Permit -4 i L a CITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00290
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/8/2008
PARCEL: 2S 109AD -11400
SITE ADDRESS: 14892 SW LOOKOUT DR ZONING: R -7
SUBDIVISION: ARBOR SUMMIT LOT: 012 JURISDICTION: TIG
PROJECT: BANIYA
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
PRADIP BANIYA
14892 SW LOOKOUT DR Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 7/8/2008 $36.25
[TAX] 12% State Surch 7/8/2008 $4.35
Phone : 503- 620 -6421 Total $40.60
Contractor:
BRUNER PLUMBING
PO BOX 23985
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 624 -4880
FAX 503- 624 -2173
Reg #: LIC 81837
PLM 26 -445PB
•
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: 73 7?//
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.
Plumbing Permit Application Cf AD
Site Utilities ^Lo FOR OFFICE USE ONLY
City of Tigard t 1` O u � Permit No.: / All" = ��
u 13125 SW Hall Blvd., Tigard, OR 97223 •JV {�
c P Plan Review
Er
Phone: 503.639.4171 Fax: 503.598.1960 (*AI l O , Otl>erPermitNo.:
� =my,
TIGARD Inspection Line: 503.639.4175 `` r.DIV1a Date Ready /By: Jum- fa See Page 2 for
Internet: www.tigard - or.gov v� i� Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE '
• ❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
® Addition /alteration /replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION • SFR(1)bath 249.20
® I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( , sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION • . Site utilities •
Job site address: 14892 SW Lookout Dr • Catch basin or area drain 16.60
City /State /ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60
Suite/bldg. /opt. no.: 1 Project name: Footing drain (no. linear ft.: ) Page 2
'Manufactured home utilities 110.00
Cross street/directions to job she: Bull Mtn Rd
Manholes 16.60
•
Lt on Greenfield Dr Rain drain connector 16.60
Li on Winterview Sanitary sewer (no. linear ft.: _) Page 2
Rt on Lookout Dr • Storm sewer (no. linear It: _ ) Page 2
Subdivision: `Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
. Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer x Page 2 24.5b
Install sprinklers in the backyard. Backwater valve 16.60
td / l0•J Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER I • ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Pradip Baniya Expansion tank 16.60
Address: 14892 SW Lookout Dr Fixture/sewer cap 16.60
City /State /ZIP: Tigard, OR 97224 Floor drain/ floor sink/hub 16.60
Phone: (503)620 -6421 Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
® APPLICANT ❑ CONTACT PERSON Ice maker 16.60
Business name: Same as above Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ _) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: ( ) 1 Fax: : ( ) Tub /shower /shower pan 16.60
E-mail: Urinal 16.60 •
CONTRACTOR Water closet 16.60
Business name: Bruner Plumbing Water heater 16.60
Address: PO Box 23985 Other:
Subtotal
City /State /ZIP: Tigard, OR 97281 Minimum permit fee: $72.50 k ',
Phone: (503) 624 -4880 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: $ 3? 0 Plumbing Lie. no.: P lumbin /'N 06 Plan review (25% of permit fee) $9-
4 L
! , State surcharge (12% of permit fee) ti . %
Authorized signature:
/ TOTAL PERMIT FEE 44 p , (DO
A Date: 7 r� C f� This-permit application expires if a permit is not obtains d within
Print name:
1Q I2(L>!/ • 180 days after it has been accepted as complete.
11 / *Fee methodology set by Tri- County Building industry Service Board.
I :diuddingd'ermia doe I2.27i0b 440- 4616T110i02'COMIw'EB)
T - d 90 =TT 80 80 Inc
r. .
CITY OF TIGARD , _
BUILDING DIVISION PERMIT #: PLM10013-00290
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/8/2008
Phone: (503) 639 -4171 ,�
Inspection Requests (24 Hrs.): (503) 639 -4175 ' W- °-_ I
INSPECTION WORKSHEET FOR DATE: 7/29/2008 TIME: 7 :01AM PAGE: 50
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 14892 SW LOOKOUT DR LOT #: TYPE OF USE:
PROJECT NAME: ARBOR SUMMIT 012
BANIYA
DESCRIPTION: Installing backflow preventer.
OWNER: BANIYA, PRADIP PHONE #: 503-620-6421
CONTRACTOR: BRUNER PLUMBING PHONE #: 503 - 624 -4880
Inspection Request Scheduled For: Date: 7/28/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 073342 -01 503-620-6421 N
Corrections /Comments /Instructions: g06 03 gar,
Te e 04,u r 6_e- I S,Q,,,A, - re r ac -(A. l-r - rb (--) e V A -A„
CA tr C 6 1...c.L.-71 94.—/
,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CR ‘44.....).- f ) \% Lit. Date: - 3 12):71 I 67) Phone #: (503) 718-