Permit - M
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
P ERMIT #: PLM2006 -00429
A� I �'
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 DATE ISSUED: 9/15/2006 PARCEL: 2S111AA - 07700
SITE ADDRESS: 08905 SW REDOAKS LN ZONING: R - 4.5
SUBDIVISION: GREENSWARD PARK NO. 3 LOT: 061 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
BRANDON DOSS
8905 SW REDOAKS LN Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 9/15/2006 $36.25
[TAX] 8% State Surcha 9/15/2006 $2.90
Phone : 503- 936 -7886 Total $39.15
Contractor:
PIPELINE PLUMBING
PO BOX V -108
333 S STATE ST REQUIRED ITEMS AND REPORTS
LAKE OSWEGO, OR 97034
Contact # : FAX 503- 624 -1926
PRI 503- 624 -1906
Reg #: LIC 158260
PLM 3 -510PB
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: %Q 2 (� \c
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.
Sep 15 06 11:38a PIPELINE PLUMBING (503) 624-1926 p.1
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Plumbing Permit Applica i , _ p 1:(112 OI 1 1( h: ['SF U'.'l.l
City of Tigard RE�j V R r / 1 f) 1-0)0 Pest1 ) ZOd DO ( 0 4 9
13125 SW Nall Blvd., Tigard, OR 9 Plan Review Other Permit No.:
Phone 503.639.4171 Fax: 503.598.1960 ti' =y' ~� b. (+ DatrJBy:
24- Hour Inspection Line: 503.639.4175 SE P 1 5 2001 I-, Date Ready/By:
)c ® see Page 1 for
Internet www.ci tagard.or.us Notifed/Method: .) / Supplemental Information
TyiiiibY CibIM ikED FEE* SCHEDULE
I I 1 I `k . -' For spedal information useeheckitst
CI New construction Description I Qty. I Ea. I Total
r-y�a�a1����am� ❑ Other. New 1- 2- family dwellings (includes 10011 for each utility connection)
►� ^ CATEGORY OF CONSTRUCTION SFR (l) bath i I 249.20
❑ Commercial/industrial SFR (2) bath 350.00
i 1- and 2- family dwelling
SFR (3) bath 399.00
❑ Accessory building ❑ Multi - family
Each additional batldkitchen 45.00
❑ Master builder ❑ Other: Fire sprinkler (__ sq. ft.) Page 2 ,
JOB SITE INFORMATION AND LOCATION Site utilities .
Job site address: / 1 r L,' Catch basin or area drain 16.60
City/State/ZIP: ! p (, 9 7 T ; i.f DMvell, leach line, or trench drain 16.60
Footing drain (no. linear R: __ J Page 2
Suite/bldg./apt. no.: I Project name: Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60
4' � t S Z UN.) `" fY D d & 98 Rain drain connector 16.60
0_41)..-, r Sanitary sewer (no. linear fL: __) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear R: ) Page 2
Subdivision I Lot no.:
Fixture or item
Tax map/parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventerSr 0 naS i ( (2 • Page 2
i a' ! ' I a , GC '1 ' : r ._ - 16.60
Backwater valve 16.60
,, f ,t.(,
Clothes oth washer _
p i , II.Q✓1 d d (i.0 12 . Dishwasher 16.60
Drinking fountain 16.60
.43 PROPERTY OWNER ! 0 TENANT Ejectors/sump 16.60 -
Name: " 3 Y QIr `�0r.. 6S5 Expansion tank l 16.60
Address: Fixture /sewer cap 16.60
City /State/Z>P:
Floor drain/floor sink/hub 16.60
Phone: ) 7 J
( G1 - - 7 C, Fax: ( ) Garbage disposal 16.60 Hose bib 16.60
?/' V
i APPLICANT ❑ CONTACT PERSON Ice maker 16.60
Business name: /_.• 1 r . . ..1 a IP l. Interceptor/grease trap 16.60
Contact name: _,.I ° a d a O - it ail Medical gas (value: S ) Page 2
/{ �
Address: 2 S . s j�,*- . S} mis V -i o8 Printer 16.60 � 16.60
a - 3 � Roof drain (commercial)
City/State2IP: �Lt/ (7 f I v 16.60
SSink/basin/lavatory Phone:.)3) (,Pa t f ^ 1 glot) ( Fax' t : ( 13 ) IP aH ^'(i au Tub /shower /shower pan 16.60
E -mail Urinal 16.60
CONE CTOR Water closet 16.60
Business name
Water heater 16.60
-
Other.
Address: A • r_ 1 S _ A. I Subtotal
IMP m City/State/ZIP: Minimum permit fee: $72.50
Fax: ( ) Residential back low minimum permit fee: $36.25
Phone: ( ) Plan review (25 °�6of permit fee)
j 5 � S
CCB Lic.: , • Plumbing Lis no.: 6- �Q „ Of
State surcharge (8% of permit fee)
Authorized signs , L��1 / A ■ . i TOTAL PERMIT FEE i
Print name: L.ryt !.1 I� .0 Y V�+f V1 �t , A , n' Date: q ( s C , This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tr i- County Building Industry Service Board.
i'lBuotrute&Permin PLAt•PermitAPP.doc 06105 4404616T(10)021COM/WBB)
CITY OF TIGARD s
BUILDING DIVISION PERMIT #: PLM200G -00429
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/15/2006
Phone: (503) 639 -4171 4u'It ��
Inspection Requests (24 Hrs.): (503) 639 -4175 �' `'!��
INSPECTION WORKSHEET FOR DATE: 9/19/2006 TIME: 7:05AM PAGE: 832
SITE ADDRESS: 08905 SW REDOAKS LN CLASS OF WORK:
SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 061 TYPE OF USE:
PROJECT NAME: DOSS
DESCRIPTION: Backflow preventer for irrigation.
OWNER: DOSS, BRANDON PHONE #: 503.936-7886
CONTRACTOR: PIPELINE PLUMBING PHONE #: 5036241906
Inspection Request Scheduled For: Date: 9119/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 036733.01 503 - 624 -1906 Y
Corrections /Comments /Instructions:
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[`Re,SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
/14 i �-' Date: P hone #: (503) 718- . 3 '2 , _ , . /