Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 - 10043
DATE ISSUED: 3/24/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109AD -11200
SITE ADDRESS: 14846 SW LOOKOUT DR ZONING: R -7
SUBDIVISION: ARBOR SUMMIT LOT: 010 JURISDICTION: TIG
Project Description: Backflow preventer 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 Description Date Amount
15500 SW JAY ST
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: 71(�0 r Permittee Signature: 73.2.,-e. Pf \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.
MAR -23 -2006 THU 02:48 PM FAX NO. P. 04
Plumbing Permit A -; t � i I FOR OFFICE USIi ONLY
City of Tigard �ppp pp((�� c 00 6 Received Permit Na, -,��[
12125 SW W Hall Blvd„ Ti erd, OR 972239°tAR Date/By: — �� tom" ‘7,05/7
Plan RevjeW
Phone: 503,639,4171 Fax: 503,598,1960 knaaat i� Dete/13y, Other Permit No,:
ail�l
24- Dour Inspection Lino; 503,G39.� {17S DF TIGARD ' I Date Ready /6y; Joriz� E5 See P age : t'
Internet www.ci,tigtsrd.or.us r�ut`J1 D1 11S1 Naliierl /Method: I xl7` Supplemental Information
TYPE OF WORK . FEE* SCHEDULE •
rg New construction (] Demolition Forpecirrl informorlon use c /recklrar.
, --- Description J Qty, _ En. I Total
❑ Addi tion /alteration /replueement ❑ Other; New 1- 2•frmtly dwellings (includes I00 It. for each utility connection
CATEGORY OF CONSTRUCTION• SFR (I) bath 249.20
® i - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 -
SFR (3) bath 399.00
❑ Accessory building ❑ Multi- family -- --
Each additional bath /kitchen 45,00
❑ Mester builder Q Other;
-. Fire sprinkler ( sq. ft.) _ Page 2
JOB SITE INFORMATION AND LOCATION _Site utilities
Job site address: ) - Stk L{aO.j{J7 Q' Catch basin or area drain 16.60
City /State /ZIP: T) GAIL), Og 9 7 .2-2- 4' Drywell, leach lint, or trench drain 16.60
Suite/bldg./apt. no.: (1'rojeel: name Footing drain (no, linear ft, :,___) Page 2
Manufactured home utilities 1 10,00
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.; IQ Water service (tin, linear R,; �) Page 2
Fixture or item
Tax neap /parcel no.: ' -
o.: -
- Absorption valve 16.60
• .' DESCRiP.TION Of WORK . . • ' Bacl:tlow preventer f Page 2
NEW CONSTUCTION Backwater valve __ 16.60 --
Clothes washer 16,60
Dishwasher 16.60
1 fountain _^
.PROPI>,RTY OWNER•., ...: ❑, TENANT _
Aria king fo I fi
Ejectors/sump 16,60
Name, West Hills Development ■Y ):Xpansion tank 16 :60 •
Address: 15500 SW Jay ST. Fixture /sewer cap 16.60
City /State /ZIP: Beaverton, OR 97006 Floor drain /flour sink/hub 16.60
Phone: (503)641 -7342 Fax; (503)641 -7661 Garbage disposal - 16.60
Hose bib 16.60
® APPLICANT CONTACT PERSON [cc ninl:er 16.60
Business name; Same As Owner. T Interceptor /grease trap 16,60
Contact name: G K LAN 1 E Medical gas (value: $ ) • _ Page 2
Address: ( SittME AS ,4P)OVE) _
Primer 16.60
City /Brads /'LIP Roof drain (commercial) 16,60
--- — Sink /basin/lavatory 16,60
Phone; (503 ) 641 -7342 Fax: : ( )
C r W r `` G rr- Tub /shower /shower pan 16.60
E R LAN t E Z@ I ST H I LLSb vI N r CPM, Urinal 16.60 .
. . CONTRACTOR Water closet 16.60
Business name: ' " RA'p EM A RK Lid KDScA PE Water heater 16,60
Address; Po Box 2.1.1 -Eo Other:
Suhrow!
City /State /ZIP: • 0RE(5ON G(T! OQ q70 Minimum p ermit fee, $72,50
Phone: (503) 1 6Q4- 2013 Fax: Residential backflow minimum permit fee: $36.25
CCM Lie,: • 1 1353 Ex • 1 31 Ole Cif/ /W1eh'0 ' ‘0 7` - Plan review (25% of permit fee)
State surcharge (8% of permit fee)
11 t
Authorized signature. TOTAL PERMIT FEE
Print name: ' r 'EVE, ( ` J S - Date; 3 /21/06 This permit application expires if a per mix is not obtained within
180 days after it hiss been accepted as complete.
'"Fee methodology set by Tri'County Building Industry Service Board
- .:........... .,m, 4d0•.1616T(I o/a2/COM/WEn1
CITY OF TIGARD �' v
.
BUILDING DIVISION PERMIT � ®�° � ®0'� -�
13125 SW Hall Blvd., Tigard, OR 97223 1 a / 6 DATE ISSUED:
Phone: (503) 639 -4171 ug 111Il i I I
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 1 4 f 7 TIME: PAGE:
SITE ADDRESS: 14 1 La Lil es it,-0 Vt7 0--r. 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
4 eI. (, , et r 0 k%
Corrections /Com nts /Instr tions:
Or)
l '().13'..."--
( .
9
tgl ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �� Date: 1/61/4 Phone #: (503) 718- .2—f°,54