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Permit C ITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00159 ''. 13125 SW Hall BB 7 lvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S DATE ISSUED: 4/25/2006 CC001 SITE ADDRESS: SW CANTERBURY LN BLDG 1 ZONING: R - 12 SUBDIVISION: CANTERBURY CREST LOT: 001 JURISDICTION: TIG Project Description: Backflow preventer for irrigation. Common water. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: MF 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 CANTERBURY PLACE, LLC 109 EAST 13TH STREET Description Date Amount VANCOUVER, WA 98660 [PLUMB] Permit Fee 4/25/2006 $72.50 [TAX] 8% State Surcha 4/25/2006 $5.80 Phone : 360 - 695 -7700 Total $78.30 Contractor: ANCTIL PLUMBING INC 16900 SW MERLO RD BEAVERTON, OR 97008 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 642 -7323 FAX 503- 642 -7755 Reg #: LIC 24184 PLM 26 -162PB 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: L" ! , 2 I i 7 Permittee Signature: . %, ,CT Call 503 -6 63 -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. APR -24 -8006 01:49P FROM :ANCTIL PLUMBING 58136427755 T0:58359819 P.2 Plumbine Permit Application 1014 (II 1 It 1 1 NI ()NI 1 City of Tigard A IMF ReceivIMF "'-'17,2/ 0K'yl -- Pem,it r4 , X04 03/) q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Dato/Oy, 011ie* Permit No.: 24- Hour Inspection Line: 503. 9 7 ) J _ a •r.it 1 Intenct: www,tigard -u.gov I, 1 ! - i - - + Hale Ready/By / S See Page 2 far NotifiotYMethod � , r' S■pplemeatat tafoneatioa .1.,...s ;t ,g - giAit}lei. T YPE OF WORK` 0,15 o -`#4y ` - . «, , y ' :' FEE *&SCQIEDULE S, ' l> "a ,trl w construction ❑ Demolition For 'pedalInforntarlol ale ekerhllsr. Description I Qty. I Ea. { Total ❑ Addition /alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection) " h ‘.'•••""' 1 1' " t'y CATEGORY OF' CONSTRUCTION "trrWd,`', ; ' A. ? % SFR (1) bath 24920 ❑ I- and 2 -family dwelling Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building vtulti- family SFR p) bath 399. 171 Master builder Each additional bath/kitchen 45.00 ❑ other: �;a- yr�3 r , :� „1,,. t Fire sprinkles ( s9. !l.) ..... 1 Page 2 ,' JOB SITE INFORMATION 'AND LOCATION „;. L { 'a' It' . 4, site atilitk, Job site address: i C .5 a 5- Sw N 7 130 Catch basin or area drain 16.60 City/State/ZIP: /6 , 7/ / Drywcll, leach lint, or trench drain 16.60 Suite/bldg. /apt. no.: j Project name: 014)14./16/13L/ fli W000.5 , Footing drain (no. linear ft.: ) . Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear R.: ) Page 2 Skim, sewer (no. linear fl: ) Page 2 Subdivision: 1 Lot no.: Water service (no. linear fL: ) Paget Flst•re or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OP, WORK a » a"` te r" Back flow preventer .- ---- -, ( Page 2 4./ t , • Lie "'- V -c- Ii pt.J - pe u, c E FolL Back water valve 16.60 I Y -06- . 3 P - 4-1 S , fr y � Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 '32PROPERTY OWNER 1 w / ❑TENANT Ejectors/sump 16.60 Name: 2a � � o� P. - (Al W Expansion tank 16.60 Address: i 049 ll S 13 -4-ft St Fixture/sewer cap 16.60 V City /State/ZIP: J (...--U (,(v5 ` p n $ k, ) Floor drain/floor sink/hub 16.60 Z �] i - ( 9 Garbage disposal 16.60 Phone: (43,3) Gr p Fax: (• ) . ❑ APPLICANT C] CONTACT PERSON Hose bib 16.60 - Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name. Medical gas (value: S ) t 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: f- /G -1' (.. el L ,y J e r I� 3 _ Water heater 16.60 Address: / (o 9 C 3W /'Y e („, p Other: - - � Subtotal '_ -so City/State/ZIP: f, 5# ✓>��� v� VW' ? / Minimum permit fee: 572.50 Phone: (5l>3) ct-i 2,- l 3 2 Fax: ( 563 C 2.- - 3- "� Residential backflow minimum permit fee: 576.25 CCB Lic.: 2 , -f ( Q L, Plumbing Lie. no ' C - I (PZ P6 Plan review (25% of permit fee) State surcharge (8% of permit fcc) Authorized signature: �- TOTAL PERMIT FEE 1 ' :30, Print name: 4 (. G 1 . L Date: 14- 2.. / oC.1 This permit application expires If a permit fa not obtained width Igo days after It has been accepted as complete. •Fee methodology set by Tri -County Building Industry Service Board. 1 \Buddin1V'mnio\PL51- PemitApp doc I2/30'OS 440- 4616T( IOri2COM/WEB I, 4- lot 643e g N 5b 3 - ('i Z- "4-"?-5S __- CITY OF TIGARD BUILDING DIVISION PERMIT .: : ,PL12006-00169 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISS . / 4/7 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 11/14/2008 el 7:00AM PAGE: 17 fit5 / ---- 61:5 SITE ADDRESS: 10871 SW CANTERBURY LN BLDG • CLASS OF WORK: SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE: PROJECT NAME: CANTERBURY CREST DESCRIPTION: Backflovv preventer for irrigation. Common water. ... OWNER: CANTERBURY PLACE, LLC, PHONE #: 360-6957700 CONTRACTOR: ANCTIL PLUMBING INC PHONE #: 503-62 Inspection Request Scheduled For: Date: 11/14/2008 Pour Time: Code # Inspection Description Confirm # Contact # Mes a e /\t 399 Plumbing final 078083-01 971-563 Y Corrections/Comments/Instructions: ‘ ,,, 1 5 2 1- 4 _4( K4 1 6 , 6 _, A , /0'23 l — ,./f i - t o-.1(1 - ' ; 7 --- ..e57.1 „e_i_ — /D73/ 4 PASS fl PARTIAL APPROVAL Fl CANCEL NO ACCESS I I FAIL n CALL FOR INSPECTION III ADDITIONAL FEES ASSESSED Inspector: 14 CA Date: 1 / ( Phone #: (503) 718- 2-n1 ?sji (134 u 3 ' i s . � f ` � 4 ?£ P K n x O NEW / a ❑NEW ' N WS•AW W A EXfST .. "XISTIN E , * :":57:, Oltk ` ' BA�KELOWASSEMBLY TESTRE REMOV PLACEM cL � F� �^'.� : � e�y � �REMO 'ROPERT ❑ RE � P ° t'' t REP J1 )WN &R: t i._/ C p!A t� r N �t PHONE: 7 OWN " r tiAiL1NG f t t RI L.DDRESS: 6 C�. I _S MAILI ¢ G ! � < 4 tD c� 3 4 CITY I/r>v 1Gn,�Pr STATE t , i A ZIP Q � y Y %SSEM lo v s t ►DD 5�.3 c. r.�2 - rte / [ } 4 \Q, ill a a . s a s STREE ' . ❑AIR Q° • ao-: �R. P.H.A. D.C. V.A. ❑ R . P . D .A ❑D,C. ❑ P. t S.V.S. A. ❑ A.V.B GAP to ��,{{ � �° ., e�� V B A..` ' G j SIZE: � L[I �, I �P M A K E . e. t OC r� i et } MOD c.-0 c ( RATER f SERIAL t I '' o SER . 'U RVEYOR: ��i ci c NV -- MBER : . 'f BLy t cr : NU MB E R: } :- OC`AT ON: l t _ T O (k". .4 t T l`O.n � � d r { t = 1 2EDL'CED PRESSURE AS SEMBLY P.V.B.A. F S . V.B . A I� FAILED 1TIA T T D t� A$SEM P I .�.A ` " =INITI TEST r1 c lecK D $11 G` AIR C PASSED (` X w s PR" {A ) )1 . INLET ❑ Z Q U� 3 LE ; CH E CK A CHECK PASSED ' CHEC # # INITI RE L1 VAL � � ,:,,, •� . t C. M � INLET FAILED ❑ B TIGHT )4 � OPEN 0 C ED ar. PRESS DROP �z i � ECK #1 aPENEO A T ( ) ms y � _ ? .. TEST 1,11 2 PSID , Psto psi DA TE: ' r. c ' OPEN AT PRESS DROP iE SULTS BUFFER ( LE A KED ❑ P 4Z� 0 i1 Q� c n ,-,,,,-.7 DATE:r i SID a > e ■ t E� / ) ; A -B = I C HECK # '� t / 0 t 1 _ M IB 3 P C,] ak r CK # 2 PSID PSID [TIGHT � � t DID NOT FAI LED SYSTE � ,� t xl V REL.lEF VAL VE Cr PSI — iv �tH r DID NO T FAILE SYSTEM PAS ❑ FAIL ❑ ' LEAKED ❑ . IM ❑ - V V - V `: PAi hNDtO � �• k 4. PART :. � rl c sI cK LCEOPRESSU ass E MBLY AFTER REPAIRS i ( PRES DPOP (al ' DATE: P P . V.B.A /S. V. B.A. AFTER RE PAIRS TES CHE # I Z ''� a RELI OPEN A! PRESS DROP DATE: AFT OFE D ( I ` TIGHT PSID -,� "`.S ^' .; aY } a� ENED AT PRF,SS DROP :EPAIRS BllFF� x� e� i CHECK #2 �' F A s' PASSED '--' R $R , > . s TIGH ❑ P P SID PSID ❑ ( ) �•` t r, #Z P AS N - �7.IPLETIN AND SUBl t(ITING THIS TES[ REPORT, THE TESTER TIC CER THAT THE y � y .`[' ❑ PSID °� PSID ,µ �' . ASSEMBLY HAS BE E4 TESTED AND MAJNTAINED 1N ACCYRDANCE WTF} ALL APPLICABLE 0 %Y �s""Y ms`s �.' TH IS TEST REPORT, THE TESTE CERTIFIES THAT THE MILES AND REGSA.AT]DN5 OP THE WATER SYSTE!!, AND STATF RIGULt!tiS. 0 a �MBI,Y SB �pa M AINT AINED IN ACCORDANCE WfIH ALL APPLICABLE CO • > � rl .e' P a "O ATER SYSTE AND STATE REG1JLAr[o s. 3AUGE CA'' ON DA TE ` Z 3 DE TECTOR METER REA DING �, �I� `�� 4 _ ''N DE T O METER REA . t� yh F,. a � , ^' - : +fix ESTER SIG CE C,447\ RJ -�- L �v�/ �s 'ry / . �, — � —..._ a- I - C o 6 CER -mil ' �. k ''" . f E ' °._.- �^ ESFERS NAME IVIED -r r f �. I'r at� y 20 1 , y I . 4 .7 !J �LC i C7 � � n Zi L./ wxP y k s tsrsR$ADDR£ss / f /� s g_ t t . t . he p fy . - a.: 97140 wb '� xr OMRANY NAME 1 f l S ( l I Q C! Q �r�3 PRON r . �r F a.e r 3 a e-4. E: � 1 14 Q _ .� I? 7 - < ('- S RESTORED .�' ,s r EPOR! RECi1VED BY' (REPRESENFATIYS OF O VrNF.R id I HED BY' ,:. � ' ATl VE O ,f ^ . - t � WHITE =Wale[ System Copy PINK • Cu�mrnrr Copy YELLOW • Ta C op y W - w c t.... r,‘,,,, PIN r,.,. YFL OW Tester C'twV • CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM200B- 00159 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/17/2008 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/21/20013 TIME: 7:00AM PAGE: 36 SITE ADDRESS: 15720 SW GREENS WAY CLASS OF WORK: SUBDIVISION: SUMMERFIaD NO.2 LOT #: 121 TYPE OF USE: PROJECT NAME: BROWN DESCRIPTION: Repipe entiro condo. OWNER: DROWN, JEFFREY PHONE #: 503.291 -9191 CONTRACTOR: AAPPLE PLUMBING PHONE #: 603 - 935 - 7461 Inspection Request Scheduled For: Date: 4/21/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message • 399 Plumbing final 068627 -01 503- 936 -7461 Y Corrections /Comments /Instructions: • � r X PASS ❑ PARTIAL APPROVAL CANCEL rI k"' 1 n NO ACCESS I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: c11 Date: t-t \07) Phone #: (503) 718- CfTY SF G J �. � '� � �. � yip .Z. WILDING 0 HVISOON PERMIT # „"` ' CMS' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: CT Phone: (503) 639 -4171 r� ,4P91iitAlI Inspection Requests (24 Hrs.): (503) 639 - 4175,,_. : -;. INSPECTION WORKSHEET FOR DATE: 4 . Vert) liS TIME: PAGE: SITE ADDRESS: 151 20 S W 6°RSE0 S W Ay CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date:M ` 1 SI Ql Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /Instructions: NU. l'.' 5 r i.66 1. /A PASS I I PARTIAL APPROVAL I CANCEL NO ACCESS I I FAIL CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED Inspector: G'" Atk r'k O € Le" Date: L iI t s' oc, Phone #: (503) 718 - 14417 CITY OF TIGARD BUILDING DIVISION PERMIT #: pi NV006.00159 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 412E42006 Phone: (503) 639-4171 444 1 1 4.1 tit Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 11/4/2008 TIME: 7 PAGE: 29 SITE ADDRESS: 10871 SW CANTERBURY LN BLDG 1 CLASS OF WORK: I SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE: PROJECT NAME: CANTERBURY CREST DESCRIPTION: LuarVi p r oT n t e,! - \ f ri i r r i- 9 ., i t i ci n 0 m m oil wa OWNER: CANTERBURY PLACE, LLC, PHONE #: 360-696-7700 CONTRACTOR: ANCTIL PLUMBING INC PHONE #: 503-642-7323 Inspection Request Scheduled For: Date: 11/4/2008 • Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 077586-02 971-563-9339 Y Corrections/Comments/Instructions: P r o v: i t - c Lo c , , A - . , 00%...t. lc CAnocc, Le._ 0 ad Lt) e, 1--Aet...),-/ Tv- c _,-1-- ..--- R/OLA AL- (-0 0 v c- 1 , _........... ) • ii.......,.'7-riiiiiiiiii. (---0-tre v " O "-° MlIllIllIllIl 1 1 0 PASS 1 I PARTIAL APPROVAL Ei CANCEL 0 NO ACCESS K FAIL El CALL FOR INSPECTION D ADDITIONAL FEES ASSESSED Inspector: <Pi ' ( Date: niiiion Phone #: (503) 718-