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Permit 1 • 4 c k. CITY TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PE DEVELOPMENT PLM2006 -00484 ��I DATE ISSUED: 10/17/2006 +L 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 25111 CC -06500 SITE ADDRESS: 15955 SW GREENS WAY ZONING: R -12 SUBDIVISION: SUMMERFIELD NO.2 LOT: 092 JURISDICTION: TIG Project Description: Rough in shower and washer box. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS: 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: 1 SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES RENEAU, CHARLOTTE J 15955 SW GREENS WAY Description Date Amount TIGARD, OR 97224 [PLUMB] Permit Fee 10/17/200€ $72.50 [TAX] 8% State Surcha 10/17/200€ $5.80 Phone : Total $78.30 Contractor: PIPELINE PLUMBING PO BOX V -108 333 S STATE ST REQUIRED ITEMS AND REPORTS LAKE OSWEGO, OR 97034 Contact # : FAX 503- 624 -1926 PRI 503- 624 -1906 Reg #: LIC 158260 PLM 3 -510PB 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. Af Issued By: et4 Permittee Signature: 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. i ,. Plumbin Permit Application(L I '1..l :, r' FOR OFFICE USE ONLY 8!_ City of Tigard �" Received PermitNo Date/133r. �b .: • 13125 SW Hall Blvd., Tigard, OR 97223 Y �L /DSO �rvl ° z �� O � � � 9 • Phone: 503.639.4171 Fax: 503.598.19�Q�� t l ' 2006 Plan Review v t) Date /By: Other Permit No.: Inspection Line: 503.639.4175 T 1 G A•R D Date Read /B ry,� Internet: www.tigard or.gov y o ( Supplemental See Page l Information t . .. N _,. ,� !� d Notified/Methad: Supplemental Information TYPE OF W'()RI:t 1 VI L��'...� - q .-, -••,Ys T 110TC i •. FEE" SCHEDULE New construction :� TQ�I�emoliYion For special information use checklist Description 1 Qty. j Ea, l Total �' Addition /alteration/replacement CI Other: New I- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 249.20 MI - and 2- family dwelling 0 Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 ID Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: I4 C{ T-' t L- , e r � C� (ir[ ' ), a 1) Catch basin or area drain 16.60 City / State/ZIP: i , � a t 0- d 00, cil c 'C7 (4 ( Drywell, leach line, or trench drain 16.60 Suite/bldgiapt. no.: I Project name: ✓' Footing drain (no. linear ft.: ) Page 2 �� ���j� Manufactured home utilities 110.00 Cross street /directions to job site: ` - i . f 9 -(� 7 ` s 'f1 t ,, e .r Manholes 16.60 tr ,h� �.`) 1 . �.C1��+A, r1�1∎( Dorbrx.i rt Rain drain connector 16.60 P- 1 - 5y ' Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer(no. linear ft.: ) Page 2 Subdivision: Lot no.: Water service (no. linear ft.: ) Page2 Tax map /parcel no.: Fixture or item Absorption valve 16.60 DESCRIPTION OF WORK Hack #low preventer Page 2 o , C c J 11`1 pi (�b i u�C, 1t, Y > ht � t k Backwater valve 16.60 C.'.0C3 1 +,i -ham b e • Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 ❑ PROPERTY OWNER ❑ TENANT i Ejectors/sump 16.60 Name: &IA) f ' w � �- Expansion tank 16.60 Address: ‘ 9,,D. a, q ( t 12 -0 Fixture /sewer cap 16.60 City /State/ZIP: Lo 970 39 Floor drain/floor sink/hub 16.60 Phone: (52 Wp 3. c 3? V Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 • Ice maker 16.60 • Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) Fax; : ( ) Sink/basin/lavatory 16.60 E - mail: Tub /shower /shower pan _1 16.60 Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: pi. ;l p 1 Wrn l� ' , � RSA. C� t QQ Vs i Q�2 Water heater 16.60 , {� 1 � Address: ?�'� ,.-,, �a.t •Q "+ • f�l (f) v.-Ace V �i t?the 0G---Y) © ��` City /State/ZIP: I V p c -> go Ot C-?>4 / ?t I Subtotal h �/ `� l ` `1 Minimum permit fee: $72.50 Phone: (5 - ) j _ 9_, (,l - ) G (p Fax: ( sC 3 ) €gc--I ` 1c126 .. Residential backflow minimum permit fee: $36.25 ],,..572 CCB Lie.: I G--) psr% J Plumbing Lic. no.: 3._5 pp) Plan review (25% of permit fee) � > 0 (/ Authorized signature: t ` 17 / `, j � / > /\ State surcharge (8% of permit fee) l/ / ) / (/ TOTAL PERMIT FEE 30 Print name: p I (s `l \C u Pn D u - I •-r Thi per mit application expires if a permit is not obtained within 4 J l 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. z' d 9Z61- 1Z9 -EOS uaJej weed d9S =T0 90 91 400 . _ CITY OF TIGARD BUILDING DIVISION - PERMIT #: PLM92006 -00464 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2006 .� Phone: (503) 639 -4171 . *NM I Inspection Requests (24 Hrs.): (503) 639 -4175 ?+� '__.. INSPECTION WORKSHEET FOR DATE: 10/24/2006 TIME: 7 :02AM PAGE: 64 SITE ADDRESS: 15955 SW GREENS WAY CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.2 LOT #: 092 TYPE OF USE: PROJECT NAME: IvIIGON DESCRIPTION: Rough in shower and washer box. OWNER: RENEAU, CHARLOTTE ,.t, PHONE #: CONTRACTOR: PIPELINE PLUMBING PHONE #: 503.6241906 Inspection Request Scheduled For: Date: 111/24 /2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 038711 -01 503 -624 -1906 N Corrections /Comments /Instructions: / E 1 i tj: V ) PASS I I PARTIAL APPROVAL ❑ CANCEL NO ACCESS n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: '�v Date: /V a Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: PLIvI2006-00484 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2006 Phone: (503) 639 -4171 b t i� I Inspection Requests (24 Hrs.): (503) 639 -4175 __1. INSPECTION WORKSHEET FOR DATE: •12/13/2006 TIME: 7:04Am PAGE: 58 SITE ADDRESS: 15955 SW GREENS WAY CLASS OF WORK: SUBDIVISION: SUIvIMERFIELD NO .2 LOT #: 092 TYPE OF USE: PROJECT NAME: MIGON DESCRIPTION: Rough in shower and washer box. OWNER: RENEAU, CHARLOTTE J, PHONE #: CONTRACTOR: PIPELINE PLUMBING PHONE #: 503 -624 -1906 Inspection Request Scheduled For: Date: 12/13/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 040997 -02 971 - 235.6532 N Corrections /Comments /Instructions: ,e /2a S ° c--- ia'-'D 1-..- , .sad X9 -.5 �/#L' 2 I 1 . 2 0 (3 i• 1,be< , d D/Gce -i ;:;' t-c_.e i n P:i _S ❑ PArTIAL APPRO . ❑ CANCEL n NO ACCESS FAIL / AL • '��r PECTION ❑ ADDITIO ► .L FE' ASSESSED Inspector: 4 Dafe: Phone #: (503) 71 :_ CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2006 004i3A 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/17/2006 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 . INSPECTION WORKSHEET FOR DATE: 1/26/2007 TIME: 7 :00AM PAGE: 5 SITE ADDRESS: 15955 SW GREENS WAY CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.2 LOT #: 092 TYPE OF USE: PROJECT NAME: IMIGON DESCRIPTION: Rough in shower and washer box. OWNER: RENEAU, CHARLOTTE J, PHONE #: CONTRACTOR: PIPELINE PLUMBING PHONE #: 503 - 6241906 Inspection Request Scheduled For: Date: 1/26/2007 Pour Time: F RSc- Code # Inspection Description Confirm # Contact # Message A 3 Plumbing final 042589 971.235.5532 Y Corrections /Comments /Instructions: .5C-011— 1 • C N ) , 0 1 „ , - 7\T- ' - J J • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ GALL F'R INSPECTION I I ADDIT ONAL • ES ASSESSED Inspector: 7\ Date: II Phone #: (503) 718- -2A_