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Permit A ' CITY F TIGARD PLUMBING PERMIT �•��I�` I DEVELOPMENT SERVICES PERMIT #: PLM2003 - 00118 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/1/03 PARCEL: 1 S133CD -12900 SITE ADDRESS: 11792 SW TALLWOOD DR SUBDIVISION: PEBBLECREEK ZONING: R - BLOCK: LOT: 022 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: 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 Remarks: Installation of backflow preventor FEES Owner: Description Date Amount HODGES, CHRISTOPHER R + THERESA 11792 SW TALLWOOD DR [PLUMB] Permit Fee 4/1/03 $36.25 PORTLAND, OR 97223 [TAX] 8% State Tax 4/1/03 $2.90 Total $39.15 Phone : 503 -524 -3222 Contractor: ENCHANTED GARDENS LANDSCAPE SERVICE 25425 SWIFT SHORE DRIVE WEST LINN, OR 97068 REQUIRED INSPECTIONS Phone : 503 RP /Backflow Preventer Reg #: PLM 14613 LIC 7857 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. Issued By: j /, Permittee Signature -- 01.4.7 `\ Y /44 Call (503) 7:00 P.M. for an inspection needed th next business day ( ) 6.9 -4175 b Y Plumbing Pe t A pplication i F .. P I I Itl , ,. , C)NtI Date received: Li.- ...,0 Permit no. (7 , , 3 -0 ( 1 1r Ci � ®f '�i � i ll'. ;, Tigard and Sewer permit no.: Building permit no.: R' " - Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 - 4171 Project/appl. no.: Expire date: Fax: (503) 598 - 1960 RECEIVED Date issued: By: Receipt no.: Land use approval: Case file no.: Payment type: y x r l' - TU PF'xOF PERM1T' ;: r q , ;,- 0 1 & 2 family dwelling or accessory O at ' t•I / " $ ilk, 0 Multi - family ❑ Tenant improvement 0 New construction 11 Additio erat d r tftacement U Food service 0 Other: *,:' s r •. r ., ° ..- T „a Vi i; W 4 1 , ou. _. .^� . ,hr ;jrr - i ^ -.. JO[3 B SITL Iy \1'OR��I�TlO �,a �.; ;�.., y k : r ) . 1 \, -� f• E�E S( HEDLLE�(for 5 ic` ; ct 3t tnforto�nou nse chec{.hst_ � Job address: ii 79 5 j T ll ep� Description Qty. Fee(ea.) Total Bldg. no.: Suite no.: New 1- and 2- family dwellings only: Tax map /tax lot/account no.: (includes 100 ft. for each utility connection) SFR (1) bath Lot: Block: Subdivision: SFR (2) bath Project name: ',]✓ea 15 .- (x7)3)5 / 3 SFR (3) bath City /county: 2 : 97,z3 Each additional bath/kitchen Description and location of wor on remises* Site utilities: N p II6:4-i n• _ • _t i /, _, _ i, r. I „�. atch basin/area drain Est. date of completion /inspection: a Drywells /leach line /trench drain k, r ° � �° ,, , Footing drain (no. lin. ft.) • e2-1',..,,..!-- x„i 1 t �l [ \C `' \TA 1( ,_ ''.- ,:_ Manufactured home utilities Business name: ffn peA j �..� ( / 6 o v. T Manholes Address: ', • i'. + or e / r ■ Rain drain connector City: t P.6 - t,; State: 0 R ZIP: y . 70(p F Sanitary sewer (no. lin. ft.) s53� d .64. orm sewer (no. lin. ft. Phone: Fax: E-mail: E -mail• ( ft.) / L / � 3 Water service (no. lin. ft.) CCB no.: 7 7�Yf Plumb. bus. reg. no: `� � City/metro lic. no.: akin, Fixture or item: Contractor's representative signature: jaw / ... --_- Absorption valve Date: Back flow preventer i 3 Lam, 'S(e, !' Print name /�® Backwater valve ' co, -N, 1.1E .' PE ° -," Basins/lavatory Name: Clothes washer Address: Dishwasher City: Drinking fountain(s) ity: I State: ZIP: Ejectors /sump Phone: Fax Email � � % � w Expansion tank ,z . '., a+ :• * "' � g s ,OY \ I R ,, _ : , ,, 4 ,' r ",; Fixture /sewer cap FIoor drains /floor sinks /hub Name (print): (7i e : <; <; 0 4 Garbage disposal 5V Mailingaddress:a...c )t4..1 -S 1 . Hose bibb City: ir)tst L,; r1 il State: © Y Z1P: q-7 ) ( 3' Ice maker Phone:.'' ; 0/ ( D - I Fax: E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the prope , 1 o • as per ORS Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: - Date: et 03 Sump • a ' 4 ■''G NE' P R i - a ' • w ; - Tubs /shower /shower pan Name: °' Urinal Water closet Address: Water heater City: State: ZIP: Other: Phone: I Fax: E -mail: Total Minimum fee $ , � le .. e- 5 Not all jurisdictions accept credit cards, please call jurisdiction for more informatio Notice: This permit application ❑visa ❑ Plan review (at % MasterCard expires if a permit is not obtained ( ) Credit card number: / State surcharge (8 %) .... $ w ithin 180 days after it has been , q Expires y TOTAL $ - 3 eT . l5 Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440.4616 (6 /00 /COM) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION - DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested - 4 -5 � AM PM BUP Location / / 1 ` �-- c ra --a— " uite MEC Contact Person Ph ( ) 0 ° -sD oZ PLM 3 - e 0 1/7 Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Fi rewal I Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan � ( / : ///2 Other: �O ' r for PART FAIL i HANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 111 Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date • _ Inspector L Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL • CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST � / BUP Received Date Requested / - �� AM�� PM BUP Location /1 7 ' �n1 __v Suite MEC Contact Person s Ph ( )d°/ -5746 D --- PLM 3-60 t(g Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation j ELC Ftg Drain Access: ELR Crawl Drain Slab Inspectio i SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm �prAri o n % Susp'd Ceiling f Roof i Other: I R / ZIPW't � Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough In 2 sad Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan 46• f PASS PART FAI MECHANICA Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA I Approach /Sidewalk Date Inspecto Ext Other: Final %I O NOT REMOVE this inspection record from the job site. PASS PART FAIL