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Permit � CI T ` F TIGARD PLUMBING PERMIT ` COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00186 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/2/2008 PARCEL: 2S 111 CC -17500 SITE ADDRESS: 10310 SW HIGHLAND DR ZONING: R -7 SUBDIVISION: SUMMERFIELD NO.4 LOT: 226 JURISDICTION: TIG PROJECT: CAMPBELL Project Description: Installing backflow preventer. CLASS OF WORK: ALT 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 PHYLLIS CAMPBELL 10310 SW HIGHLAND DR Description Date Amount TIGARD, OR 97224 [PLUMB] Permit Fee 5/2/2008 $36.25 [TAX] 12% State Surch 5/2/2008 $4.35 Phone : Total $40.60 Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD. TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 692 -5945 FAX 503- 692 -0768 Reg #: LIC 7804 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: — � Permittee Signature: lt GVti /■ Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Y \. t r . �. . M_ . ila�.mbing Permit Application Building Fixtures ures FOR OFFICE USE ONLY ' City of Tigard Pr EC;E t ' � )Received 1 � DatelBy: 1 /Ui «7 PennitNo.: /I-M/,/ .0 E- --Oa; �. .4 13125 SW Hall Blvd., Tigard, OR 9722 e - Phone: 503.639.4[71 Fax: 503.598.1960 Plan Review Inspection Line: 503.639.4175 MAY 0 200 ate/By: Other Permit No.: TIGARD Internet: w�w.Ctgard Or.gov Date D Ready/$g rurir. El See Page 2 for :7-!.,':-'.e.:.: . ,_ .,.... _ a . d : - ,., Notifed/1 i :TYPE' OF::WO ,: .:,. `:.; :'�_ c i 4' : ': :: �� SC Supplemental Information ew construction � o_ htioa .., r . y .,. � For s :FE HE DLfGE ; �.i'.,:;` '..?.'-.-'_•:-....,..-::.':.:: •. <; 5 ) "" t�'kit(3 ; 1Ag4 a,ta9t v ecral in ormvo%anuse checklist Description Qty. Ea Total Addition /alteratiortrreplacement ❑ether: New 1- 2- family dwellings (includes 100 ft for each utility connection) , CA.TE,GOR7( O F =CONST iiictiOti :` ;> :i =: ;: - 4 ;':`; :. '.' "'' SFR I ba .._ ...... ... ,, , .: , -_ (1) 249.20 ❑ I- and 2- family dwelling ❑ Commercial/indusb , SFR (2) bath 350.00 ❑ Accessory building 0 Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 Fire sprinkler ( sq. ft) Page 2 _... ''''' JOB. SITE: ORM ti6N' . : AND LOCe TI • ON - -- Site utilities Job site address: i o j / 0 StJ 1-6 it, , `( (LrKL� On t.e.„ Catch basin or area drain r 16.60 City /State/ZIP: j --- G �(, 0 � ei 7 . -_3 Drywell, leach line, or trench drain 16,60 Suite/bldg. /apt. no.: C Project name:A- ," -1 -{- J f') if !s Footing train (no. linear ft.: ) Page 2 Cross street/directions to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear It: ) Page 2 Storm sewer (no. linear ft.: ) Paee 2 W Subdivision: L Water service (no. linear ft.: ) Page 2 j L , L , YY7 1Y1 ei" + e f (� Lot no.: B Fixture or item _..x no.: & �. �r e_�map/parcel :.- ;;:., on valve :DESCRIPTI ©N .OF •WOR x .. - .._. ... .._ ... ., . , ::::.� Bac owpreve I �( .� Page 2 Li �i')(.(_ SC Ct -� -P. I C)tD G4..._4-1-- / C e Backwater valve 16.60 Clothes washer 16,60 Dishwasher 16.60 Drinking fountain 16.60 :;_Ek.:P.ROPERT�;1p`IY11ER:;� _'_-` : � >�'. ❑ �: ' _ r E 16.60 Name: �t' . Li ! 1 i s. GeZ -/'Yt p he-) i Expansion tank 16.60 Address: [ C.l 0 S- Lli /-}'1 i f'i (o.`v)Ck_ DP-0--- Fixture!sewer cap 16.60 City /State/ZIP: fl CI U- '1.�.. G j' '7 .-33 Floor drain/floor sink/hub 16.60 Phone: ( ) b Fax: ( ) Garbage disposal 16.60 . _ Hose bib :•... <.: .[]CgiVT:3CT.= PERSON ,_;:._ 16.60 : .:�- : .- ..?:..[i.� = ::::- ::,.:,: -;::..,;::.'...• ..., .... Ice maker 16.60 - Business name: Lac:{ _ t4t _ OY? C� N t(, Interceptor /grease trap 16.60 Contact name: t 1 f f � � � $� C. � �C 1 '�� q -(_ Medical gas (value: $ �) Page 2 Address: f )- -(:j() ,(„C / fl (�_, f' Li Primer 16.60 City /State/ZIP: . 77 . ..,L Cte0 vL I G Q /' ---X1)&0---- Roof drain (commercial) 16.60 S ink/basin/lavatory 16.60 Phone: (5-6,7)) (D) L J � - ' 9 t_iS Fax: :(SC (.0Cf ,R _C'7 Tub /shower /shower part 16.60 , E -mail: Urinal 16.60 '.' _:. _: - i'-7, :, -:. _ :o , -- .. TR =- ` - - _ . -.. ,.._ , :-:�:. - :_ .:._. ,::_ , Water closet 16.60 Business name: (�L - 1 (�S (et y) arc 9 o -- k( - r, Water heater 16.60 Address: ) >)-o (11 S w al r , „c.., f � L/ 2_,i: Other. City /State/Z1P: - I�- 1� `� 0 1` 1 Subtotal Minimum permit fee: „.$0 Phone: (-_-5) /p - L-/ S 3 ' Fax: (5- 6)67 7LA -(` 76 ;:c2. Residential backflowminimum permit le�:5362 3LI, ;�,5 CCB tic,: S Li Plumbing Lie. no.: Plan review (25% of permit fee) rr State surcharge (12% of permit fee) L ,3 Authorized si : ' �'�� I ``pu-��' L-t✓ TOTAL PERMIT FEE Lk) ; co () Print name: t._-_-,,.[ J r cr r L ) } Date: / --O y 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. t:\ Building `PertritstiPLNff- 1'era.tApp dec 12!27MO6 440 4616T001021COJ11WEn) 'd 99L0 u d99:1.0 80 L0 Aew CITY OF TIGARD _ . • BUILDING DIVISION PERMIT #: PLM2008- 00186 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/312008 Phone: (503) 639-4171 w iii61 Inspection Requests (24 Hrs.): (503) 639 -4175 �I L INSPECTION WORKSHEET FOR DATE: 5/22/2008 TIME: 6:59AM PAGE: 7 SITE ADDRESS: 10310 SW HIGHLAND DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.4 LOT #: 226 TYPE OF USE: PROJECT NAME: CAMPBELL DESCRIPTION: Installing backflow preventer. OWNER: CAMPBELL, PHYLLIS PHONE #: CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503- 6915945 Inspection Request Scheduled For: Date: 5122/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 070282 -01 503.692-5945 N Corrections /Comments /Instructions: • XPASS U PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: (31) \N•n- ..n Date: 6)22.), Phone #: (503) 718-