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Permit 3 C ITY OF TIGARD PLUMBING PERMIT 4 1L DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00282 �`�'�' '�J 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/2/2006 PARCEL: 2 S 109 D D -10700 SITE ADDRESS: 12792 SW DA VINCI LN ZONING: R -7 SUBDIVISION: BELLA VISTA LOT: 037 JURISDICTION: TIG Project Description: Backflow preventer for irrigation. 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 RIVERSIDE HOMES INC. 1925 SW AMBERGLEN PKWY #200 Description Date Amount BEAVERTON, OR 97006 [PLUMB] Permit Fee 6/2/2006 $36.25 [TAX] 8% State Surcha 6/2/2006 $2.90 Phone : 503- 645 -0986 Total $39.15 Contractor: STREAMLINE PLUMBING 2505 SW AUGUSTA DR. ALOHA, OR 97006 REQUIRED ITEMS AND REPORTS Contact # : FAX 503- 379 -9543 PRI 503- 888 -6657 Reg #: LIC 142111 PLM 34 -370PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: Permittee Signature: _ .� Fly Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Elpmbin Permit A i' 7 V ED FOR OFFICE USE ONLY ' City f Ti and Received �, �! ���[ �f� 131 SW Hall lll Blvd., Tigard, OR 97223 UN 1 2006 Plan n Review !CO I` Pla Permit NI ` �LT��/6)rL f7`O� eview Phone: 503.639.4171 Fax: 503.598.1960r Date /B Other Permit No.: 24 Hour Inspection Line: 503.639.4175 TI...- ,, ( Y 01 O F j'j' - Date See DI VI$ 1 �!/ e Page for L N G �� W (J Supplementallnformati Internet: www.ci.tigard.or.us Information RIr _t : : . 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Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) fail:: Z; „, -z ¢ CA T E G ORY 9F\ G NSTRLTC 1 £ . 41 ��� F; ', ' SFR (1) bath 249.20 a I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: K:= . _ .<3;ft.,;�may »�;ur ,, Fire sprinkler ( sq. ft.) Page 2 � °� '� J ©B 1TE ;iNFORNIATION A1STD LO�ATI ©N ; I � �'.i�, `. m '' �.I�'� sue_' _ �r4���:�_.a �..._ � �,a,� �_: ����1��', �,� Site utilities Job site address: (7( ' Z cQ vo1 , L aptc. Catch basin or area drain 16.60 City/State /ZIP: 7 p a�` `' +�, 0e. O a ,i.-1 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: J } Project name: \ \ j Sk �, Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: e,t, f\j' Lot no.: it Water service (no. Linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: ,.,_,..,, ;,k ':.,.. sorption valve 6A , �. ,r,�,;.,r ,� °�`i :�x �:. :i = ",,; �.:� �. .., �. ,,., .:,; Ab orpti 16 60 r ay tµ - ESGRIP,T °:U iW'!" ° , v x. '.,:` >: -' =1 af.:�.. - �. . "� bl�a:r�`��h .. ; , =�z,���rh�'r .....ri.�:��� r. 0 ,��__ . _ ;°��, _; »;w'`Nst��r` - � Backflow preventer I Page 2 344 ,b Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 -; , . r> r ,.,. :.:.;r.;, "', Drinking fountain 16.60 t:: >RRUP 0*1OWAIER a:': , ; f a . 0 Y l ':1iE,„ ,, a sh '7, .. r�i,. F„ '�- 'c6'.oaa�", eas�'".� :: 613_', i�'..:"m^ei.N'�.� - - v= ..�..�\. r ' ��'" "� � � � Ejectors /sump 16.60 Name: 1 v C 14( Tykrp - . Expansion tank 16.60 Address: !C A 6.6., Fixture /sewer cap 16.60 City/State /ZIP: fei,4V,eA pc ) y -100 ( J Floor drain/floor sink/hub 16.60 Phone: (5 ) i _ be? 55 ( Fax: (5 1, -2_c Li Z Garbage disposal 16.60 ., , Hose bib maker 16.60 16.60 �,: �,:, ��' a ...,:..� �;a -; . �.�x.,.'� :; G 'OIH`I'AG'I'�: .,ar..; �:. . �t,. e ,.K. ��, . �.. ,era,'''r �. ;, <., . _. �, r ,�,��,:. Ic _ - .. _�,,,� � . � x:<��- .. ... Business name: . {-mil V'QiYS I at ► Ir' r WL S . 5 - ) .' Interceptor /grease trap 16.60 Contact name: At, ( 5c--/,2. h Medical gas (value: S Page 2 Address: (Ci 'Z NW 1 6 „ j pr,, 1 , ZOO Primer 16.60 ti City/State /ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: ( ) I Fax:: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 FS+YS ,�¢, _ zhO;',5. ; . �cY3- %q ,�xx, } � v.. `C, :: . %�' ,1 & r @O , g - CTOR ; . ) ; t ; , W ater closet �,. a, ,.. ���-" .,.. = �'`g4a.�nrc»'Ob, " 3,�,$?t��na °y ,., ,. _x; s'-x"'�s. 3l .., ,r•¢i�; , � - .'^.,.�'..a.,, s 16.60 Business name: v tr 1 t � `'�-� fl'w i�'1 V) c 01 V v1/10; 115 Water heater 16.60 Address: ''S (Y5 - S • (,t; . A v (Pj _ bi • Other: City/State /ZIP: 4 t.,,„ k o f 9 -700c, Subtotal Minimum permit fee: 572.5 0 • Phone: (5 ) @98 - Co 6S 7 Fax: (563 ) >'7 a - 95 `I 3 Residential backflow minimum permit fee: $36.25 CCB Lic.: ( Y 2 ((f Plumbing Lic. no.: 3 ii - 3 -7 0 B Plan review (25% of permit fee) State surcharge (8% of permit fee) 2 9,2 Authorized signatures G Lif., TOTAL PERMIT FEE 3 !$" Print name: � `' �3D)1 ��� h t j f � � ( Date: � - � -- d J This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i:\Building \Permits \PLM- PennitApp.doc 12/03 440- 4616T(I0 /02 /COM /WEB) F CITY , OF TIGARD BUILDING DIVISION PERMIT #: PLM200 &-c)0282 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2/200G Phone: (503) 639 -4171 ' iiimv � i � Inspection Requests (24 Hrs.): (503) 639 -4175 --9.' '_L INSPECTION WORKSHEET FOR DATE: 617/2006 TIME: 1 :06AM PAGE: 102 SITE ADDRESS: 12792 SW DA VINCI LN CLASS OF WORK: SUBDIVISION: BELLA VISTA LOT #: 037 TYPE OF USE: PROJECT NAME: BELLA VISTA DESCRIPTION: BacldloW preventer for irrigation. OWNER: RIVERSIDE HOMES INC., PHONE #: 503-645.09 CONTRACTOR: STREAMLINE PLUMBING PHONE #: 503'888 -6657 Inspection Request Scheduled For: Date: 6/7/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 031234 -03 503572 -4708 N Corrections /Comments /Instructions: . 4■ . (I 1, _ i j kjj / ----• . , / BASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL I f CALL FOR INSPECTION ADDITIONAL FEES ASSESSED VAVL Inspector: - Date: ��/ Phone #: (503) 718 - Z Y2-1