Permit •
•
CITY TIGARD PLUMBING PERMIT
PERMIT #: PLM2006 -10044
DEVELOPMENT SERVICES DATE ISSUED: 3/24/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109AD -12800
SITE ADDRESS: 14813 SW LOOKOUT DR ZONING: R -7
SUBDIVISION: ARBOR SUMMIT LOT: 026 JURISDICTION: TIG
Project Description: Backflow for irrigation.
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 97006 [PLUMB] Permit Fee 4/5/2006 $36.25
[TAX] 8% State Surcha 4/5/2006 $2.90
Phone : 503- 641 -7342 Total $39.15
Contractor: •
TRADEMARK LANDSCAPES, INC.
PO BOX 2410
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
•
Contact # : PRI 503 -504 -2013
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: 4 Permittee Signature: , q
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.
MAR -23 -2006 THU 02:49 PM FAX NO. P. 05
. RECEIVED
Plumbing Permit AppliWiton , 3 2006 FOR OFFICE USE MIA' •
City of Tigard Received ' � ./
Qate/BY: Permit Noll �,- d 0
13125 SW Hall Blvd,. Tigard, OR 97223 CITY OF TIGARD Plan Review
Phone: 503.639.4171 Fax: 503 "D DNISI•" 2 ° ,1 i Dole Ready/By: t'n Date/Bv: Other Permit No.:
r�
24 Hour Inspection Line; 503.639.503.639,4175 175 Ll ;Ali uri•: See Page 2 for
Internet: www.ci.cigard.or.us Notified/Method: T I & - to `Supplemeutol
TYPE OF WORK • ' • . :FEE* SCHEDULE
• E New construction ❑ Demolition For special Information use checklist.
Description I Qty. ]a. I Total
❑ Addition /al teration/replacemeut ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection;
. . CATEGORY OF CONSTRUCTION. SFR (I) bath 249.20
2 I - and 2- family dwelling ❑ Commerci4l/industrial SFR (2) bath 350.00
❑ Accessory building El Multi-family SFR (3) bath 399.00
D Master builder p Other: Each additional bath/kitchen 45.00
Fire sprinkler ( sq. ft.) Page 2
JOB, SITE INFORMATION AND •I•OCATION Site utilities
Job site address: 14 t E 3 Sim - 00K.Ch3 f )V Catch basin or area drain 16.60
City /State/ZIP: -r) t;/4RD 9 7 12-'4- Drywall, 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.: 26, Water service (no. linear ft.: ) Page 2
Fixture or item
fax _
ax map /parcel no.: _ _ . Absorption valve 16.60
DESCRIPTION OF WORK . ' • •• . ' • Backflow preventer I Page 2
NEW CONSTUCTION _ Backwater valve 16.60 —
Clothes washer 16.60
Dishwasher 16,60
• ® •PROPERTie OWNER ❑, TIN ANT : Drinking fountain 16.60
Ejectors/sump 16.60
Name: West Hills Development
Expansion tank 16.60
Address: ]5500 SW Jay ST. Fixture/sewer cap 16.60
City/State/ZIP; Beaverton, OR 91006 Floor drain /floorsink/hub _ 16,60
Phone: (503)641 -7342 Fax: (503)641 -7661 Garbage disposal 16.60
CONTACT PERSON - Hose bib 16,60
® APPLICANT -
Ice maker 16.60
Business name: Same As Owner.
Interceptor /grease trap 16.60
Contact name: Ric K LAN! eR Medical gas (value: $ ) Page 2
Addr CSena k S � UF> Primer _ • 16,60
City/State/ZIP: Roof drain (commercial) 16.60
Phone: (503 ) 641 -7342 f Fax; : ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pun 16.60
l -nail: RI-AN Ie.tz.@wEST HILLSD _EVEI.oPME T. COM, Urinal 16.60
. CONTRACTOR . • Water closet 16.60
•
Business name: " _.(A A R1< LA LAKDSCA PE _ Water heater 16.60
Address: ' PC {7OX 2 4 (p Other:
C C( O d 7O l-� Subtotal
City /State /ZIP' •
��� � x R Minimum permit fee; $72.50
Phone: ( 20 (? Fax: Residential backflow minimum permit fee: $36.25
` CCB Lie,: '' 1 1353 E . ( 31/0 CHI/Ad � 4-- Plan review (25%ofpermit fee)
State surcharge (8% of permit fee)
Authorized signatur D _
� � TOTAL. PERMIT FEE
Print name: x r Ei ,' cZ I Date: / / This permit application expires ifa permit Is not obtained within
t80 days after it has been accepted as complete.
"Fee methodology set by Tri -County Building Industry Service Board,
:...,..:.,i..,an.•...:,.m •�_a..mB.� „dn�. iA lol Ado- -0el fill lala'JCOM/W69)
1
CITY OF TIGARD - a 19(,IM 260(2 - , 60 4
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171 .� p y i ' a
Inspection Requests (24 Hrs.): (503) 639 -4175 -.
: iif
INSPECTION WORKSHEET FOR DATE: ■ At /o'7 TIME: PAGE:
SITE ADDRESS: \ b i 3 L_b G . CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: , Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
.c► PIS,,,,,,,,, b (AA P F7 t
Corrections /Co ments /In tructions:
r\ } 1 (4 4 (/ ;
d PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C/� V Date: 1 e6.1 Phone #: (503) 718- 2N L'Lf
./-'17