Permit CITY TIGARD PLUMBING PERMIT
A A DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00053
�'� � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/31/2006
PARCEL: 2S109AD - 13800
SITE ADDRESS: 12947 SW WAHKEENA CT ZONING: R -
SUBDIVISION: ARBOR SUMMIT NO. 2 LOT: 034 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
15500 SW JAY ST Description Date Amount
BEAVERTON, OR 97006 [PLUMB] Permit Fee 1/31/2006 $36.25
[TAX] 8% State Surcha 1/31/2006 $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: Permittee Signature: j D t o\?, ____I
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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Plumbing Permit Ap 11 41.!';i 1 1 ` . ii® , Folt OI�rIcE US ONLY
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City of Tigard J A N �� ? Permit Na.;
13125 SW Hall Blvd., Tigard, OR 97223 i `� Pl an Review
Phone: 503,639.4171 Fax: 503,598.1960 1 4UU1 r� r =ir ; F � l, t ),1 t, Date/By Other Pcrmil N°.
24- Hour Inspection Line: 503,639,4175 CIT , „t .� Date—Ready/By. Jar gJ See Page: for
In teener tyww.cl.tigard. ❑r.us BV b OF Tl GA-. Notified /Method ) Sapplementnl Information
. TYPE OF W a ' /SION ' , FEE" SCHEDULE
® New construction ❑ Demolition For special information use checklist
Description { Otv I Ea. 1 Total
❑ AddtuorvalterntioiVreplacement ❑ Other New 1.2- family dwellings (includes 100 ft, for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) 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 DO
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: Z./ U Ui YVa a„ Catch basin or area drain 16.60
City /State /ZIP: TI (MARD OP 9 7 2...2-4. Drywell, Icech line, or trench drain 1660
Suite /bldg. /apt. no.: Project name' Footing drain (no. linear fl,; ) Page 2
Manufactured home utlltttes 1 10.00
Cross sh eet /directions to job site:
Manholes 16.60
_ Rain drain connector 16.60
Sanitary sewer (nn. linear R.. ) Page 2
-
Storm sewer (no, linear ft.: ) Page 2
Subdivision: Arbor Summit L no I L Water service (no linear ft,: ) Page 2
' j Fixture or item
Tax map /parcel no.: -
Absorption valve 16.60
DESCRIPTION OF WORK ' Backflow premier 1 Page 2
NEV' C:ONSTLJCTION Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16,0
Drinking fountain 16.60
' ® PROPERTY OWNER ' ❑ 'TENANT' —
Ejectors/sump 16.60
Ntime: West Hills Development Expansion tank 16.60
Address; 15500 SW Jny ST. Fixture/sewer cap 16.60
City /Stale /ZIP: Beaverton, OR 97006 Floor drain/floor sink /hub 16.60
Phone: (503)641 -7342 Fax: (503)641 -7661 Garbage disposal 16.60
Hose bib 16.60
® APPLICANT ® CONTACT PERSON Ice maker 16.60
Business name: Same As Owner. Interceptor /grease trap _ 16.60
Contact 11E11nc: .Z14 K LPN l ER Medical gas (value; l ) Page 2
Address ( tti ■'`E AS ASoyE) Primer 16.60
CI ly /State /ZIP: (roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone (503 ) 641.7342 Fax. ',( ) _
Tub /shower /shower pan 16.60
E -mail. R Lkt�E E Gt; ( XVvfL5� HI LLSDtVE WPM. ENE cPM Urinal 1660
CONTRACTOR Water closet 16 60
13usiness name. 'Y p..p.. D G M. cc pi< LA NJT Cfr PE - Water heater 1 16.60
Address: pc -Liy, 2_41c, Other: J _
Subtutal
City /State/ZIP•' OE. cAry OQ 97045 Minimum permit fee. $72.30
Phone. (503) t r D4— 2 0 13 1 Fax: Residential backflow minimum permit fee' $36.25
CCB IItc.' y'{/(4�Crep - r' � '6P Plan review (25% of permit fee)
1 " "' 5 3 EX • • J C l 1 State surcharge (8% of permit fee)
Authorized signature s t —_
�.' A. J TOTAL PERMIT FEE
Print name r ( /,(� \ /� Date; ( l�l/ 0 6 This permit application capir'ee if a permit is not obtained within
vvv. -��NVV 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
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CITY OF TIGARD QHoc003
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 1 1 1 3SUED:
Phone: (503) 639 -4171 11
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 1/4/ b e l TIME: PAGE:
SITE ADDRESS: 1 4i lA.1 4 It-e2 / c•_. �. 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 kk D .
-- W1 PI WI/14, t) LAA ---z-yz a Corrections /Co men�ts /IInstrructions•
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9 j( f- - . 11 / 1 I g 9 - --14 _
PASS ❑ PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS
FAI ❑CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED
Inspector: 1�� " — Date: l/ C Phone #: (503) 718- �