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Permit CITY OF TIGARD = }_ PLUMBING PERMIT _ COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00167 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/21/2008 PARCEL: 1 S125DC -07300 SITE ADDRESS: 07105 SW ASH CREEK CT ZONING: R -4.5 SUBDIVISION: ASH CREEK ESTATES LOT: 006 JURISDICTION: TIG PROJECT: ASH CREEK ESTATES 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 GOODLETT MARSHALL BUILDING PO BPX 91551 Description Date Amount PORTLAND, OR 97291 [PLUMB] Permit Fee 4/21/2008 $36.25 [TAX] 12% State Surch 4/21/2008 $4.35 Phone : 503- 297 -1881 Total $40.60 Contractor: BURNESS LANDSCAPE 9330 SW LEHMAN ST TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 432 -8525 FAX 503- 432 -8525 Reg #: PLM 13007 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 B A / �� �— Permittee Signature: 5e€ 7� � `' � i 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. I 'R - 18 -2008 03:14 PM THOMAS.S.BURNESS 5034328525 P.02 , 400D Building Fixtures a „ � q � ► , 6 i ; 1 j l ( (II I I I I 4 • ; i � a ' ' I IN ..., City , it No,: c,�JCo7 131 of Ti SW Hail Blvd., Tigard, OR 97223 and k t - .6 s it �Uly } 1.� , it; , A , 'i ' Review Other Permit N �► s i Phone: 503.639.4171 Fax: 503. t Z. U DeteM : r e+�T i�_ f " - �7 { Internet www Inspection Lino: 503.639.4175 IBM- M- e, n papa R /Sr AIM m see Pats 2 for tgard -or acv ∎ ied /Met ed; Su . lemental Information I. 4',, , r, 7 I ,. , ' {. _ ( �•,1� r_..... l ;04 , 1;119. Not , i �` i , r 1' t " pe , a t91 L� ,,1 1 " 1 "'�lel,; � I'•.I1.4.111,4', • t 1 • 'i�ll i ^ aa,1! l;r ` aP 'w�y" °n� +' " ' ° a �a { D , 1 i' r , ,,,I,t,,I,.. .� i 4 oma 1+ ,t� lit : fir' . , i ,, . . , { E 1 New construction 0 Demolition Fors card Jrtjnnrwdon use checklist .. Description 1 Qty. 1 Ea. 1 Total © Addition/alteration /replacement 0 Other: New 1- 2- atolly dwellings (includes 100 t1. for each utility connection) I , t!I >{ r�!,�lit,1tj Y1 ,t 7 : ,7' q;.te t 'y�,�!j �1ti 3 _ - _ Lf;1jl )! s " t ? 'y ! i { F t ! ,; t i I;; <" Y ' ;h ,4 4 a t ) to "s " lttt Iln i vii ! SFR (1) bath 24920 CI I - -and 2- family dwelling 0 Coenmetcial /industrial SFR (2) bath 350.00 ^ - I Accessory building ❑ Multi - family SFR (3) bath 391.00 - Each additional bath/kitchen 45.00 ❑ Master builder 0 Other Fire sMflnk�er �1 It) Page 2 ;1,„,, l� 7 I : 1, 7 F' '7,:p Ipi 1 '1 1 �II��'ppq��y�{�� y�,�at p (_ e 1. .. ; " i Plf 1 1 3d,; u fV' (, p 1 ,' I '1 ,, a 'i I1 .. •fl i / 4 ' _- ' ' " ,f I , " " ; > Site u tili ties _ tiy >�,k {,F ., ��Cr ,» ,, >1 �,61, 1 � � ��>b' tmb �� ^.iax a,ios6'nti6'e,1rd�F',,,,• r ��, Job site address: Ash Creek Lot 6 - .7 ()S" . . e h begin or area drain 16.60 City /State/ZIP: r ` a' Drywall, leach line, or trench drain M 16.60 • Suite/bldg, /apt. no.: Project name: Winwood Homes Footing drain (no. linear ft.: Page 2 Manufactured home utilities 110.00 Cross strect/di ections to job site: oles 16.60 Rain drain connector 16.60 • Sanitary sewer (no. linear ft.: __-._J _ Pago 2 Storm rawer (no. linear 11.: ) Page 2 A Subdivision: Ash Creek Estates I Lot no.: 6 Water service (no. linear $,: ) Page 2 r 1 - Fixture or item Tax map/panel no.: • "l - ! a n,a [ f i I r M {' 7 1 Absorption valve 16.6 p,I , ,\r,Jpp � , ', 11� 1�' �' ti �, t� l w 14: I I • , ' I � " M fl 1 M 1 ( , n I L . t � rTF dilQ' �r1„1 'A,, " ! hh i„,,u 4 r1, y h1 f ,,.;I i r,,Y ,, • .I.,. ,_ G r'�.. , .e.), 'Ik' t , g ;Pi . %claim prevemer 1 page 2 36. 25 ,, landscape Irrigation Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 , ( la t�� e��e� a+ + I tt !!r t , dd I s dr p n I' -Drinking foutttaitt I 16.60 1 p; � I 1'w utos kNaMl. t'� u 1 , aa ^I " , '> F { y '�T a 1 ,.;t I" , (1 aaia, <s „Fr rlla�,c" < „d�a�i�at,`..��6 r , lyjeelurslsump 16.60 Name: Winwood Komes _. gxpangion tank 16.60 Address: Fixture/sewer cap 16.60 - City/State/ZIP: Floor drain/iloor sink/hub 16.60 Phone: ( ) Pax: ( ) Garbage disposal 16.60 ',,,,,,,,0,11.4 �d ( . ' 0 a." 7 ,,,,,, 'Cut < £u "' r, ,, , -- r. , AI hale bib 16.60 ,,u,12) l i ( 01 1 1`F° + t, ar,4;L ," . .I > .0. ' 0 ' " . i •04 .f 4r40.1.47/4)a?ii(tl'Hni ;u:: icv mac,. 16.60 Business name: Burnes* L/S - . . Interceptor/grease trap t 6.bt1 _ Comas name: Tom Runless Medical gag (value: $ �) Page 2 Address: 9330 SW Lehman St Primer 16.60 City/State/ZIP: Tigard, OR 97223 Roof drain (onmmerelal) 16.60 Phone: (503) 432 -11525 - - Pax: : ($03) 432-8525 Sink/basin/lavatory 16,60 Tub /shower/shower pan 16.60 E -mail + { yi m s s Urinal 16.60 ,li.}l`'4 al ,`r Il 44 : i , I I ,(ri" 1.0 t tr&ati 'h r, 4' ' ,.. ler � f , ti'fi11 Water Uosnt 16.60 Business name: see above Water heater 16.60 Addrasa: Other; City/State/ZIP: Subtotal Minimum permit fee: $72.50 _ 36.25 Phone: ( ) Fax: ( ) Residential backilow minimum petrnit tee: 536.25 CCI3 Lie,: 13007 P bin i no.: Plan review (25% of permit fee) State surcharge (12%o> permit fee) 4.35 Authorized signature: TOTAL PERMIT FEE 1 40.60 Print name: Thomas Runless [ Date: 041808 This permit application expires if a permit is not obtained within 180 days after It has been accepted as complete. *Pee m thndnlnav set by Ti (' aunty Relldinv Industry Service Rrn,td r ' . CITY OF TIGARD / BUILDING DIVISION PERMIT #: PLM2008-00167 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 412112008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 Jit 1 / INSPECTION WORKSHEET FOR DATE: 616/2008 r TIME: 7:01AM PAGE: 10 SITE ADDRESS: 07105 SW ASH CREEK CT CLASS OF WORK: SUBDIVISION: ASH CREEK ESTATES LOT #: 006 TYPE OF USE: PROJECT NAME: ASH CREEK ESTATES DESCRIPTION: Insialling bacIfIow preventer. OWNER: GOODLEIT MARSHALL BUILDING, PHONE #: 503-297-1881 CONTRACTOR: BURNESS LANDSCAPE PHONE #: 603-432-8526 Inspection Request Scheduled For: Date: 61612008 Pour Time: Code # Inspection Description Confirm # Contact # Mes e 395 Misc. inspection 071029-01 503-537-8654 Corrections/Comments/Instructions: ____ TR 5 - r-g. — .o P . J .-- r - D - A - ss fl PARTIAL APPROVAL 7 CANCEL 0 NO ACCESS l FAIL 0 CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector: ..... Date: (C) Phone #: (503) 718-