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Permit C ITY OF T I GA R D PLUMBING PERMIT rr wi4 DEVELOPMENT SERVICES PERMIT #: PLM2006 -00267 ri DATE ISSUED: 6/2/2006 11 - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 109D D -09100 SITE ADDRESS: 12689 SW DA VINCI LN ZONING: R -7 SUBDIVISION: BELLA VISTA LOT: 021 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 S 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. • P1umbin Permit A ttob F OR OFFIC U ONLY Ci of Ti d an Tigard Date Receive B I /' /� Permit No`y�,, w�u '�v 7 /'�I� /� 7 13125 SW Hall Blvd., Tigard, OR 97223 1 2006 Plan Review / Phone 503.639.4171 Fax 503.598 196 Other Permit No . 24- Hour Inspection Line. 503 639 4175 .. (J�.... i I Date /By. , s Internet. www.ci.ti ard.or.us CITY OF TIGAR a' . -:.— - Date Ready /By El See Page 2 for BU�L ©ING,DIVISION Notified /Method: / Supplemental information _ E , r ..P xa - a, _ :.x ^,r•• i g �, ° .z� :, E ,;,, � �. ,gin , li j zi New construction ❑ Demolition For special information use checklist. Description Qty I Ea I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) ,•' x a3 I: v:.��e? - "% � ; . Y3'ybN 3Iffi"t�� ' �' S , J „ �A`s " y ,._ .. • }: , ' ;'" �;,; 5 ' �'�•�':ib S FR (1) bath 249.20 ' ''' e - ,„ - ACA, m- - t- + - ''�GODiSTRt GTI®N- „,, -_ : y, ,.' [a 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 CD Accessory building ❑ Multi -family SFR (3) bath 399.00 Each additional bath/kitchen 45 00 ❑ Master builder ❑ Other: Fire sprinkler ( sq ft) Page 2 ,: N' P,W,, a : z , oN : A vD ', .,. = _ , , �� ° °' - .. ,t� ,: ..•• ,..- ..,�a.�..,. -- ��-° .7 .. � <_ <.. —�A Site utilities Job site address: I � SG) sv ®G+ b Le vi ( Catch basin or area drain 16 60 City/State /ZIP: "" , 50 ,„„6, O e c , a a 1..� Drywell, leach line, or trench dram _ 16.60 Suite/bldg. /apt. no.: l Project name: Q \\ \J S k r , Footing dram (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: " e" V hcAeN I Lot no.: 2 4 Water service (no. linear ft ) Page 2 Fixture or item Tax map /parcel no.: . , ; , _ ;, _ ,, , , , Absorption valve 16 60 ESCRIP,TIO OI� ; ,.:;'' ` . -�:€ ® . :. .. ,: ,- . . .., >;3s,,,: °�. , '',.t* s.° � K,..,,�.�, .. ,., Backflow preventer q -� ��: -.:: ,. '�' � ;., < afr B kfl w pr Page 2 34,, 2 3" Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 �> ���•.�t � <.� -� °: 3 � � Drinking fountain 16 60 - . .. -PR PERT I. "'- -.,.., ' � = ' _ � 0-; N tiN : , ' , <. ° t 4 Ejectors /sump 16 60 Name: P._ V-evy i r,L L - ) - 1t YI-.e) _ r.>-'- • Expansion tank 16.60 Address: let S ( ,4., ( t • s V- 7- c (-) Fixture /sewer cap 16.60 City/State /ZIP: few 4 ,( ,.1 p q'/ 300 (., Floor dram/floor sink/hub 16.60 Phone: (�•j -j ) L 4s- _ b 7 cU LP Fax: (Str•) it 0 --Zq 0 Z Garbage disposal 16 60 — -p " z,- , 4 - . , m , z rx^�:. Hose bib : ^ ❑P .LICAJ!71 . p s; ® . 16.60 :24 °.... _ -. .. s,.:-; . .,,. ,Ifrei - ; , Ait4M i COI &ICC 1'ERSU0 ,,;,:_ Li Ice maker 16.60 Business name: Iii v- ii, a e ) v ' ,, , J - �6.,. Interceptor /grease trap 16.60 Contact name: AL (..,4' cyL ./ u...iit Medical gas (value $ ) Page 2 Address: ( tj ' -j AAA/ Ani b4 1 , Pr ii z Primer 16 60 City/State /ZIP: Roof drain (commercial) 16 60 Phone: Sink/basin/lavatory 16.60 ( ) Fax:: ( ) Tub /shower /shower pan 16 60 E -mail: �, „ Urinal 16.60 ', d''- -~ x , <Gt3L ,,, , , . C'I'UR�; , � ., ' 3 • .1 -, :„ „ fc, `, a Wa t er c loset l 6 60 Business name. r, `� �,sm � „ roe c; � ^ \, _ ,. &' u n�, , a _ � .. 3 „ , . ,h'f 3 'f-V t PI h a Water heater 16.60 I r trot � Address: 2S D5 S • ( • A v 1) _ b • Other ,l1 1 Subtotal City /State /ZIP: )~-°1 L 1 ti COQ. 700 Minimum permit fee $72.50 Phone: (5 ) e2f j - f j 6S 7 Fax: (503 ) 341 Z - 95 Li 3 Residential backflow minimum permit fee $36 25 CCB Lic.: j q 2 (1 1 Plumbing Lic. no.: '3 Li - 37o 'pa, Plan review (25% of permit fee) �'/ 04 .6„. ` — I` 1 �,� State surcharge (8% of pent fee) 9 2 Authorized signatur TOTAL PERMIT FEE 39 is Print name: ,3p>> & A, iv, 8 1 i' I i Date: ._ - g -° 0 j This permit application expires if a permit is not obtained within 180 days after it has been accepted as comple te. *Fee methodology set by Tn - County Building Industry Service Board. I \Building \Permits\PLM- PenmtApp doc 12/03 4404616T(10/02/COM/WEB) CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2006-00267 13125 SW Hall Blvd., Tigard, OR 97223 gv_p_ , I 1 0/ , D DATE ISSUED: 6/2/2006 Phone: (503) 639-4171 t "Ipifiliiiti / Inspection Requests (24 Hrs.): (503) 639-4175 Atifr ■■■•■• INSPECTION WORKSHEET FOR DATE: 9/13/2007 TIME: 7:01AM PAGE: 60 SITE ADDRESS: 12689 SW DA VINCI LN CLASS OF WORK: SUBDIVISION: BELLA VISTA LOT #: 021 TYPE OF USE: PROJECT NAME: BELLA VISTA DESCRIPTION: Backflovv preventer for irrigation. 9/4/2007 Reinstated for (30) days for final inspection. OWNER: RIVERSIDE HOMES INC, PHONE #: 503-646-0986 CONTRACTOR: STREAMLINE PLUMBING PHONE #: 503-8L18-6657 Inspection Request Scheduled For: Date: 9113/2007 A Pour Time: --v-- T ) me: Code # Inspection Description Confirm # Contact # Me, 399 Plumbing final 056646-04 971-246-1996 4'(-5' tres vir Corrections/Comments/Instructions: t /1/4• 5- } ( t 5 L- i j VI, PASS PARTIAL APPROVAL CANCEL El NO ACCESS , - • FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: _ Date: 9 13/ d' Phone #: (503) 718- , ,