Permit Sr? CITY OF TIGARD
PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00012
DATE ISSUED: 1/10/2006
�, 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S109AD -12700
SITE ADDRESS: 14810 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: ARBOR SUMMIT LOT: 025 JURISDICTION: TIG
Project Description: Backflow preventer for irrigation, common area landscape.
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
WEST HILLS DEVELOPMENT
15500 SW JAY ST Description Date Amount
BEAVERTON, OR 97005 [PLUMB] Permit Fee 1/10/2006 $36.25
[TAX] 8% State Surcha 1/10/2006 $2.90
Phone : 503- 641 -7342 Total $39.15
Contractor:
TRADEMARK LANDSCAPES, INC.
18478W WALKER RD.
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -631 -3890
Reg #: PLM 6796
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: > 74 3:Le t- Permittee Signatu d
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.
...t
Plumbing Permit App4 afo nn �� � FOR OFFICE USE ONLY
City of Tigard JAN 10 2006 Received
t' Date/By. / - /o - d6 -y Permit w �w o N ze o ` 0 a J 7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 1 \ V V pL�
Phone: 503.639.4171 Fax: 503.598.1901TY OF TIGAR[ I I +' . Date /By: Othei Permit No.:
24- Hour Inspection Line: 503.639 41 e•'�
Internet: www.ci.tigard.or.us ' UILDING DIVIS�_ � . Date Ready /By. 1 //_ 0 See Page 2 for
g Notified /Method: Supplemental Information
TYPE OF WORK - FEE* SCHEDULE
® N construction ❑ Demolition For special information use checklist.
Description 1 Qty Ea. I Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft for each utility connection) • . . CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building 111 Multi-family SFR (3) bath 399.00
Each additional bath /kitchen 45.00 •
❑ Master builder ❑ Other.
Fire sprinkler ( sq. ft.) Page 2
• JOB SITE INFORMATION AND -LO TION Site utilities
Job site address: 1 LI g i 0 S reek , ( a D f Catch basin or area drain 16.60
City /State /ZIP: T) GARB 01 9 7 Z-`E Drywell, leach line, or trench drain 16 60
Suite /bldg. /apt. no.: Project name: 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: Arbor Summit Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK.
Backflow preventer O Page 2
NEW CONSTUCTION O p , / Backwater valve 16.60
8/}C, GOW 033. /RIV } - ,4 - 7 W At Ere? y � .. Clothes washer 16.60
let /177W
16.60
' - ® PROP1u_RTY:'OWNER. ❑, TENANT . ,
Drinking fountain 16.60
Ejectors /sump 16.60
Name: West Hills Development Expansion tank 16.60
Address: 15500 SW' Jay ST. Fixture /sewer cap 16.60
City /State /ZIP: Beaverton, OR 97006 Floor drain /floor sink/hub 16.60
Phone: (503)641 - 7342 Fax: (503)641 - 7661 Garbage disposal 16.60
® APPLICANT ® CONTACT PERSON Hose bib 16 60
Ice maker 16.60
Business name: Same As Owner.
Interceptor /grease trap 16.60
Contact name: k K LAIN I ER Medical gas (value: $ ) Page 2
Address: ( 5AME AS A bOVF) Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: (503 ) 641 Fax::( )
Sink/basin/lavatory 16.60
_ t I ', e - Tub /shower /shower pan 16.60
�-I
E -mail: k N lap..< 'WG5 r. r ;1IU,SPCvE1,0PM Urin 16.60
. • CONTRACTOR Water closet 16.60
Business name: ' - Ti D E A RI< LA (JDSGAPE Water heater 16:60
• Address: ' P0 Box 24 i o Other:
City /State /ZIP:' O 0�� c-(� 0' t OR. '1704 Subtotal
�
Minimum permit fee: $72.50
Phone: (503) t5' 04 - %r 013 Fax: Residential backflow minimum permit fee: $36.25
CCB Lie.: ' 11353 Ex.. 1 /3 i /O(p e l l//4 7 -= *F; Plan review (25% of permit fee)
t ( R t ' State surcharge (8% of permit fee)
Authorized signature i
A TOTAL PERMIT FEE
Print name: !J /EVE � � Datea �D� d{ 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- PermitAppdoc 12/03 440- 46I6T(I0 /02 /COM/WEB)
CITY OF TIGARD •
BUILDING DIVISION ,; PERMIT #: p j,.,, O ,- O Oi / j
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Ai q���iipj@ I
Inspection Requests (24 Hrs.): (503) 639 -4175 �f �..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
e'
SITE ADDRESS: I g- � LfeLd r �� rtZ CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE 45 3.19 r- rio 3 3
CONTRACTOR: ��„L� � PHONE :
Inspection Request Scheduled For: Date: 4-6 -- EX Pour Time:
Code # Inspection Description Confirm # Contact # Message
359 cl,,,,k,,,„c, -.
Corrections/Comments/Instructions:
0 JO ..----
. - -
-710-i c. ----. . -------
c...„, "/_-- : -.,:- .
7---. _,/...e.-7,,, AP
,Allidi i
Age / ' `.'..d At.; A( I , rte.
`PASS in ° ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL , CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: f lit( ( Date: 4 / I Phone #: (503) 718-