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Permit f4Ft 2- 01-4 a C ITY OF TIGARD PLUMBING PERMIT �arr� DEVELOPMENT SERVICES PERMIT #: PLM2006 -00013 ;.� II 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 1/10/2006 PARCEL: 2S 109AD -11000 SITE ADDRESS: L14.94)9-SW LOOKOUT DR ZONING: R -7 SUBDIVISION: ARBOR SUMMIT LOT: 008 JURISDICTION: TIG Project Description: Backflow preventer for irrigation, common area landscape. 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 WEST HILLS DEVELOPMENT 15500 SW JAY ST Description Date Amount BEAVERTON, OR 97006 [PLUMB] Permit Fee 1/10/2006 $36.25 [TAX] 8% State Surcha 1/10/2006 $2.90 Phone : 503- 641 -7342 Total $39.15 Contractor: TRADEMARK LANDSCAPES, INC. 6 t3 O )/ �/D OREGON CITY, OR 97045 r REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 631 -3890 Reg #: PLM 6796 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. rj i Issued By: Permittee Signatur • A k Call 503 - 639 -4175 by 7:00 a.m. for an inspection that b - - - • ay. 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 ApREC IVE FOR OFFICE USE ONLY It City of Tigard JAN C Received / / �� /�, j 1 l ` _ay.& 13125 SW Hall Blvd., Tigard, OR 97223 J 10 2UU Date/By: 0 t 7 Permit No'7 0 Phone: 503.639.4171 Fax: 503.598.1960 fi r.. tt )� DateBeview 24- Hour Inspection Line: 503.639.4175 CITY O F O th er Permit N o.: TI ' '�II y: In www.ci.tigard.or.us BUILDING DIV ` =" " '7 --� Date Ready /By: • Notified /Method: lurir ®See Page 2 for �( Supplemental Information TYPE OF WORK FEE* SCHEDULE ® New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 249.20 ® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi-family SFR (3) bath 399.00 i Each additional bath/kitchen 45.00 ❑ Master builder ❑ Ot her: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 1446.4 S w Lap K De . Catch basin or area drain r 16.60 City /State/ZIP: Ti GAgbl O2 9 7 2 -7-4. Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (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 -- ..- - Water service (no. linear ft.: ) Page 2 Subdivision: Arbor Summit Lot no.: Fixture or item Tax map/parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK • Backflow preventer "PIP Page 2 I v' Ck'f' / 0 w r ire :KorI Backwater valve 16.60 rne� `.// Clothes washer 16.60 Dishwasher 16.60 - ® PROPERTY OWNER . I - . • D. TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: West Hills Development Expansion tank 16.60 Address: 15500 SW Jay ST. Fixture /sewer cap 16.60 City /State /ZIP: Beaverton, OR 97006 Floor drain /floor sink/hub 16.60 Phone: (503)641 -7342 Fax: (503)641 -7661 Garbage disposal 16.60 ® APPLICANT • ® CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Same As Owner. Interceptor /grease trap 16.60 Contact name: -lc K L. AN 1 EFZ Medical gas (value: $ ) Page 2 Address: (SAME AS ABOVE' Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: (503 ) 641 -7342 Fax: : ( ) Tub /shower /shower pan 16.60 E -mail: KLAN IE WG51 H(LL VEL.OPbtEhtMCOM Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: ' • RA D EM k RK L{lt IJDSCA PE Water heater 16.60 Address: - PG Box 2 4 f 0 Other: City /State /ZIP: - ORE o 4 Grr', OR. 6170 Subtotal Minimum permit fee: $72.50 Phone: (503) t 60:4 - 2013 Fax: Residential backflow minimum permit fee: $36.25 CCB Lie.: • (i353 Ex , 1131/ c i fy/M , T 4- (, 7% Plan review (25% of permit fee) Authorized signature State surcharge (8% of permit fee) TOTAL PERMIT FEE Print name: ' 7 \ � i � S Date:, /1D' O& This permit application expires if a permit is not obtained within `-' 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. i:\Bui [ding \Permits \PLM- PermitApp.doc 12/03 4404616T(10/02/COM/WEB) CITY OF TIGARD BUILDING DIVISION r PERMIT #:P1m)A,19 ©UOi j 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 / uyp,o'�I�I Inspection Requests (24 Hrs.): (503) 639 -4175 `_.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: (,:ff 1.,0 0 g w1" b " CLASS OF WORK: SUBDIVISION: //i LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE €503) 3i5 -GC b3 CONTRACTOR: �� V PHONE #: Inspection Request Scheduled For: Date: 14 ' ©k Pour Time: Code # Ins ection Description Confirm # Contact # Message 3 Corrections /Comments/ Instructions: • �._ � L " e.',/ r 11 / - I I , ' -.411MIIII / Ir-,,e .',,,,... . 0/ / 74r--- ___ee_e...._-e.. 4 zt.to,a...5.- ___,e_pr--A - 4. ', SS • ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS a FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' " V l\ Date: V` k Phone #: (503) 718- 2 4 //. f