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Permit
tr- CI TY OF .TIGARD PLUMBING PERMIT � DEVELOPMENT SERVICES PERMIT #: PLM2005 -00446 �' II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/$/2005 PARCEL: 25111 AB -06100 SITE ADDRESS: 09235 SW VIEW TERR ZONING: R -4.5 SUBDIVISION: PENROSE TERRACE LOT: 006 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 NANCY JOHNSON 6235 SW VIEW TERRACE Description Date Amount TIGARD, OR 97224 [PLUMB] Permit Fee 9/8/2005 $36.25 [TAX] 8% State Surcha 9/8/2005 $2.90 Phone : 503- 670 -0435 Total $39.15 Contractor: DRAKES 7 DEES 16519 SE STARK ST PORTLAND, OR 97233 REQUIRED ITEMS AND REPORTS Phone : 503- 256 -2223 Reg #: PLM 5259 SUP ALL PHASE & BA 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: ;71,01/ Permiftee Signature: j,e;q., 9) 1 g 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. n I- : r • Plumbing Permit E® = : `FOR OFFICE UsE , ONLY - • City of Tigard Re ivea /1 Date/By. 9 �� vs I Permit No - F1`I• Y7,0 l !/V ��/ 6l 13125 SW Hall Blvd., Tigard, OR 97223 0 Phone: 503 639.4171 Fax: 503.598. r ( 0 Other Permit No 24- Hour Inspection Line: 503.639 41 . �'° z� I 1 Plan Review + Date/Ready/By � - -- ' ' lure ® See Pa ge 2 for w. ct.tigar d .or.us Internet: ww T1Q� � - ' ` -- -� D ate _ TY OF Notified/Method. / /r Supplemental Information • • ; . S �1.; •. jt: y�,1•,.a11i FEE* SCILEDULE • For special information use checklist ❑ New construction ❑ Demolition Addition/alteration/replacement ❑Other: Description Qty Ea. Total Addition/alteration/replacement ,, � ;:� a New 1- 2- family dwellings (includes 100 d. for each utility connection) ':'��T:^S. ,- . .., i�w i GORY- :O�:CON (�bitt ,'[� `` =: t;; : .,. SFR (1) bath 249.20 ) si1- and 2- family dwelling ❑ Commercial/industnal SFR (2) bath 350 00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399 00 Each additional bath/kitchen 45.00 ❑ ❑ Master builder Other: �,«r ��,- a �,.9- . , ,w. O , - ..�_�. �. 1 Fire sprinkler ( sq. ft.) Page '- .4s. : ;rt..: 14,61-..la.... 1�FRMVATIOI F►ND4 OCATINS,- `'..a. S --- _ - + -�ti O �," � " " " . .- _ Site utilities Job site address: 2,3 u , e, '" e✓ r o.r e Catch basin or area drain I 16 60 City/State/ZI: '7,9 ad ` f e -1 2-12.1 Drywell, leach line, or trench drain 16 60 Suite/bldg. /apt. no.: Project name: - 3 . p (r\ „ v\ Footing drain (no linear ft. ) Page 2 Cross street/directions to job site. Manufactured home utilities 1 10 00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no linear ft. ) Page 2 Storm sewer (no linear ft ) Page 2 Subdivision. Lot no. Water service (no linear ft ) Page 2 Tax map /parcel no.: Fixture or item -. - „fi ° : -, _; ” , 0 _ - _�” _ Absorption valve 16.60 - :, = _-:'s , ".__ DE •„ ;' ., ...` _ ,r. . - . ` • .. ,. Backflow preventer ( Page 2 3f. - 2 c 1 a )41 C'.JiCe �r J_ rir t '. 4 t3. Backwater valve 16.60 Clothes washer 16 60 Dishwasher 16 60 '' ° ?$ROPER GX• ; O �"� '"" y; Drinking fountain 16 60 r :tf. ; ,.: , .. u y :fir. .; .;w,vEPFAi�Fr = w ,, - • r 6 .' ` ''''' D Electors /sump 16 60 Name: /V& IAc 0 vk e\ S0 l ^ Q Expansion tank 16.60 Address: -1 ,S' l (J I c („, cr t Q Fixture sewer cap 16 60 City/State/ZIP: T 1 C a i � C) r ,e c " - t. J Floor drain/floor sink/hub 15.60 Phone: (S1:33)( )0 3�' Fax ( ) 7 Garbage disposal I 16 60 c : 7�, s'PF;rC�AHT:; . ``°';,:.- :v7, H., CQ1 A- . & , yERS'ON -,..5, ,. Hose bib I 16.60 1 \ ice maker 16 60 Business name: U re..k eS 7 Dees f •-, L Interceptor /grease trap 16 60 Contact name: a J ice) 0 r 1 h K I ( Medical gas (value. $ ) Page 2 Address: ( S ) S . E: . S f k J -1- Primer 16 60 City/State/ZIP: ' o 4- /p a, O q 7 2 3 7 Roof drain (commercial) 16 60 Sink/basin /lavato 16 60 Phone: (ri) .-e' s2 Fax (SO ?)2 _©��6S— ry E -mail: Tub /shower /shower pan 16 60 Urinal 16 60 -, ' : ✓. .. _r .. _ ; ;.,1•. , : CONTRA `, . ... ' , - Water closet 16 60 Business name: b .- ,‘ \<;,..e S ' Y 8 is l . Water heater 16 60 Address: + t S L( _ S � t k ,• Other { . Subtotal �� ' -AA. 7 X3 Minimum permit fee. $72 50 Phone: (S'Zj)) 2 j� Z.2 Z y Fax: (S'b3)2 S L, -- 0 f c,r Residential backflow minimum permit fee $36 25 Z CCB Lic.: 72 s Plumbing Lic. no.. ( / ) 7 f Plan review (25% of permit fee) Authorized signature: `' ; • State surcharge (8% of permit fee) Z , q O I TOTAL PERMIT FEE 3 q - is- Print name: " qr./ a rl L . � Date: ' Z 0 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tn -County Building Industry Service Board. aBudding‘Pernw \Pt.M- PeminApp.doc 12/03 440- 4616T(IOIO2/COM/WEB) CITY OF TIGARD . BUILDING DIVISION r PERMIT # : PLM2005.00446 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/8/2005 Phone: (503) 639 -4171 l # Inspection Requests (24 Hrs.): (503) 639 -4175 . I II. INSPECTION WORKSHEET FOR DATE: 9/9/2005 TIME: 7:07AM PAGE: 66 SITE ADDRESS: Q9235 SW VIEW TERR CLASS OF WORK: SUBDIVISION: PENROSE TERRACE LOT #: 006 TYPE OF USE: • PROJECT NAME: JOHNSON DESCRIPTION: Wallow Preventpr forr-irrigation.,__J OWNER: JOHNSON, NANCY PHONE #: 503.670 -0435 CONTRACTOR: DRAKES 7 DEES PHONE #: 503.256 -2223 Inspection Request Scheduled For: • Date: 9/9/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 325 RP /backflow preventer 015275 -01 971-219-0483 N • Corrections /Comments /Instructions: f- , (0 Y / �_ . ir 0 i .-11). 0740 ,,, T • • ASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED A •� Inspector: Date: ' Phone #: (503) 718 -