Permit C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00223
l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/31/2005
PARCEL: 2S101 AB -02201
SITE ADDRESS: 07117 SW BEVELAND RD ZONING: MUE
SUBDIVISION: BEVELAND LOT: 2 -3 JURISDICTION: TIG
Project Description: Commercial backflow preventer.
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
MICHAEL ANDRUS Description Date Amount
7255 SW BEVELAND ST.
TIGARD, OR 97223 [PLUMB] Permit Fee 5/31/2005 $72.50
[TAX] 8% State Surcharl 5/31/2005 $5.80
Phone : 503 624 - 3732 Total $78.30
Contractor:
GREGORY LAW LANDSCAPE LLC
PO BOX 23663 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97281
Phone : 503- 639 -0968
Reg #: LIC 7232
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: 4- � . Perm ittee Signature: �CG -tJ� �-
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.
/2005 07:17
Ilp 0/2004 077 FAX 6.84-4039
_, ..13A 50:35V-Une
,.. CITIZ" L".F T GREGORY LAW LANDSCAF PAGE 01/03
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City of Tigard M; A DRecarl'edp)05 HP> Pannit NR ? 22
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. , . 23 sw Hall Blvd_ Tigard, OR 91223 AY 2fr
Plan Revi •
Phone! 503.609.4171 Fax: 503-598.1960
"'A 1...::. ■,...;.,•,:. DaDaB ; Qtherr revisit No.1
I 24-11cur in*Pcctiardli"1 g1"9.41" CITY OF TIGA4
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g New oonetreetioA o Damlition Per , : dopt i . , maiden, maw eltscirlisL
- Description, I . E. Tom'
0 Adciitionialterathaihaplaeewent L:j Otbrst New 1.2.family dwellings (Includes 100 ft- ibt leatCh lli111V COPrIcc
T 4 : 1;74 7 4 ; i' l i frO. ) ; I ON•l : . '1 4::::4' i!.'' °FR ( bRtil. Ell 249,30
0 1 - and 2 dwelling Zreomnercial/incniattial SP (2) bath , 1111 - 350.00
snip) 'Oath 399.00
0 Accessory building 0 Multi
Blei additional baChflciashap 11111 45,00 11=1.1
1,3 Master builder 0 Other:
„ ,, , . . .., ,, „. : .. Fire sprinkler ( sq. fl.) IIIIII Page 2 IIIIIIIIIII
: ;kj• :" ,.; " ::;•: : ';':Ii.ILH:;;:! , ..4/5A.1:44071,' .t....1 ' .4 .' ,'' • "!..;' . ,4: .......,' 4. ill '1 •':, '. ; '' - ..r.4 ; Sift 11041ha
Yob alto ttiid; 71/67
- 4 1 11111 Catch baain Or itTra thin 16,60
Cjty/StatraM .--- / Drywall, leach line, or ratrat artrirk 16.60
dr Flouting drain (no. linear tt: ICU
Suitesibldgispt raa.: Pect name:
Manufactured liaTna utilities mai 110.00
Cross street/directions to jotr siur
- Manholes 11111 16.60
. 7 ' Ad ■/ / 4 a . .
Rain drain connector 16.60 .111
__.
- ______ Sanitary sewer (cc linear ft-: L) page 2
Storm BitWe! (MI linear R.: ) Page 2
Subdivision water service (111). Ilnear R-: j Petp Z
: • Lot no.:
...-- Pixture or Item
;: Tax maFrarcal no,: /
Ahsarotton valve 1,6,60
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.... 'Olt 1 . :.. , . 2 .;'.q, ' -:::'•::: : 1•71RtEdli..::..:.:' : '. : • .., Backe;ow praVeb ter _ 1111 Paw 2 _
tlackwater vaive 16.60
-
Chillies washer NM 16.60
_ -
Distuvasher 16.60 MI
-.....- •
16,60
I . 0..:1,. •i;vtii, , ,Ilt j t .*. 7 . 11 , 1 , 91 1 1 . 1 q1 1 r 4 ii, .-. . , '10,;:i -?:, :-:.: - 1,;.;.;;,5%;:,i; . .. io .,,i,w Ake: .•,.;: ...; J , 1)11 17C4T1t4in
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Name! . „ ifliI '' M 16.60 6 . 6 ° IIIIIIIIIII
I- . sxpanstem unite
Addrcaa: ,.. SY- (,.,. k4fe,.. _ _ di_ g • . piztot,we 16.60 IIIIII
CityrStat IIM
ernP: Vet : Floor drajnifIcior sink/bun .111 16
Blwas: ( ) ri IZIMII °717b431*cliFFIc444 16.61)
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Belo bib 16,60
''....,11::::::::,-(.041.11EITILatia311M111110101**0444172::31111 len maker 16,60
Business name: :,re 40.11Effismffiza
Intereeptedgeoe trap 16.60
Contact name: Medical gas (value: $ _ ) Page 2
- ....-.., -
Address': Primer 111 i six
. . ........,--
City/StaterZIP: Roof drain (ournmercial) 16,60
..._ Sink/basin/lavatory 16-60
Ti : )
- - - _ Tub/shower/shower pan 16.60
B - thinal I cell
" i i. lfivo''?`;''4 • •• , 1 0 ---,•• • ••, -..,' 4 ' ' Waft: Cl MCC MI 18.60 MINI
Rosiness nazi= , , Jo :,, aj14, ec;i0.. / Cotce Water Matte
---.... MI 1640 MEM
Addrenat
Other: IIIIIIII
... 6 ,q .7. • • 7 '. 11111 Subtotal WOAkt2a
City/StatetZIP;
_/_e_9' i.- • 7 / . OPC- , •''' AI" tviinimumpeonit fee: $72-50
Ph a' ( ) & 22 -S144?Z- Fax: (.Te_3)Y--- 41.10,7?_ RzEfidcnrial bactalow riljnina-t-en .ermit fee: $36-25
CCB Lio.; . z_ 3 2, .le Plumbing Lie_ tn..; - Plan review (21% otparenit fee)
. .._- State surcharge (844, anemia fee) l'Orall
..,-- -.• •
Authorized signature: ,
." TOTAL PERMIT FEE vacourtr••••':'
Print raw= - 1.-
•f -.1.-j Date: " A7,Allt This permit oipplieuee.frn oxpires If a pernut is rat a ■ - Red within
130 days after It has Prawn acccatod as conplon.
, 4 1 4 0c rnuthadulogy gat by Tri Building Industry Service Board.
ineaueenerroo.itaatm.. • - . , •vase* 1.2itu 44a.aciarcterearcomr-waaj•
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