Permit C ITY OF TIGARD PLUMBING PERMIT
, ,� DEVELOPMENT SERVICES PERMIT #: PLM2005 - 00538
el I DATE ISSUED: 10/13/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S114BA 05500
SITE ADDRESS: 09970 SW KENT CT ZONING: R - 4.5
SUBDIVISION: PICKS LANDING NO.2 LOT: 085 JURISDICTION: TIG
Project Description: Backflow preventer for irrigation.
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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
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DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
GLORIA CRAIG
9970 SW KENT CT Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 10/13/200` $36.25
[TAX] 8% State Surcha 10/13/200E $2.90
Phone : 503- 430 -7070 Total $39.15
Contractor:
DOWN TO EARTH IRRIGATION
13075 SW PACIFIC HWY
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Phone : 503- 684 -3500
Reg #: LIC 8169
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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: i '7 � r L 4 ,2; C Permittee Signature: , 91.c
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.
FROM : FAX NO. : Dec. 25 2002 05:03PM P2
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Budding Fixtures I D --
.Plumbing Permit Application FOR OFFICE USE ONLY
City of Tigard OCT 12 20 ► . Received / I� %,� s i l`- Permit NOT) . 4 ' ,( 0_5 ;
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax 503.598.1960,,-, -- ar / 'rya ; r° p''+ B .
Other Permit No.:
24 Hour Inspection Line: 503.639.4175 L i 1 I. �} • . � . ;`' _ J + , Date /By:
h ardor us T f 7 - , Dare Reedy/By; J 63 See Page 2 for
S p lli ,M N a v 1 Nodfied/Method: 3p l Supplemental information
Internet www.ci on
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ew construction ❑ Demolition For special infornrstion use checklist
Description I Qy- I Ea. I Total
❑ Addition/alteration/replacement ❑ Other. New 1- 2- family dwellin s includes 100 ft. for each utility connection)
6'� I' T,,,.4}tl v aT.�t7Ci �R" uT.°9" a: . !..,i]'4 r �r'r N .. ( O
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i'1..Ls .., va rtY ."� i , rt., 1..��.;� � Q :31 �'rl�E����i..i , u `'!r' �f:�f SFR(1 } batl 2
t , �kwr _. �,F .:r�a _ 249.20
1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
0 Accessory building ❑ Multi- family SFR (3) bath 399.00
1:1 Master builder p Others Each additional bath/kitchen 45.00
I� .nr � , 2 - r+� [r nr Fire spunkier ( sq. ft.) Page 2
rkee -ItOtt,'frw. I� ,z' °�fivrf5: iP { ti � `� �":,'� "� " l Mr\+�I' --site _ g
�l A. �, +tu F i,J I tp v ... NNN r�.... � f7e1��b:,�;�rr{ �.,:, 7%.'_ �14S. e. 7r�z.' �' �k": lil�✓ � +IuM�f('.�i�(��[+»�,..r.S��B,�+ .SitC utilities
Job site address: "' - r I 1 _ ..g4& Catch basin or area drain 16.60
City /State/ZZP: "T' 7Qr oz Q1 - Drywell, leach line, or trench drain 16.60
Suite/bldg- /apt no.: Project name: Footing chain (no. linear ft: __) Pagc 2
Cross street/directions to job site: • Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sower (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Pagc 2
Subdivision: • f Lot no.: Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: Fixture or item
1 ti U (" } }�`l�Ct } a�� I , a�Jt r Absorption valve 16.60
fill: iflIIi T iM - Ti ai wtl 7 •d (`r.77,, �, .M4K.,p � l •'.:
mt.r al ir,���er .s:]f� A'i r aS b � he r. .d;, "�i.T !1 5 ����1Vtir ?c.lzad "` i. V 1 Bac
1, 8 3 `�
rl .. , . o kflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Fifjr �;nn�r ` �r :��
l� it ,� 1 t Y i "7illlt i( y r^ t r e �!�¢¢^7 II ATP i .y ry i t "� t' II Drinking gitlf,+l2 .,vc • -l I lip �! r rA fl't1 . y i r,'{R a ltr1'" I. 1: �,.. , i * r g fountain 16.60
�">, imv - g. �,,.±aaW t.� �ilLc`Vf�Y Yl;'y ,�..rifJSl�, 1 le+ , I1rF F� +�I''I. rr '��
Name: F ' ' Ejectors/sump 16.60
A r i a Cc qs t Expansion tank 1640
Address: 9 of -7 5 t o K-p�'i } a i•. . Fixture/sewer cap
_ 16.60
City /State/ZIP: , - . , r - ® Q .41-1-r- y Floor drain/floor sink/huh 16.60
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Phone
(J �� 9' Q 1 01 (� FaX ( ) Garbagc
£� Ira >> (f r 'y rlv � r �, �. e 16.60
1rE 4 ni l r -F � 1 P v y1f iR of 1CRi $. 4 r }�` 1 E �'d T' 14; i A 1 �' S 1 r ,v an q Dose bib
dic.7 %14.. . _5�rc.,:. • W s `, r i rc* f'. r t r > r ! 6.60
��� I..,:r..,Cd[;' ���, '4 11w , t �, �i ±r.L.�,.�J't�a i; %ka,!},,�!? � � �tif � � {4
Business flame: De 4A , Ice maker 16.60
i • 4` Interceptor /grease trap 16.60
Contact name: ..... • 9h ` , 0 ,
y �
Primer cal gas (value: $ ) Page 2
Address: r - 0.
Primer 16.60
City/State/ZIP: ; . r Roof drain (commercial) 16.60
::: � Sa O y 16.60
Tub /shower /shower pan 16.60
Urinal
l [r+( r rr�R ai°c a 7 �� d�'bfi la pfi '(.� ru r *�`xq� " .'�...'aiC9`�iW7ry'� ' + r �� , t
i 7 51: r ne 4...::i.:',`?:-.A. I ` 7 '7i - 1R;'x�l� i ,1 a' tau � l • . ' , t ii% i . l sl Ir..,-1.1 7t 1 6.60
'.' .,.. ' `-°�r ..te F .N Water closet
Business name: ' 16.60
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• Water heater .
Address: , i .• 16.60
Other: _
City /State/ZIP: ... , 4 .W Subtotal
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Phone:
ECM - ) 446, a oa Fax: (S q • a • • d gackflow minimumiermit fee: $36.25
Plumbing Lic. no.: __._ l ba Plan review (25% ofpermit fee)
Authorized signature: _ State surcharge (8% of permit fee)
TOTAL. PERMIT FEE 71
Print name: Date: a 7 4 , This permit application expires if a permit is not obtained'witfrn
*Fee 180 days after it has been accepted as complete.
:�Buiiding�ie nnuApy,Qoe 12103 methodology set by Tri- County Building Industry Service Board.
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