Urinal 16.60
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.:. } 5 ..::: :::.::.:...:..; ]; :::.;:;;;-
.. :::« < :z: >:� ; > Water closet 16.60
Business name: C JWe__ Water heater 16.60
Address: Other:
C i ty/S tate/Z1P: Subtotal
Phone: Minimum permit fee: $72 :50 �2
( ) Fax: ( ) Residential backllow minimum permit fee: $36.25
CCB Lie.: 66 6p- Plumbing Lic. no.: 1 1 Cr7 LI Plan review (25% of permit fee)
Authorized signature: �Stat e surcharge (8%of permit fee) 4 - � TOTAL PERMIT FEE `� 'SO Print name: C � .. P Date: J/ 3/ �ot e This permit application expires if a permit is not obtained within
J 180 days after it has been accepted as complete.