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Permit ill CITY OF TIGARD PLUMBING PERMIT ° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00171 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/22/2008 PARCEL: 2S 103AD -07600 SITE ADDRESS: 12721 SW 108TH TERR ZONING: R -4.5 SUBDIVISION: MILESBROOK LOT: 007 JURISDICTION: TIG PROJECT: MILESBROOK Project Description: Installing backflow preventer. CLASS OF WORK: ALT 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 BUENA VISTA CUSTOM HOMES Description Date Amount 5665 SW MEADOWS RD. STE. 150 LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 4/22/2008 $36.25 [TAX] 12% State Surch 4/22/2008 $4.35 Phone : 503 -443 -6033 Total $40.60 Contractor: TRUSCAPES INC 21600 NW ANBERWOOD DR. HILLSBORO, OR 97124 REQUIRED ITEMS AND REPORTS • Contact # : PRI 503- 969 -2144 FAX 503 -531 -9216 Reg #: LIC PLUS BACKFL PLM 7962 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: ` 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. Apr ?1 08 05:19p PENIUK 503 - 352 -4607 p.2 • Plumbing Permit Application, ' 4 VIII Building Fixtures Q PO . . . oFFIrE c' r ONLY - City of Tigard D 2j '1% w Received ill qP I� Date/By: Orr en Permit No.: p40 . `�l I - . 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 593.598.1960 1 1 = I t Da " Review „_ y ^ l0/ dtS f it " Da Rev Oder Perini t No.: r ► �G TIGARD Inspection Line: 503.639 -4175 C1TN t1,® DateReadyB or • ris: ris: H See Page 2for rn Inteet ww I tj''t� - w.tigard -or.gov ! - § , r N J1.w NurifiedlMethod: - Supplemental Information • TYPE OF WORK FEE* SCHEDULE k i - New construction 0 Demolition For special inJbrmarion use checklist . Description ( Qty. I Ea. j Total ❑ Addition/alteration/replacement 0 Other: New 1- 2- family dwellings (includes 100 II. for each utility connection) CATEGORY OF CONSTRUCTION . • SFR (1) bath 249.20 • W1- 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 J j Site utilities Job site address: 12 S W fog 'i H Catch basin or area drain 16.60 City /State/ZIP: ') (et pap OQ 9) . 2_23 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: 1 Project name: 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 ft.: ) Page 2 Storm sewer (no_ linear ft.: _) Page 2 Subdivision: /LES$ �) 0K Lot no.: 1:1 Water service (no. linear ft.: 1 Page 2 • Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK • Backdlow preventei J Page 2 '7, 1 P SI IL f / CtAw UEVI(E fiz. 14.(6/'rflOtJ Backwater valve 16.60 Clothes washer . 16.60 Dishwasher 16.60 Drinking fountain 26.60 J�. PROPERTY OWNER F G .TENANT Ejectors/sump 16.60 Name: f 1J /A VIS { r I cm From GMe Expansion tank i 16.60 Address: 5 3S j W M E fro owS po Fixture /sewer cap 16.60 City /State/ZIP: 11\14" 4S W jv 60 r Gie ti-)03S Floordrain/floor sinklhub i 16.60 Phone: (St1 3 ) L 3 - 02 3 I Fax: ( ) - Garbage disposal 16.60 g APPLICANT ❑ CONTACT PERSON' Hose bib I i 6.60 S e P e S1 1,4...C., Inc maker 6.60 Business name: C Interceptor/grease 1 easetrak 16.60 Contact name: / f EN i k4 K Medical gas (value: $ ) Page 2 1 a p Address: � I � Q [� u tIV l f �/1 a E� �U l� �� 4 0g. Primer 16.60 City /State/ZIP: I L(-S'$ ()N O. q'? ILL( Roof drain (commercial) 16.60 Phone: (9) ) 9 h er ` a j l.(y Fax:: ( 3) Sat- 9 a 1 C , S inidb v e vatory 16.60 t t TubJshowert rfshower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 ' J ' �i Business name: t 0 & S , (,LC Water heater 16.60 Address: l j , 00 /VW J' ix, Other: Subtotal City /State/ZIP: NI Lt - SRO, OA ? ?1 2y Minimum permit fee: S72.50 p Phone: (9) ?) / l d 1 K 11 Fax: (31 S q2( C. Residential back/ow minimum permit fee: $36.25 3(0, 4 4-5 - CCB Lie.: L W # .. Plumbing Lie. no.: • Plan review (25% of permit fee) fJ State surcharge (12% of permit fee) 1,'35 - Authorized signature: /L� TOTAL PERMIT FEE t 0 4 Print name: , , ',14 i Date: 1 1- f - U This 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. CITY OF Mk pLrn2o -001 / t IOL lNG DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2 `Iisr` 001 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 a k . ,_ INSPECTION WORKSHEET FOR DATE: ;: 9/2O0f3 TIME: 7: 00AM PAGE: 41 SITE ADDRESS: 1: >'/21 SW 108 ERR :: R CLASS OF WORK: SUBDIVISION: MIIfSE R OOK LOT #: 007 TYPE OF USE: PROJECT NAME: MI E;: ;BBBRO K DESCRIPTION: ,:*E' - DEMO Ckff' rx1`:.> FROM BUP2006 00496 WERE APPLIED TO THIS PERMIT. OWNER: BUENA VISTA CUSTOM i • PHONE #: 503-443 CONTRACTOR: BUENA VISTA HOMES PHONE #: 50 L *- 13 -k:a13 k 7 Inspection Request Scheduled For: Date: 5/912008 Pour Time: Code # Inspection Description Confirm # Contact # Message 3 99 Plumbing final ( W ; 6 0 0 1 1:01710 7350 I Corrections /Comments / Instructions: �� �i t�✓ �r/v►, 1 -44- LW 20 F-00 ( - 7/ ct c Loz-.i - : • o 71+, f z - Jb✓ ° r c}✓ �" tXt PASS I PARTIAL APPROVAL CANCEL I I NO ACCESS FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: 1-1 1N4. -�i% ' Date: SI'i 1,r).-.> Phone #: (503) 718-