Permit CITY OF TIGARD
PLUMBING PERMIT
4 DEVELOPMENT SERVICES PERMIT #: PLM2006 -00256
..,-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/2/2006
PARCEL: 2S 109 D D -08000
SITE ADDRESS: 12876 SW DA VINCI ST ZONING: R -7
SUBDIVISION: BELLA VISTA LOT: 010 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 NW 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 $39.15
Contractor:
STREAMLINE PLUMBING
2505 SW AUGUSTA DR.
ALOHA, OR 97006 REQUIRED ITEMS AND REPORTS
Contact # : FAX 503- 379 -9543
PRI 503- 888 -6657
Reg #: LIC 142111
PLM 34 -370PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: / /J' f �[ Permittee Signature:- (V
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
Plumbing Permit Applica FOR OFFICE USE ONLY
` C EIV 'o
City SW a and Received / / �\� v6
�1 g / ' � PennitNo.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Date/By:
Plan R
Phone: 503.639.4171 Fax: 503.598.1960 U N' 1I t 'I Date By: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 C ITY OF '` T / Date Read /By: is / 0 See Page 2 for
Internet: www.ci.tigard.or.us r", y U g
` �lG,,DIVI$IQN .
Notified/Method: Supplemental Information
..,...., � .., ... . �. � O � � „ -. , ..::_�. .� "� ": 1.. ��� EEE �<S
New construction ❑Demolition For special information use checklist.
Description Qty. Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
_, ;, , 1 §A?T =EGORY:,� 3F `t flNd#1t� 0170 - N A, : 9
vv,.....- sie., �:� AU�yz�,Y3�3� v_.._ .._ - ... -, �y, "� l SFR (1) bath 249.20
. .-
N 1- and 2- family dwelling . ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
El Master builder Each additional bath/kitchen 45.00
❑ O ther:
. >, '.z. =Wr _ Fire sprinkler ( sq. ft.) Page 2
a JO * SIZE INFO L O CA fi11 E l iN < , * ,
N:�� ;H� ,.. � ,. .a� .- - - ;.r._� r,3 1,ax o,2r_. , s. .,- .._,t� ..: t_- � ; : .: :��: + >;. � <._. Site utilities
Job site address: i z g . 1 , s (pi 13 Ut�'Ill � Catch basin or area drain 16.60
City/State /ZIP: \ Q a �r�, , O e c, 044 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: J ` `+ I Project name: 1\ \ t, Sk0,.., 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 ) \ \ v Lot no.: I
f Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: Fixture or item
"'s N s .' iP� . .. " :., Absorption valve 16.60
s' : n 1 IUN' sIi .1lFO,RT';' .;' ',, „ , .,_ gF °: . / / 7
a +,x� %r' y� -'�< �,° �'��:, �� B ackflow preventer Page t
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
p . • ` ^:- rs Y >. ; ` > ,, . , ..:r.:_.:; 1 .:, -< Drinking fotmtain 16.60
,m. -`�:i a, -. ,rva',,=�, e , .ei'a 'ze;&93;,r� '^Y�.- s-z:- .a�'',xi;:. 3x?
Ejectors/sump 16.60
Name: P.I V - -I (-L. 7,7Y14.4 .. I /"TC • Expansion tank 16.60
Address: )Gi. 2 S ft tv itrvi h_e_4'.4 ( ,tom Pru,oti M - . c n Fixture/sewer cap 16.60
City/State /ZIP: Bf Y q. 1 ( j Floor drain/floor sink/hub 16.60
Phone: (573 ) L 4S _ b 55 ( Fax: (cel) te 0 - U Z Garbage disposal 16.60
R Y I r ,.; : +'+ aF =° -- t n:.., '« Hose bib 16.60
IQ ;17t:#0' , , , i.. ,,„ A P , -I.;' da: s ,, A I PERSON-
4
-a ,�,� -. '� �. - �, v� � _ � ,, ".�'����� . ' -. Ice maker 16.60
Business name: Li 11,,e,Yf a Hr„,,,,te 5 37.1,16_,
Interceptor /grease trap 16.60
Contact name: A ,Eir �e.-c-t. Medical gas (value: $ ) Page 2
Address: i Ci 2 J Am/ A 1
J 1y-1, PK JL\ IT ? oo Primer 16.60
City/State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( )
Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
Y, r;.c..3GONTRACrOR _ „_ ..
= e:
_ ..., .. ^-a, � .:� > .. _ _ . . ,.:� ..�' .,.,..... �r Water closet
< < _= �"s�,���s'a, ,.:c � .,, _ ���� %�_..:'t'.';.,a r . 16.60
Business name: 3 ` v 1 t O �)
7'f' ENJ! VYt VI � I V la. ti15 Water heater 16.60
Address: .Z S OS • S • LA) . A v5 L j(- p+ • Other:
City/State /ZIP: 4 L..,‘,, 61 0 t e/ 7 p06 Subtotal
Minimum permit fee: 872.50
Phone: (5 ) op, - (_,6s 7 Fax: (563 ) ?Ai 2-, - 95-`1 3 Residential backflow minimum permit fee: 836.25
CCB Lie.: / Y 2 (I I Plumbing Lic. no.: 3 1-f - 370 t) e, Plan review (25% of permit fee)
j � State surcharge (8% of permit fe 9
Authorized signature (� TOTAL PERMIT FEE 2 9 is 2.
Print name: 3 i4 8 t 1 I Date: - e_. j This permit application expires if a permit is not obtained within
180 days after it has been accepted as comple te.
*Fee methodology set by Tri -County Building Industry Service Board.
i'/ Building \Permits \PLM- PeemitApp,doc 12/03 440 -4616T( I 0 /02 /COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ¥L) ( "OOHS_
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: D
Phone: (503) 639 -4171 a � � iu j ) „\ . �` /
Inspection Requests (24 Hrs.): (503) 639 -4175 , --u.
INSPECTION WORKSHEET FOR DATE: (p 1 y 16 Y' TIME: PAGE:
(
SITE ADDRESS: l M7& ��' 1 Oi lvc..1 aT CLASS OF WORK:
SUBDIVISION:` ELL6 D t c a - ( - LOT #: 10 TYPE OF USE:
PROJECT NAME:
DESCRIPTION: 'CgrwL0
OWNER:, /f_k_/?..t- � s PHONE # 3 -9g- ?kg
CONTRACTOR:
Ri)fg--1--- n n PHONE #: /1 0 0
Inspection Request Scheduled For: Date: (
6//t/ 0"Y4 Pour Time:
Code # Inspection Description Confirm # Contact # Message
i
3-99 P / / J — —
Corrections /Comments /Instructions:
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tii
((/ II / \
s' 7 ..„,
J
fli
( IL /1 z
' 14 i /Vtt, /-'
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7
1 .
L PASS ❑ PARTIAL APPROVAL (l CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 12A
Date: L a Phone #: (503) 718-
CITY OF TIGARD (1.-1 -17 d -- 6
BUILDING DIVISION' PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 L � ' DATE ISSUED:
Phone: (503) 639 -4171 NAllIf i +�
Inspection Requests (24 Hrs.): (503) 639 -4175 r� e &U,kS
INSPECTION WORKSHEET FOR - ��" i, 0 Lp TIME: PAGE:
SITE ADDRESS: 241 t )J 1/4/1 C A CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Pi - 6
Corrections /Comments /Instructions:
- (
/
•
PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I L/L Date: LO / (.15 Phone #: (503) 718 -14 Z%-f
','•
CITY OF TIGARD
, BUILDING DIVISION PERMIT #: PLIv12006-00256
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 612/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/7/2006 TIME: 7:06AM PAGE: 97
SITE ADDRESS: 12876 SW DA VINCI ST CLASS OF WORK:
SUBDIVISION: BELLA VISTA LOT #: 010 TYPE OF USE:
PROJECT NAME: BELLA VISTA
DESCRIPTION: Backflow preventer for irrigation.
OWNER: RIVERSIDE HOMES INC., PHONE #: 503-645-0986
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 031234-08 503-572-4708
Corrections/Comments/Instructions:
?7/ T - CO A r kC &
I I PASS I I PARTIAL APPROVAL LII CANCEL 1:1 NO ACCESS
I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: C2 (C) £ Phone #: (503) 718-