9741 SW OAKS LANE-1 NI 5)lV0 MS M6
.IT
x
co
a
0
� u3i
r
9741 SW OAKS LN
CITY O F T I GA R D _— PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2005-00304
13125 SW Hall Blvd., Tigard, OR 9722.3 503-639.4171 DATE ISSUED: 2511/005
PARCEL: 25111 CA-12000
SITE ADDRESS: 09741 SW OAKS LN ZONING: R-7
SUBDIVISIO14: SATTLER PARK LOT: 005 JURISDICTION: TIG
Project Description: Irrigation backflow preventer.
CLASS OF WORK: O1 R GARBAGE DIQPOSAL a: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: 'A " 7 ER 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: FAIN DRAIN: ft
Owner: FEES
LISA VON WASbtUTH Description Date Amount
9741 OAKS LANE - ---
TIGARD, OR 97224 (TAX] 9%State Surcharl 7/12/2005 $2.90
[1'LUMr3] Permit Fee 7/12/2005 $36.25
Phone: 503- Total $39.15
Contractor:
DRAKES 7 DEES
165'.9 SE STARK ST REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97233Phone: 503-256-2223
Reg#: PLM 5259
SUP ALL.'PHASE&13A(
a
ac
U)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
m and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if wa;k is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
w requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
a
952-0001-0010 through OAR 952-0001.0100. You may obtain copies of these rules or direct questions to OUNC by
calling 50'3-246 699 or 1-800-332; 344.
Issued By: Permittee Signature: 4.2
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.
• flu bttiU PermWAj)Pk*tivtr-
k_ity of ►tgard ---� _1VED i Recewe
13125 SW Hall Blvd.,Tigard,OR 97223 LJateiBV 0� "- Pemus N j /)/Jt -h r-,�+w
Phone. 503.639 4171 Fax: 503 598.1960 'JUL
J L I 200. I`t Kev1e —..-- "tet "�—��._
v L pst�y Other Pemut No.:
24-Hour Inspection Line 507.639,4173 - _
Internet: www.ci.tigard.or.us Date Readv,Bv RI See Pap t ror
Notified/Method:F• i, - • .•. - Suppl•rnentallnrormatlon
IP + T P ^'^'! y!�yis Pl' FEE- SCHEDULE
❑New construction OfrT''• _- for ,•'ial it nar/on use r'• klisL
Descn non Ea. Total _
AddiuoNalteratioNrrplaeetttent ❑ er:
Oth _ New 1-2-family dwelht,�,ilndudes 100 d.Cor each utility conTotal i
v,;�,.'.r•*^�',�tTpr 'xfT erOVS'TR --,0 —
., UCfI , e SFR(1)bath 249.0
I-and 2-farruly dwell,ng ❑Commercial/industrial SFR t'-)bath _ 350 t1t)
❑Accessory building ❑Multi-family SFR(3)bath -- 1q9 00
Q Master builder I ❑' the Each additional badt/kitchen - I gS,00
Fire sprinkler�_sq.R-) Page'_
grr' c,!1!4? ..ai09t-dt-817 F► QRM11TiOPr'AIVDRCO(aTIbN•: —
u Site utilities
Job site address: / (� Catch basin or area drain t 6.ti0 _
City/Statrj71P:'-3`' � --
��/ 7 ZZ Ctyw;ll,leach line,or trench drain 16,60
Suite/bldg./apt.no.: Pr0)ect name: 0„\ Footing Crain(no.linear R.._ Page
Cross street/directions to job site: _1tL� Marufactured home utilities—� 11000
Manholes
Rain drain connector _ 16.50
Sanitary sewer(no.linear R.:
-�—_ Storm sewer(no linear R.._� ?age_
Subdivision: Lot no. Water service(no linear R.. ) Page 2
Tax map/parcel nr.. Fixture or Item
---- Absorption valve _ 16.60
Backflow preventer ( Page 2 1 .3
•z s`
A C O W E'�/ L e �! 1 t fr. o r Backwater valve
16.60
Clothes washer 16.60 �
Dishwasher 16 6o-i----T.
., ►- "« '« '.._' x Drii kin fountain
!_..i-Pt t�PE GY �WPiLRf; ":+ , • g 16.60
Ejectors/sump 16.60 !
Name: S �l �/ Q to �ta�r\
Expansion tank 16.60
Address: q -7'41 T( — _,� —���„ci Fixture/sewer cap 16.6060
Ciry/State/Z1p: �
C4r,
/ Z _ Floor drain/floor sinkJhub _ 16.60
Phone:( ) Fax:( ) Garbage disposal— 16.60
.z )Q'lE'TL�i1VZ'; I'j`'':y .�_, •a CQI'47`AC[aF&R,SbIY '" Hose bib —
+ 16.60
"'•. '. •..«- „�,. � = • --t. I
Business name: ro k e,� Ice maker 16.60 Z La CS t,��
-- Interceptor/grease nap 16.60
Contact name: ir l
dl J w U kMedical gas(value:S ) Page 2 i
aAddress: 11;,S Cj S.L S r k 3.� ` Pnmer 16.60 T
NCity/State/M: 190V C. 72 Roof drain rcommerciall 16 60 —
Phone:(�( ?)) ZI t Fax Sinkibasinilavatory 1650 I
_� O / (S"U))2 �, —Q j'�d S
E-mail: Tub/shower/shower pan 16.60
JC
Unnal
Nater-Inset 1166.6600
'
—
W Business nsme: 1 •�k t,j `I t,s" f v, -_ - r Water heater 16.60
J Address_ ! ' f. S 1�1 r k,3. �
Other
Ciry/State/ZIP: o ; b Subtotal
7 Z�� Minimum permit fee: 572.50
Phone:(5 U„)) 2s-(. ZZ Z I Fax (S'b))Z S --V y�S'' Residential hackflow minimum permit fee: ;36.25 z�_
CCB Lic.: rZ -rq Plumbing Lic.no. '7 ( Plan review (25%of perrtut fee)
Authorized signattrre• � -� - State surcharge(81A of permit fee) 2 •96
TOTAL PERMIT FEE J3
Pent name' ey/L G_)-M a,,j�•�stt (� — Dale: 7[71 0S_—I This permit application expires if a Hermit Is not obtained within
180 days after It has been aeeeptud as complete.
*Fee n, thodology set by Tri-Cotmty Building Industry Service Board.
EVluitA:nal► .,wA►[M-rmnitAppMc ILO] 44"IMIwvco )
CITY OF TIGARD* �
BUILDING DIVISION PERMIT#: MM-00304
13125 SW ria!! Blvd., Tigard, OR 97223 DAZE ISSUED: 7/1MIXI'i
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/20/2M TIME.: 7:11AM PAGE: 30
SITE ADDRESS: 05741 SW OAKS LN CLASS OF WORK:
SUBDIVISION: sATTLER PARK t.:3T#: 005 TYPE OF USE:
PROJECT NAME: VON WAS+MUTH
DES( TION: Irligafif)n bacldirwr prevertter.
OWNER: VON WASMUTH, LISA PHONE #: W. 3.,503.."—3
CONTRACTOR: [RAKES 7 DEES 7
�/ PHONE #:903.26 2223
(�
Inspection Request Scheduled For: Date: 7/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
375 RP/bat:ldlow preventer 011787.01 971 219.11483 N
Corrections/Comments/Instructions:
a
w
$-PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �� __—�_ Date: _ / P'iona #: (503) 718-