Permit Av * CITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2005 -00599
III DEVELOPMENT H BMENg Tigard, -639 -4171 DATE ISSUED: 10/24/2005
PARCEL: 1S133CD-11200
SITE ADDRESS: 11689 SW WILTON AVE ZONING: R -25
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT: 144 JURISDICTION: TIG
Project Description: Install residential backflow prevention device.
•
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
JULIE WHITMAN Description Date Amount
11689 SW WILTON ST
TIGARD, OR 97223 [PLUMB] Permit Fee 10/24/200: $36.25
[TAX] 8% State Surchari 10/24/200: $2.90
Phone : Total $39.15
Contractor:
DOWN TO EARTH IRRIGATION
13075 SW PACIFIC HWY REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Phone : 503 684 - 3500
Reg #: LIC 8169
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
require . • • ; low rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 i 001 -0010 through OAR 952 -0001 -0100. You may obtain copies of these ru -s or direct questions to OUNC by
c- ing 503 - 246 -6699 0 1 -8 332 -2344
I -sued By: Permittee Si • , . _%� y/. ,,'?%f
/'
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.
FRGil : R FAX N0. Jan. 06 2003 12:20PM P2
r lb
Building Fixtures • , .
Plumbing Permit App ' FOR OFFICE usr ONLY
City of Tigard i (.)
EIV � ,�
13125 SW Hall B1vd..1lgard. OR 97223 oatdsr. r . � w •
Phan: 503.639.4171 _Nu 503.598.1960 " ' •• • aw �a Other Iton
24- >3ourr Inspection Line: 503.6394175 UL 2 4 , ` . ..I','i Da • ca l -
tiitunot" ww ectio .01.6prd.r us ' . 1 ' "" Daft r S Sea Page 2 for
s- :• �p _ N � . I� Supplemental tafo�matloa
'�'�L Xu?G.^�aX !, �� , j a.- 'ff • = �• I `5,�iy�«JO�I ,. -. "r �rt. '+, » • - _ . .
L J o '1 'A .." Y7. --a%w? J.y.�7� i'F1..-i.r1i.. ,- ' ,i'ara -4,-x0 •4.« -'',0+,,•:.--.... - : ' _' - 1 C1 %' '.
�' _ , . fJ+1+ . Y.
0 New wnstittedan 0 Demolition Fes spedsti i orm tIon use checklist
D Addition/alteration/replacement la
Description pry_ En- I Total
o i t «: , 1 T4 . • • 0 Mtn New 1-2-family dwellings (includes 100 R for each utility connection)
f� E41 e :L. Gy < s . 1 -, ^ -.7_ a �,t.. �` () 24920 J
'w? �:r...� t. -21i.._ R { �: a.. Fxa.- : -._ ,i I SFR 1 bath
150- and 2-family dwelling : • D SFR (2) barb 360.00
❑ Accessary building ❑ Multi -family SFR (3) bath . • • 399.00
Q Master,bmlder D Odra: > additional ' a5.00 •
y \,'�rN .... - .. sr ._: . T.- _ gmspra�9a $ 2 I
FGA 2.v `1T .IJ�-- 1'�,H� i[: •I .11�• _ \'.�'l,. L�. /�I:._.d L�.
adrSlcyA2�i ::F�L q �, i"'.�'1'�i "� = a' /��, iL 'ry. � �'�- c�� ^�:�� v, Site militia
s4 )
Job site earn= I`, (48 1 0 tx ) i 4. o .j I✓ Catch basin or area drain . . 16.60
Mt 1 r: • . 0q_ (4 7 ZZ� Dll, leach terra. or trench inapt 16.60 - •
Suite/bldg./apt no: Pro et t intim "- Footing drain (no. linear t.:_) Page 2. .
Cross sbriet/ditectiams'to , M� caned home utilities 110.00
C�
Maahotes -• 16.60
Rain drain ooanaotor 16.60
Sanitary Muter (nu. linear ft: __) Page 2
Storm sewer (no_ linear it.: ) Page 2
Sabdivision: I ;,ot t Water service (no. linear i� Page 2
Tax map/parcel no.: Feature or Item
•
rou <r y�w;y�� �•, a` �N c� a o -��zsr Abs rp6ouvalve • 16.60
? � `_, rt}" ^_ .
�Cfr ' . ;:: "r ,�...t �.' Yr'�. ]r,:U;.` a premiff, • Page 2 II
backwavx valve _ 16.60
, Clothes washer 16.60
•
•
• Dishwasher 16.60
-1:^ r z � ..: .,.�;. - 'N e iro`^ • -•=7 � 7 -rte .z.- .�:
s a .��3�r w �w ,J; JFri : , y. ", x- - ��(�, r n A
� . � �• DIiGIC.O�rOt®taltr 16_60
ai11C: 1.1 ' p v . ... ... Ej ectots / sttmp . _ 16.60
i j 3.- Lk i `� . . __ ti Dq sicet tank 16.60
M • N dliSS :1 1 (9$°1 sc o a ) 1 ✓ ._
..II t �a , � ��p 16.60
My/Stale/ZIP: -- ; �a t d ' °.. 1 7 2z.Z .. . Floor drain/flour sinldmrb 16.60
Phone: (. ) Pam ( ) 6 i 3 baSegisPotal 16.60
. °&k:- .?w.:vz - ,. .4 •=x... i- y=.` ti�i'.;s j_ z.:: ' .'zi -.�Sr '' � jr ?...n 1>�sbib 16.611 .
$t>eiaas name: PO tot - mar Li _ toe make • - • 16.60
lneaoepDOa/gtr trap 16.60 •
Contact natno : et; It (1 e.$ OL . .. Medical gas (value $ ) Page 2
Ad dress: ff 3 0 7.8 5 (A) 1 c . : 4(4 > . . 16.60. •
al Ya : • - . o .. 4 7223 Ralf drain (commercial) • 16-60
]phone' 05 f$ q . . XSelo Fax:: (5031 - ,: i 4 Sink/basin/lavatory 16.60
> : - Tub/shower/shower pan - . 16.60 . . .
w ,°'F , . rte,: ,,.�> „__.�, Urinal • l
J ie : fN' a '� : . + :.1 , £ .,. a N•".. • 4 .,;:._,• 6.60
Business nag= N , r �ri'x.- :''�;.: c�,� water • 1660
Address: • ' - .. • ex r` j- j-14 . Water heater . 16.60
aa/s�t �r� c, 97'7. 2 '• _ . _
� Subtot l
Phone: ( )
Residential baekttow
Minimum pernnZ fee: $72 .50
CCB Lin:
Fax:
Phuab minimum !ix" ¢3625
Plumbing no.:
Authors,' sd '■ . . _ State =charge (8%of pent* fee) •
l I IL" S .._ • ... TarALP
�tvl� d Q
' Dam � O This. � e days after I t �� it a permit is not obtained within
' '
been accepted as complete.
`Pee methodology act by Tri -County Building industry Service Board.
CITY OF TIGARD A .
BUILDING DIVISION PERMIT #: PLM2005-00599
13125 SW Hall Blvd., Tigard, OR 97223 , 6 DATE ISSUED: 10124/2005
Phone: (503) 639-4171 i �I
Inspection Requests (24 Hrs.): (503) 639 -4175 - "I ..
INSPECTION WORKSHEET FOR DATE: 1/9/2006 TIME: 7:01AM PAGE: 53
SITE ADDRESS: 11689 SW WILTON AVE CLASS OF WORK:
SUBDIVISION: COTSWAI D MEADOWS NO.3 LOT #: 144 TYPE OF USE:
PROJECT NAME: WHITMAN
DESCRIPTION: Install residential backflow prevention device.
OWNER: WHITMAN, JULIE PHONE #:
CONTRACTOR: DOWN TO EARTH IRRIGATION PHONE #: 503634 -350O
Inspection Request Scheduled For: Date: 1/9/2006 Pour Time: 1
Code # Inspection Description Confirm # Contact # Message
335 024E49 -01 503-664 -3500 Y '
Corrections /Comments /Instru tions:
2 _Ani ' / r r •
, ,-(- r
(,.'k-a- f/-1'.
Ir 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t)2 ,2 Date: i q ()-_ Phone #: (503) 718-