Permit •
C ITY OF TIGARD PLUMBING PERMIT
.641I DEVELOPMENT SERVICES PERMIT #: PLM2006 -10058
�•� DATE ISSUED: 6/16/2006
13125 SW Hall Blvd., Tigard, OR 97223 503-639-4171 PARCEL: 25111 DA -17400
SITE ADDRESS: 08995 SW GREENING LN ZONING: R -7
SUBDIVISION: APPLEWOOD PARK NO. 3 LOT: 167 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
SHELLE MORARY NIIYA
8995 SW GREENING LN Description Date Amount
TIGARD, OR 97224 [TAX] 8% State Surcha 6/14/2006 $2.90
[PLUMB] Permit Fee 6/14/2006 $36.25
Phone : 503- 922 -2674 Total $39.15
Contractor:
GREEN DAY LANDSCAPE
PO BOX 2613
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 658 -2685
FAX 503- 658 -5342
Reg #: LIC 8046
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: jj / , `i ,,e4`
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
JUN /14 /2006 /WED 03:46 PM P. 002
nimbi.+ Permit ' PP t b ` \E® volt oteNCE USE ONLY
l � �p
i 3125 SW Hall
Received
f 815 ?L• "\ Ji - 006 K
City of Tigard T
r g 1 4 2006 ► cnni Ne.
Blvd., Tigard, OR 97223 �,1 Dn lc/13 : / 'J r O
Phone: 503.639.4171 Fax: 503.598.1960 U 1V I'l �,i Revie+v
J ! ' (1' DDate/113y: Other Permit 110•:
�
24- 1-lour Inspection Line: 503.639.4175 of - r G ' o: Date Ready /6y: ) t$ See Page 2 for
Internet: www.ci.tigard,or.us
CM 9 1V( • • ' "" Notifted/tvlethod: / / t Supplemental lhforntation
,4 5 ,� y � .� ..�. ,, +R ' • 1 a y$5,' '' ; /'' r r r ,i ': „' _ : ;.. ;: ;' ;,, 4 - ' -ACS,' : Y; ,, , . . -,. i�' :7b # ' 4, ;.,1 ,
t �y� :c:, ,,, :,., . � =? : . . a; .: ./ . • _K „ " " + � : '` Y ?t:; : ""., ". t ar :; • : .. r r . - ., $'4' - -e, J,;. r ..= l r,,,:w1tl $ C '' 't"4'4''''"...-.'4....:' 4'a :)`;;C oa t
'� •�.7: v P€: .�t. tom` r �.. .. �' � .-- . 5 •'f :: n'rir. ��.'y �%...�.. � "�,��C ,' ' <J_� � Y�.� , �� �.5 .: 1: ,7,..:��J
` $' 'i :e�:.:. ..,. s t °� -: - v ,;,;_,„„,n7._ 1' a , :..t i ��. ., r• o _a5•::• . �. - -. �'G
W ew construction In De,nolition y For special Utfarmalinn use checklist
Description I QI'- 1 En- I Total -
❑ Addition /alteration/replacement ❑ Other; New 1- 2-family dwellings (includes 100 ft. for each utility connection)
;f > l F' 4 ) ; ;g p , ' * : s 4 .. itGt5iii( i1!?s".GfQN TJO Y ` s i- . r- s''' ; f ' ..' =: S (1) bath - - 249.20
a nd 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
11) Accessory building El Multi-family SFR (3) bath 399.00
Each additional bath kitchen 45.00
❑ Master builder ❑ Other:
, :'>Y;'ria_kt; :,. r.. . � ,` ; ,,�:: „ ^: • Fire sprinkler( sq,ft.) Paget
^
{,•;;.... '7Olt S;ET,B; pl QRM ' i6rt! Ni i'LOCA ION:: .=, .
: ... - ... ,,.... -•. ... .. .:.:...:.. :.:...:.:::. .:. {� ?'" Si te ut
Job site address: g 01 CIS �' 0S 4 ) ,(\ ■ne, Lr\ Catch basin or area drain 16.60
City /State /ZIP: V C \ rl _ At: � KL of - 7 7 L4 Drywell, leach line, or trench drain 16,60
Suite /bldg. /apt. no.: -' Project name: Footing drain (no. linear ft.: ) Page 2
Manulaetured home utilities 110.00
Cross street /directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no, linear ft.: ) Page2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.:
Water service (no. linear ft.: ) M __w Page 2 I -..1
Tax map /parcel no. Fixture or item
>.. .... r.` ,. .. Si; +)';j;.;; ; `i g ';�:c <c . , Ab sorption valve 16,60
.... ,- .': •.:a, ,.:::.�11:+ : ...: :. .c, , ,.. ,. ; ,..t.. � .. � ..n., .;,,:.e. ,..c+l'; ..� +. n;,i `. , q,, `h ,„ �' ?�t: a;:�':i:ii`i 13ackllow ))feVettleC Page 2 , `
U ^ .. •n: t' , e - `v \ S 4 F- t,,, -, Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
` ., ,,,; x .. h : >, d5 r•„ n . ew. C fi r.: t.:i a. t bricking fountain 16.60
`l ;., - :4:... - M•.. V .. . ' '):� ,. . , . f�Je0t0l'$ /$tltl)I) 16 -69
Name: 5 - \` . P V1y 0 (-- Y -, L ‘ . 0 . Expansion tank 16.60
Address: q 9 ,s L-.•-~ C e..•e_r\ ■,1• C., rl Fixture/sewer cap 16.60
City /State /ZIP: it A ( • ' i . Floor drain /floor sinIVItub 16.60
Phone: (C;(p -) t�� 1 ( L Fax: ( ) Garbage disposal 16.60
•: ,r.: 4• a,f•� , . �,; ,r, O , •µ; ; ,, t... ;•., 'MVO �.., Hose bib 16.60 • `'� ,. .,':�'.f' ,. .,.,. „)1' + M A ,Al. : i . \, � 4 .t.• ,. e ljtls:.e - ,o,•.: ,I ..,,., .:ht`:u \;,
lee maker 16.60
Business names -.it , . • • :. - i a .i .•,• • / _ Interceptor /grease trap 16.60
Contact name: c \ el y YllA.._. _ Medical gas (value: $ ) Page 2
Address: \ ( \"? _Primer 16.60
City /State /ZIP: LA CA C,lC ea 09 J eAc _ q " ols" Roof drain (commercial) 16.60
Phone; ( 1� --- Fax: : ( j.co e.^ �-); H 2_ Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
, `i, S1;3`<<;h�:.; �:2r:. ,:'t) %:}:: : '�. y) �,^ ' . r. s^ ,. ..� +,
���, `x '41' ^ •i <
� "`o`�'1 �a;q �. i: c:;� .,r ; , ',1', : �.,: :�., �(,> r.. Urinal 16.60
�yY:y gig a';: r.,1. )� b g, � + y � . 6i il : .i, . ` i:;, ∎: oc % :
.i • ..1.;:,,,..7......, :.. -. ,`.%t: ,:1 j �' • "•:' • � + :;:'Y: , {, 44' �?■, >. .. ./.. • (!.,.;i ,;7 ...,IP:`:r:'i ,.. r . 1 . \'t= tatt: - A .,, Walet•C104et 16.60
Business name: • _ _ * Water heater - 16.60
Address: V (', ) 0 ( ...a il . ` Subtotal • - S
City/State/ZIP: CAA r . k_( - ). 0R. of minimum p ermit fee: 5 72.50 _
- Phone: (s-t. �) co 5 cy (4 , , Fax: (<;-(1- � , r (A 7_ Residential backflow minimum penult fee: $36.25 3 �
CC/3 Lie.: OO 12,1....k + - I'i Plumbing Lic. no.: Co .,.,. -,'` Plan review (25% of permit fee)
(0
Authorized signature: 1114&'4114 . State surcharge (8% of permit fee) 'Z ,
A TOTAL PERMIT FEE 75 Ci i
I Print name: 1J A Date: (i, - This permit application expires if a permit i$ not obtained within
180 days after It has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
i :■Building •Pcrmi,g`PLM- Permiu\pp.doc 1203 1,10- :IG16'1'tt0.OVCONt'wE13)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006- 100513
. A
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6(16/2006
Phone: (503) 639 -4171 kolliopotilifil`
Inspection Requests (24 Hrs.): (503) 639 -4175 Ar 1L
INSPECTION WORKSHEET FOR DATE: 6/20/2006 TIME: 7:01AiMt PAGE: 60
SITE ADDRESS: 085'95 SW GREENING LN CLASS OF WORK:
SUBDIVISION: APPLEWOOD PARK NO. 3 LOT #: 16/ TYPE OF USE:
PROJECT NAME: NIIYA
DESCRIPTION: I3ACKFLOW PREVENTER FOR IRRIGATION
OWNER: MORARY NIIYA, SHELLE PHONE #: 503 -9212674
CONTRACTOR: GREEN DAY LANDSCAPE PHONE #: 503 - 658 -2685
Inspection Request Scheduled For: Date: 6/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 03196401 503 - 658.2685 N
Corrections /Comments /Instructions:
i
[1152
�(FASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
n FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: M x "1..1 Date: ‘Y- G �� Phone #: (503) 718-