Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00090
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/17/2006
PARCEL: 2S 110DC -01000
SITE ADDRESS: 11295 SW MEADOWBROOK DR 1 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT: 014 JURISDICTION: TIG
Project Description: Unit1, install washer.
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 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
SUMMERFIELD ASSOCIATES, LLC Description Date Amount
HSC REAL ESTATE
1500 SW 1ST SUITE 1020 [PLUMB] Permit Fee 2/17/2006 $24.25
PORTLAND, OR 97201 [TAX] 8% State Surcharl 2/17/2006 $1.94
Phone : 503 - 546 - 5712 Total $26.19
Contractor:
RAY'S PLUMBING
15200 NE CAPLES SUITE C REQUIRED ITEMS AND REPORTS
BRUSH PRAIRIE, WA 98606
Contact # : PRI 360 - 892 -8700
FAX 360 - 892 -9644
Reg #: LIC 33217
PLM 37 -149PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503-246-6...:.t or 1- 800 - 332 -2344.
Issued By: 1110 7 4 , ,24... c ..„ Permittee Signature:
503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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^`- 02/10/2000 1.1:50 FA$ 5035981960 CITY OF TIGARD 2 004 ,
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�u»atbin +e1t'mitA tO1l 1tn i:', r I '1)Nf 1 •
-City of. Tigard � -_. a w' Permit Na: L , (o boo -D
131;5 5W Nall Blvd., Tigard. OR 97"323 Pant UV • Ottt• ' - nit No:
Phone: 503,639.417 YEA: 503.598•1966 � r.. y � .,
7A - Hour Inspection Line: 503,039.4175 ° . Ooze ltendyr> 0 Set Page x ter
Internet www.tigntd- or.gar Noafi tothnd; 9wppltmeectet
' TYPE'.OF Q R]t . • t . U74., . • , • G lt
' - - For - ute cherJdisL
❑ New constrcrriom ❑ On ■• olkion on T oToak 1
[{ Addifonlakerationfreplaremertt 11 • then tiew.1- 24 aity dwellings (Includes 100 ft for each utility connection)
I ' 'C.A.itGQiitr O CGivS't'RLfnOri:, ,. ' I, I 'i.!, SPIt :(1)bath 249.20
[2 1- sad 2- family dwr U ttg 0 C. :040/industrialSEI ) 350 -00 •
o .6.t+>v07 thAlcliug VP ultidemily A) both -- = - 399.00 •
Sack additlunal bw hndta1 45.00 J •
0 Maeter 1naidor 0 tea: Fin sprinkler ( -rte I.) Pate i '
' 400 oin INFO MATTOI A'LOCAir-oly . _ • .. • � ptilinea -
lob site address: a
*-1:)0(4.) l'IM.3110•2111 d ch basin or area drain 16,60
CityJSetts/ZIT j V, ) biz___ 72_2_+'. De. veil, 1¢tclaHoe,orI:molldrain 16.40 .
1 > a,amE dwlt, (no. Iineae t�: __J Page?
Suiulbldt3A : �tT 1 Prgjoetnant .t[� Manlifieturedborneurilities 110.00
Crpyg slxsevttlrcodoara to job site: `' ,-.} � :. ZG 3 Mnnheloa 1 6.60 .
AMIMI
£) -. : Ci V4 _ Rant drain e0nttoCtOr 16.60 • •
• S:utitary sewer (no. Virrxtr Ft; __) _ Pent 2
Sterm ocwer(nalineeric :, 1! Pop l
Subdivision: �� - ... t taa : mortar MO= eOn- lin= it: ) Page 2
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- __ �--', P{1;taro or horn
Tax map/parcel nu,; AEzoepiionval�re 16.60 •
DESCRIPTION OF. WORK - it ^.. 1 l o w vreventcr Pa6e 2 Mill .
• " 16.60
. a- t� ' r tlaal muterYAW* Mil
tom.
Cluthcswaoher M- 16,60
nR,w,uuhQ 1660
1]rmking faamta n 16.60
QP6RX10.00IRtER �" li .' • .' �t; 16,60
N$ as+t C..; 4_ . nit. iG . is allusion tank 16,60 ,
Address: - ':,,,,., , - 1 e...- , 2. _ 1- ' I Pb tselaewer can 16,60 •
City/Seine/Mt . •, i , e - . ( Floca drain/floor sink/hub 11111 14.60
• . y F>u t � , G&bage tfisposal 16,60 r
Plaona .,1 r to ►
Nes, ,
bfb 16.60
blai'LFCAITIC . ! ' Ci N't'
OACx 1 igcsOh1 lee maker 16.50 MIE
Stv nG56nanre: 8\ 4 .p....p c -�'t p' ✓C t e r4 lntorseptederametrap 16,60 ;
, Contact Stance: 1 j - - 1�1: ^teal l'�19 ohm: : s' �„- 1 11111i= Adtlre S; 1 . CI - 2 N4-&. , C..51-LL Z Primes MI 16.60 • •
City/State/ZIT: L Re atdraia (entwined al) 16.60 1111111111 •
City/State/ZIT:
p�af =.�l=- ,3
Siunasinflavatory Ell 16.00
note: (3C,C) c -.. - = Fax; : af✓) r ice _;c .
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Toe'alrow�oviahowerpan _
1.1:1.01 16.66
17pltl? ACtOR Waal-alotiet 16.0
t tutliZen emu: fd If‘ ` '� t LA en. W I n f , Water beater 15.60
Addtreas: , 0 a o � S Other. __ -
Stegall City Sumer +: P r• ' .; , ' ■ 6 d nrn parra:t � .,; s
Phone46 0 ) , ' 7 D D F ( ) ( 1 ) $'' Z ' v I- Rasldandai gacktlow mrainum permitfl:c: $31.25 ,. -
CCB Lkc.: 33 2_17 ,--- Plumbing Lie- 11.13.: 3 7., / 4l 7 p J Plan *view (25144Pmautflea) Min
Shan aordharge (896 of permit fnc) �
Authorized signature: � � TC TA.t. PERMIT P2E Fr l •
Plan name: r ,, / eAle rG ict.e. Date: This permit application copircs We pa-mit h not olrtntued with n
•
300 dnytt p*er :e hap born aenept a AO comp'ela.
•
'r methpdo1ogy set byTrl -County building Industry SS[rvlse Hoard.
t: Wait'idoty.w.:wel.rwCaantv.yoJrw Israot1s 4tnjairrntMu0oure I '
T 'el ia{79G 288 09E ZutganTd sFed d82 :E0 90 OT qaj
CITY OF TIGARD PL
BUILDING DIVISION PERMIT #: z6 at:7- 6 0 9 0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 !'�rym�i�l
Inspection Requests (24 Hrs.): (503) 639 -4175 ��' W
INSPECTION WORKSHEET FOR DATE: TIM 0 PAGE:
SITE ADDRESS: 1 / ) C ASS OF WORK:
SUBDIVISION: I LOT #: 1 , r, TYPE OF USE:
PROJECT NAME: `j
DESCRIPTION:
OWNER: PHONE #:
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CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3-(„-o c Pour Time:
Code # Inspectio Description Confirm # Contact # Message
3 " 0 1/1 - 7
Corrections /Comments /Instructions: /
,= ` / , i. ` , ,
R
i // z / / ,/,' / / ';
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SS _ PARTIAL APPROVAL El CANCEL fl NO ACCESS.
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: "�:e_ Date: 43 /� `� Phone #: (503) 718- V� `