Permit t! '
C ITY OF TIGARD PLUMBING PERMIT
JI DEVELOPMENT SERVICES PE
DEVELOPMENT PLM2006 -00269
DATE ISSUED: 6/2/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DD -09300
SITE ADDRESS: 12675 SW DA VINCI LN ZONING: R -7
SUBDIVISION: BELLA VISTA LOT: 023 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: fG� f(�%t�`b Permittee Signature: s
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.
. '
• 1 .oing Permit Ap ± , V E FOR OFFICE;, USE ONLI'
�f Tigard 1F 1 i 2006 ReceDatervBedP OJ
y 6 0 \\\N I _, „11� PermttNo�`�, „ ,,�� `' �
/ SW Hall Blvd., Tigard, OR 97223 l�L
Plan Review
Ze 503 639.4171 Fax- 503.598 1960 a l
Notified Method Date /By Other Permit No
Hour Inspection Line: 503 639 4175 C��� I' I
/ emet: www.ci.tigard or us sUeL'�®Gi F 0e ite� � .,,,, Date Ready /By '( S See Page 2 for
V Supplemental Information
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New construction ❑ Demolition For special information use checklist
Descnption I Qty 1 Ea. 1 Total
I ❑ Addition/alteration/ replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft for each utility connection)
`' : . -aa " ; `AC0401*: :AcoNST1tim: iN: , , s SFR (1) bath 249.20
i a 1- and 2- family dwelling ❑ Commercial/industnal SFR (2) bath 350 00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath kitchen 45.00
❑ Master builder ❑ Other:
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Fire sprinkler ( sq. ft ) Page 2
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r S11 �E ,Y?�.m.1 \l' " L . E1i�'ltil�iOtl i'y iG � Vl i23 1 , T 03 \i Y' " • "
�zl .�� %��;z.. .,. - `f�;�.a�:��r: . .�,1,;�- ;:::.� ; s.;,,,:. >.3. :,,; w, 3 :�:',:�33;s„*A�:.�- a;:�u�s.'�.' .. . - -. ;, :'��j Site utilities
Job site address: 124 7s S 1 J b ,yl L.�. y , e _ Catch basin or area dram 16 60
City/State /ZIP: 71/4 q J a ,, O on a � Drywell, leach line, or trench dram 16.60
—
Suite/bldg. /apt. no.: 1 Project name:11a V Sk"„,,, Footing dram (no linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16 60
Ram drain connector 16 60
Sanitary sewer (no linear ft. ) Page 2
Storm sewer (no. linear ft. ) Page 2
Subdivision: ' e`1 \r Lot no.: 2 Water service (no linear ft • ) Page 2
— Fixture or item
Tax map /parcel no.:
;,.. v«,' I ate o' ° * "_;,:. , sorption valve
Ab orpti 16.60
t e ; :. t a a„ ' ,ESGKI'h1Ql . w.. k
4, ;laV O . ltT� ;:;' ; :: %4 8 M , -,
.. - ,�;,��,� . ���,��,- �.,,a „4,,,3�,"�'�,e« . - � .� . ,. - .,F. b,- r - Backflow preventer 11 Page 2 3( Sr
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
1 ;, g igiWi_ - r,3 ? a „ r ° :,, 3�: c� -,,, . Drinking fountain 16 60
�` .,.: ® ",,, -„ , WNEfi`: ,,s,,, , , < ,'. "'''. T: 1 `r
�: ,�:.. - x« x- .�_d =�,.� �,•'�� "T�, . - ..;. �,k� '�� y �� _.' ,, - - ,.. , -; `��s' �, tors ors/sump „ ,�- F.=' - `' °_ °� ' " Exec / mp 16 60
Name: Ili l/ i r.ii, 4kr'1 Lee, . r-T-7e: • Expansion tank 16.60
Address: 6 �l/ )� Fixture/sewer ca
Z � �f" � f!?2�l' - c<S �.L7.�t� (�� �" � CJ t� cap 16.60
City/State /ZIP: BeikV rl 0 �� �� ' Floor dram/floor sink/hub 16.60
Phone: l9 ) (4_5 _ b-). 55 ( Fax: (cti ) o ' 0 --2_41 Li Z Garbage disposal 16.60
0 -, , :»-..,� ; ;,, , _ t' «� ,, ,;' ;;�;•w),, Hose bib 16 60
:: r ; x ' l'E I C A N1' � " -, l : Il' C ' • . '
3 Vs6ysi
{- `�� - ° ' I maker 16.60
Business name: i%f-e I le'y 5 k J--Y?C. Interceptor /grease trap 16 60
Contact name: At LA' Dcyt . Medical gas (value S ) Page 2
Address: ( t 2 iv A /Irv')' 1. / p yU t N Z oo,.> Pnmer 16.60
City/State /ZIP: Roof dram (commercial) 16 60
Sink/basin/lavatory 16 60
Phone: ( ) Fax:: ( )
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
� , ,
., 'w' ;P«.," fl.- O tt c o o , A.CTQR' ' e 'G% , ,
:rv .mrr�r� < <=<r. "xa'wss =,�m . .. ...,,,^`, - , Via.., « .:3, , ,;:,'' ` .. .,' Water closet 16.60
Business name• '' v 1 7 j' Prwio' C pi V W 0 Water heater 16.60
Address: 'OS D5 .5 • WI - A 05 tP- -- D • Other.
City/State /ZIP: 4 tj,„ & 01. 7006 Subtotal
Minimum permit fee: $72.50
Phone: ('5 ) (;i3 e - ( 65 7 Fax: (5d' ) .317 Z, - cis - el 3 Residential backflow mmumum permit fee $36.25
t t f Z (I I g 3 L - 3 . 7o O Plan review (25% of permit fee)
CCB Lic.: Plumbing Lic. no.: L7 �
J ..- s State sur (8% of permit fee) . 9__
Authonzed signatureC_— G TOTAL PERMIT FEE 39. fs
Print name: Son n A vv 81'W Date 2 - e __ 05- 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
1 \Building \Permits \PLM- PermitApp dot 12/03 440- 4616T(10/02 /COM/WEB)
r.)--
CITY't)P TIGARD
BUILDING DIVISION
4 11 PERMIT #: PLM2006- 00269
3125 SW Hall Blvd., Tigard, OR 97223
B 4 $`■\ • DATE ISSUED: 6/2(2006
Phone: (503) 639-4171 ,_..14 0,evtiii, _
Ivspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/7/2006 TIME: 7:06AM PAGE: 99
SITE ADDRESS: 12675 SW DA VINCI LN CLASS OF WORK:
SUBDIVISION: BELLA VISTA LOT #: 023 TYPE OF USE:
PROJECT NAME: BELLA VISTA
DESCRIPTION: Backflow preventer for irrigation.
OWNER: RIVERSIDE HOMES, INC, PHONE #: 503
CONTRACTOR: STREAMLINE PLUMBING PHONE #: 503-808-6657
Inspection Request Scheduled For: Date: 6/7/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 031234-06 503-572-4708 N
Corrections/Comments/Instructions:
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4 - 0 - e-g - S ;
4 5 ' ' 1 ( 4-." 1- ke
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I PASS I I PARTIAL APPROVAL or CANCEL 0 NO ACCESS
n FAIL 0 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
\/&\ _ Date: la 2)12-0
Inspector: - Phone #: (503) 718-