Permit CITY OF TIGARD PLUMBING PERMIT
eI � DEVELOPMENT SERVICES
PERMIT #: PLM2006 -00050
��I — — DATE- ISSUED: 1/31/2006 —
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109AD -13300
SITE ADDRESS: 14925 SW LOOKOUT DR ZONING: R -7
SUBDIVISION: ARBOR SUMMIT LOT: 031 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
WEST HILLS DEVELOPMENT
15500 SW JAY ST Description Date Amount
BEAVERTON, OR 97006 [PLUMB] Permit Fee 1/31/2006 $36.25
[TAX] 8% State Surcha 1/31/2006 $2.90
Phone : 503 -641 -7342 Total $39.15
Contractor:
TRADEMARK LANDSCAPES, INC.
PO BOX 2410
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -504 -2013
•
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.
Issued By: % Permittee Signature: s S(/.e . _, 1:;
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.
JAN -31 -2006 TUE 11:18 AM FAX NO, P. 03
i
Plumbing _Permit A lication FOR OFFICE USE ONLY City of Tigard REC ED Received _ _ .
r� Date/Bv: I a v hermit N•., • Od • / ` •
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503,639.4171 Fax: 503,598. Q� y p t, Other Permit No.:
24- Hour Inspection Line: 503,639. 41 PI 31 2006 / ntsM,t Tl1 Date Ready /6y, • • . 1101 ` See rage 2 far
In temet: www.ci.tigard,or.us Notified/Method: I Supplemental Information
• TVPIW ON16§4R9 . • . FEE* SCHEDULIE
:1 a • " For speClul Information use Checklist. ® New construction a emolWOn Description J I Total
� C]tY, Ea.
❑ 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
Multi-family SFR (3) bath 399,00
[] Accessory building Each additional bulb/kitchen 45.00
_
❑ Master builder 0 Other: Fire sprinkler ( 'sq. ft.) Page 2
' JOB SITE INFORMATION AND ••LOCATION • Site utilities
. Job site address: i 6W .0 • Orth. 0 . Catch basin or area drain _ 16,60
City /State/ZIP: TI GARB 01Z et 7 22.4 Drywell, leach line, or trench drain 16,60
Suite /bldg. /apt, no.: 1 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
Subdivision: Arbor Summit I Lot no.: 3 1 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60 •
• ' DESCRIPTION OP WORK • Backflaw preventer / Page
NEW CONSTUCTION Backwater valve 16.60
Clothes washer 16.60
- Dishwasher 16.60
Drinking fountain 16.60
PROPERTY OWNER u, TENANT. , '
Ejectors/sump 16.60
Name: West Bills Development _ Expansion tank 16.60
Address: 15500 SW Jay ST. Fixture/sewer cop 16.60
City / State/ZIP: Beaverton, OR 97006 Floor drain/floor sink/hub 16.60
Phone: (503)64] -7342 Fax: (503)641 -7661 Garbage disposal 16.60 _
Hose bib 16,60
•' ® APPLICANT • _ • • ® CONTACT PERSON Hose
maker 16.60 _
ice Business name: Same As Owner. Interceptor /grease trap 16.60
Contact name: 'lC� LAN I Eft Medical gas (value: $ ) Page 2
Address: ( SAME _A S A PaoVE) Primer 16.60
Roof drain (commercial) 16.60
Ci ty/S tate/ZIP ;
Sink/basin/lavatory 16.60
Phone: (503 ) 6:11 -7342 I Fax: ( C ) /, Tub /shower /shower pan 16,60
E -mail: RLls,,N tE��V(SI tilLi t)EvEWPmSnir Urinal 16.60
CONTRACTOR • . _Writer closet 16.60
Business name: ' 1p E k t x LAhf'DScAPE Water heater 16.60
. Address: ' P D atOX 2. 4 t 0 Other:
Subtotal
City /State/ZIP: - 0R5tW CA OR 6 170(4- 5 Minimum permit fee: $72.50
Phone: (503)1504— 2 0 13 Fay: Residential backflow minimum permit tee: $36.25
c.- . I . Plan review (25% of permit fee)
CCB Lie.:. t 1 - 3 EX. 1 ME (r �' meh,o -� 6,7 G 16
_ State surcharge (8% of permit fee)
Authorized signaturr. � J , 1 J > • TOTAL PERMIT FEE
Print name; f. �i L% a) I D ate: / / 31 / This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fec methodology set by Tri- County Building Industry Service Board.
..in..;,dine\Per nhms 't.M- PernlIIApp.dae 12109 440.46I6T(IO,aJCOM/WE8)
,
CITY OF TIGARD PL-rvi
BUILDING DIVISION r PERMIT #: o? Q G 6 -- D 06666 .-U
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 d ip j I1
Inspection Requests (24 Hrs.): (503) 639-4175 " ..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: ) Li 9 oZs `_ 4 d`""f4'� CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 ' 7 - O C Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 g 9 p 1 tAdrelet (e, \ - - % ' # k ..__
C rrections /Comments /Instructions: /
1 'Pro\// l �� Z� / R � S U L- F � f� iU 1�
, e / , E_
❑ PASS U 'AR • L APPROVAL ❑ CANCEL ❑ NO ACCESS
0 FAIL ' A FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED •
Inspector: Date: S . Phone #: (503) 718 -
CITY OF TIGARD eiM2066- 00046
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171p I
Inspection Requests (24 Hrs.): (503) 639 -4175 A
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 1 L V 1 ZS" LAN !) "..,kk 0_ - CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # 'Inspection Description Confirm # Contact # Message
I v P l vwv b (.M k - I^L- ►.,ki ` T 1)
Corrections /Comments /Instructions:
t
9
„.„. '' - ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
V ./ a Inspector: k./' C Date: 2 Phone #: (503) 718-