Permit C ITY oi TIGARD PLUMBING PERMIT
_MA. DEVELOPMENT SERVICES PERMIT #: PLM2006 -00089
� I � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2 06
PARCEL: 2S 5 2/1S110 2006
SITE ADDRESS: 11270 SW MEADOWBROOK DR 5 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT: 014 JURISDICTION: TIG
Project Description: Unit 5, 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 Surchari 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 or 1- 800 - 332 -2344.
Issued By: �j Permittee Signature: d1-1
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.
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r' 02/1012 000 .3 :50 FAX 5035981960 • CITY OF TIGAARD 0004
•
1u) bin a rl1 ApplCatiOn rt m t l 6 I to i:• l NI: 0 \I
City of 'Tigard
414 i Mice; '! �� ,�•. l..il r /rh►,. 13123 SW Wall Blvd., Tigard. Olt 97223 plan Oth - • - t No:
Phone: 503.639. Fax; 503,398.1960 .' ,.: -
24- Hour Inspection Line: 503,639.4175 M . 4 ' � j gam Reedp'Sy: I . ® See rage z for
internee www.tigard•oi.gov lion -• 1 . i , 6pppleaeeehel leruneatloe
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fa art!& ontrgfle,ralseeht
❑ New construction ❑ 0. o Total •
❑ AdditiaMaitCrarionhepl3CCmtart • Noel- 34subly dwell (Includes 100 A for each ul0'ty connection)
f ' •C'AiLtt3RY OF' CONsrazi xort; ' i, I '� i $PR {1) both 24920
❑ 1- anti 2 -rawly &Oita ❑ Caraeteit1) ft nstAttl -Eli 330.00 -
CI Acceassay building , bath 399.00
East additional bat /klub= 45.00
0 Mutatbuild= _ ' _ 0 Other: I�1ulh�nm 11Y ' F t�tl�lt>� ) —� pie 1 2
• ' 300 Oat $NFORMATI'OI41.A'lt)'1.ACATP Sltatilatea
Tub site address'. 11 270 --7:4 . Casco bash or area drain 16.60 03
Ctty/Stath r T7 c* 72 y 7 - " - A'•'we11, tine, orttvoaadrain
16.60
�p Sorting 41141i (no. limo fi _.) P:ge Z
S6rilcAslegJa13tn =WIT .T I Predectnarae- 0-t�31,�a.�aa i.) lH home utilities 110 0
Crimp ah aeVdheodtlpta to job aac,�f / �0. (} � , �(2 C�i fK MAnbeltp II 16.G0 . •
C> !f Rum din C011fectOr 16.60 all i
ga:riau s ewer {no. Fmeut R1 Pen I
Swat eewer(na linear •-!, ) I Pnge2 •
Stlbdivisionl Lot tha l Ware service (no. linear It: •�„) . � Page ?
Pirates or team
Tax map/parcel no Absorpti von aloe 16.60
• . • • • • . • •. DESCRBTIOri OF WORK- : ' • I: : The n = mkt. Pace 2 •
7 • $selmater% lva 16.60
QM* water l 1660
Dish/ alter 16.60
1]rmldngfonmtain 16.60
• iv „ • • ERT1P .OWf;
N ' • • : Cl"zsv,►rrt' • C eltltutauno l e,6o
a _ ty y - - _ F,rxa+slon talc 16.60
Addhess: I. - S..A-r , 1 6 , ,s- L.. - Plrlraelanrercep 1640 •
City/Srate/Z14! ' . g 1,,, __ c• • I Sect dtainMoor ninirA ult 16.60
•
Ga!bape tl WO601 1660 i
'6 Itiiila..r�`i�J�eyneRw�ea • 16.60
t11/11•1CA1'1T , .. • 'YA
NCr FIPOON Hc let e_bib 16.60
'Business thine: C9 j.' l o , R (y*i•e ► ...d FJ lntemeptorkeeme trap 1660 • •
Catltaet Horne: > -.sue e . d _,...-.••=1 weal gJ9 ("sl= s ____ 3 1111 Pogo 1
Address; I - C) : Na. CS L 4 E. Pump- 16.60 •
City/StubMP: •?. - pa__ - . 'z. leretdmia(eommorelal) Il 16.60
Siiii4bnsin/lavetury 15.660
•
p(toae
( .F • r Fin:: ) - I�- 'Mn'ehoworldsower cam =1 16.60
•
• t;.eenil: (� , c _ ._ w tined 16 -
CO1V ACIO� vrmrolaeCl 16.60 •
•
E=:=lfrjillIll..IIIIIMIII Wa- rbeater = 16,60 •
Addrausi: 0 Otlrx. •
My/State/ P r• ' . , Pt ' , 6 d . minim. saptont / minim. parm6t �ww; � rd 1 •O •
1 (16 0 ) , ' 7 ; Do Fax (3 6 a> 8•' Z ' .1 Resldondal badaene redon m Durnit fee: $311•25 ^ T
CCB Lie.: 33 I plumbing Lie. DELI 3 7. , r ' P V pion mow {75v, airmail he)
Stnsi nutvlwrge (0% or permit the) j . 9 4/ •
Authorized stanaGhle: TOTAL MOAT an ff
Ptiat names Date TSB permit application mina Ira penult Is not oltte u wi t � •
�• 36G dnya after Is has been accepted as eemptetc, •
'Tee methodology set byTel•Caumy Building tndn:my Salvia Board.
munt14 0orkl weAuPmna+hwdn+ mseats WWI elTICO 0O i
T ' 171796 268 096 2utgwn 'td st;ea d82:C0 90 OT clad
CITY OF TIGARD ' ' P L ni
A vi ,, l
BUILDING DIVISION v PERMIT #:a,0 o 6- O 0081
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Mi
Inspection Requests (24 Hrs.): (503) 639 -4175 . ��� °__-
INSPECTION WORKSHEET FOR DATE: T E: CO PAGE:
SITE ADDRESS: / / 7,7 6 CLASS OF WORK:
SUBDIVISION: / / LOT #: 14 (`�[ , TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: j - 6, - O' Pour Time:
Code # Inspect' Description ' Confirm # Contact # Message
!� y"5 310 -7/8-7
Z
3- w? 0„
Corrections /Comments /Instruct
/ / ''')/"-C2-4-4) •
-97ct, -r/4<e
(Y._ / 0, ,
9 ("Li
J ,..4)._ ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: J A0/6 Co Phone #: (503) 718- 24-ay