Permit <
CITY 1]GARD PLUMBING PERMIT
PERMIT #: PLM2006 -00292
11i1 DEVELOPMENT SERVICES DATE ISSUED: 6/2/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S114AD - 02600
SITE ADDRESS: 08876 SW WAVERLY DR ZONING: R -12
SUBDIVISION: WAVERLY ESTATES LOT: 025 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
SCHWEITZER, BRENDA LEE
8876 SW WAVERLY DR Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 6/2/2006 $36.25
[TAX] 8% State Surcha 6/2/2006 $2.90
Phone : Total $39.15
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # :
Reg #:
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: a d . ) / /Lt&i
Call 503- 639 -4175 by 7:00 a.m. for an inspection that ' ess 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 FOIL of iii i l s, ONl.l
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City of Tigard �� Received aI /�� Permit No. 1 / ��([ -�
131 SW Hall Blvd., Tigard, OR 97223 30N 2 2006 Plan Re. 6 (, y lit 1 7Ll�Kl) r��/r�
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 T �GA ' '��r!r`f`•O I .., . Date/13y. Other Permit No..
24- Hour Inspection Line: 503.639.4175 1T( OF _ r_ _1 • _. _ Date Ready/By: t "" 5 r� 0 See Page 2 for
Internet: www.ci.tigard.or.us c aZ ALD •1G DP" - - Notified/Method: f v l Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
"0 Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
114 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: et lig S 01/41 aV 4' k\ bvI vo Catch basin or area drain 16.60
City/State /ZIP: -1--�✓ 0 6 1 -- 4" ZZ `4 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 5 Project name: Footing drain (no. linear ft.: ) Page 2
� Manufactured home utilities 110.00
Cross street/directions to job site: hu,(hO,rY\ � - ^ 16.60
` y � Manholes
q 7,�Q ) Qi 2S� ( � `� Rain drain connector 16.60
VI UV) lip /pY Q, € g_el t s` , , Sanitary sewer (no. linear ft.: ) Page 2
w I ./ y Storm sewer (no. linear ft.: ) Page 2
�
Subdivision: j4 ( ,,�(Q,j'j lx1J I Lot no.: Water service (no. linear ft.: ) Page 2
1 Fixture or item
Tax map /parcel no.: R. q 1 45(00B Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer / Page 2
Backwater valve 16.60
3 2bnQ &pviaw IR_i4. T l 'V...J Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: +7e nd a_ , S (, Ii A j ? ( Expansion tank 16.60
Address: ] W kAJOL V of t\ Fixture/sewer cap 16.60
City/State/ZIP: / �') y M I- Z Floor drain/floor sink/hub 16.60
Phone: (6t ) - 1 OCi 1- Fax: (51.J3) (o 31 _4,-33 -3- Garbage disposal '16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: 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: ( ) I Fax: : ( )
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Water heater 16.60
Address: Other:
City/ State/ZIP: Subtotal
Minimum permit fee: $72.50
Phone: ( ) 1 ( ) Residential backflow minimum permit feg36.22 /
CCB Lic.: Plumbing Lic. no.: Plan review (25% of perm t'cc)
State surcharge (8% of permit fee)
Authorized signature: ��� / TOTAL PERMIT FEE j 7 /5
Print name: 13 re (" ' k wil ! �t- (l Date: 5 v 4 T his permit application expires if a permit is not obtained within
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 - ,- 'y
BUILDING DIVISION PERMIT #: PLM2006.00292
13125 SW Hall Blvd., Tigard, OR 97223 II' DATE ISSUED: 6/212006
Phone: (503) 639 -4171 A �I�
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/20/2006 TIME: 7:04AM PAGE: 50
SITE ADDRESS: 08876 SW WAVERLY DR CLASS OF WORK:
SUBDIVISION: WAVERLY ESTATES LOT #: 025 TYPE OF USE:
PROJECT NAME: SCHWEI fZER
DESCRIPTION: Backflow preventer for irrigation.
OWNER: SCHWEITZER, BRENDA LEE, PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 7/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 033288.01 503 - 819.1097 N
Corrections /Comments /Instructions: • n .r(3
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P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: vij; Date: " 4 Phone #: (503) 718- y