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Permit CI TY OF T I G R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2006 -00266 ..��I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/2/2006 PARCEL: 2S109DD - 09000 SITE ADDRESS: 12697 SW DA VINCI LN ZONING: R - SUBDIVISION: BELLA VISTA LOT: 020 JURISDICTION: TIG Project Description: Backflow preventer for irrigation. 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 RIVERSIDE HOMES INC. 1925 NW AMBERGLEN PKWY #200 Description Date Amount BEAVERTON, OR 97006 [PLUMB] Permit Fee 6/2/2006 $36.25 [TAX] 8% State Surcha 6/2/2006 $2.90 Phone : 503- 645 -0986 Total $39.15 Contractor: STREAMLINE PLUMBING 2505 SW AUGUSTA DR. ALOHA, OR 97006 REQUIRED ITEMS AND REPORTS Contact # : FAX 503- 379 -9543 PRI 503- 888 -6657 Reg #: LIC 142111 PLM 34 -370PB • 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: 7t /L/ r �' . 7? E Permittee Signature: -e- (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. Plumbing Permit Application �� FOR OFFICE 11SE ONLY City of Tigard Received - .-0 / Permit No ` ©� 13125 SW Hall Blvd., Tigard, OR 97223 Date By s .k f Phone. 503 639 4171 Fax: 503 598.1960 JUN G ��'� O. . � Date/By Other Permit No • 24- Hour Inspection Line: 503.639.4175 i� ,6 Plan R I. Date Ready/By s, H See Page 2 for Internet www.ci.tigard or us ��' � TtGA' _ ° Nonfied/Method: V Supplem ental Information �a � =w��p , . - z`et.: ,, ➢%.3 ;ar, ,"6 C, 'rOI S19.* .. ,'''' ''' ,Y�•.,, ,=Ntr' xs ,tt.,' A ,'= ,.�%`�` .).aka, .l�`- :.,'3 •h - xx 3>= �� �,9 �,,,.e`�nr •' a,k`�,Y,:�9 _ r:F. :::Yk.., �� ",'35 .,r,�r,.,- �.tt'i°A'?.f` ! 'An':i. ':.e ;Vki � > ':, �..�r h : TIP ' �,��,�,... ,�,. >lrE - .. SCHEDi7L � E:',.. �, ... o . 3. _...� -,�� �: �R._ , .. � ,,,,, ...�, : -_ �.. - r93 „j �`_., .. -. __ , .,.. „ �� '��__„ � _ _.,, ., „�.',z.._ .. .. „ Fes. ,���' New construction ❑ Demolition For special information use checklist Description Qty Ea Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) € C, ,, , , , C ILY ,,. r OF G U .. , :: 7 , GT , "r y SFR (1) bath 249.20 .vfs �rs ,�'sri�rt�' > >� =r.,,, z:�n;� . _. - ,,,�,�a•=s��r=*a_.,F _.. . _ .,.. � ,,, w� � _" = u RS:,,,, .. a 1- 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. r- .r, t, I MCAT ire sprinkler ( 4 ) Page 2 r q i•, i a r.. -- fT"E�'IlH.F 'I'I ®N I'+I`S�Y''''`,,:�?��.�._`::: `�� , IU ;DUBS URIGIA, -,, fY LA N �. D W a e .: ,,.,,.�, pax "..;.;_. -'... ^.: „/,;,R-,.:. ��33,' �. ,;�:'�:���,�<�, „- , =x�r��'.: _ .,,,,' '.. „ • ,.. �. ._ ...x , .�- � Site utilities Job site address: ) 2 i„4!.. S W b Wh'1G! / e. e c Catch basin or area dram 16.60 City/State /ZIP: - j`, p J a �` �`rr J O o a0 ,4 Drywell, leach line, or trench drain 16 60 Suite/bldg. /apt. no.: Project name: 1\ J; S k �, Footing drain (no. linear ft ) Page 2 — Manufactured home utilities 110 00 Cross street/directions to job site: Manholes 16.60 Rain dram connector 16.60 Sanitary sewer (no. linear ft. ) Page 2 Storm sewer (no. lmear ft : ) Page 2 Subdivision: eAka v 6 ,,A 0N I Lot no.: z Q Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: 4 ,,,r,�;rRr;;:.= r,;,; ,�<; Absorption valve 16 60 '�'�_ n „.�,,,��,,... -r > €�„ ,� ;tv Backflow preventer 1 Paget (,0, r Backwater valve 16.60 Clothes washer 16 60 Dishwasher 16.60 r> i;,;,e. . °; - _` ,, .� r , ”, , :< la'P RURE R TY,,:U EB � 3 „ °=� 3r' ;�.', ; ? °.- _ � x .,;,;;;, %' �,�: Drinking fountain 16 60 tit „M-' �i� . , b, •a a : „-, �'�,'� „ `'�� - �a� - �. . �,, .:.:�,,__. . ,; _ „� >;.��:,��_�' >:�,;,�� -e' Electors /sump 16.60 • Name: 2 1 lyefai ! 44 C. 1p F- -)-- Expansion tank 16 60 Address: 2 X 1,1 � j)jr Fixture/sewer ca t! e � � rJ �/ �`i'ri�6 �')-t'�1' - Gt �.L►n� � 1. -L � � C.; C7 F / cap 16.60 City/State /ZIP: :12,e,,,y,, , 4, (zv 4 -7L>U cf.- Floor dram/floor sink/hub 16.60 t � Phone: (Lj� tl� (4S - tA ce, L Fax: C ' 1a 0'2-1 t-I. a Garbage disposal 16.60 �' =a �,_ •,ia,;: ��:�' . ,;� �: ,.� ,- �»z;r, ;,aa���a >,,: �v+ Hose bib 16 VOW) : � 60 s s, k;;AP *' ; ,, '',, `i _ b :' a ❑ -A:'6 TAe i'i iir6\ , ;;hen <: �,, ,, . „ ,. .,- _ , ..: � Ice maker 16.60 Business name: L V €,,,, ()Le Hry'l,LO c? t o1 Interceptor /grease trap 16.60 Contact name: Ai, C rcyz. ,A.At�A Medical gas (value S ) Page 2 Address' [ 61 Z NWrvl / p ruCJi , 7_00 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 3-& C — O T Rz -CT�R ` =_ ': g ; .,,,,_ ..;, 1' Water closet 16 60 r, .:.�S:fE,'�^thsD'�R`4'� , .., .. � .s^.:;tX'�°5` . >. _, ,,, <., �'e, , -, , , - . >fi Business name: al- v w 1 i yi C v Al 05 Water heater 16 60 Address: 2 S D5 . s • l z,J . A u5 tP4 b . Other: City/State /ZIP: L� 6 1 0 E 7D06 Subtotal Minimum permit fee. $72 50 Phone: (5 ) OM - 6 6S 7 Fax: (5p3 ) .,7 z - 95 Li 3 Residential backflow imimum permit fee 836.25 CCB Lie.: / y 2 (1 i Plumbing Lic no.: 3 ti - 31o'p p, Plan review (25% of permit fee) State surcharge (8% of permit fee) . Authorized signature�� 6 3 f IS j y TOTAL PERMIT FEE Print name' 3 i t, 8 t l I I Date: - e _. a j This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tn -County Building Industry Service Board I \Building\Permns \PLM- PermoApp doc 12/03 440- 4616T(10/02/COM/WEB) CITY OF TIGARD { BUILDING DIVISION PERMIT #: PLM2006 -00266 13125 SW Hall Blvd., Tigard, OR 97223 k 1 /6 / b DATE ISSUED: 6/2/2006 Phone: (503) 639 -4171 i`1 a3u�11111j I (JG Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/13/2007 TIME: 7:01AM PAGE: 61 1 SITE ADDRESS: 12697 SW DA VINCI LN CLASS OF WORK: SUBDIVISION: BELLA VISTA LOT #: 020 TYPE OF USE: PROJECT NAME: BELLA VISTA DESCRIPTION: Backflouv preventer for irrigation. 9/4/07 Reinstated for 30 days for final inspection. OWNER: RIVERSIDE HOMES INC., PHONE #: 503- 645M986 CONTRACTOR: STREAMLINE PLUMBING PHONE #: 503•8B8 -6.6f r Inspection Request Scheduled For: Date: 9/13/2007 /� �, � -r,,,� Pour Ti _ ko �1 L Code # Inspection Description Confirm # Contact # Me age 399 Plumbing final 055516 -03 971 -246 -1996 Y 4e S t fo-s Corrections /Comments/ Instructions: C I ii } 7 ,,z / f ,ASS 1 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: 1/& Date: a ) I t 3 ( 2iT 7 Phone #: (503) 718 - ' Z