Permit CITY OF TIGARD
PLUMBING PERMIT
, rsl rt , DEVELOPMENT SERVICES PERMIT #: PLM2001 -00399
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 08/24/2001
SITE ADDRESS: 15309 SW REGENT TERR PARCEL: 2S111 DA -10900
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7
BLOCK: LOT: 102 JURISDICTION: TIG
CLASS OF WORK: ALT 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
Remarks: Installation of back flow preventer.
FEES
Owner:
Type By Date Amount Receipt
LEGEND HOMES PRMT CTR 08/24/2001 $36.25 27200100000
12755 SW 69TH AVENUE #100 5PCT CTR 08/24/2001 $2.90 27200100000
•
PORTLAND, OR 97224
Total $39.15
Phone 1: 503 - 620 -8080
•
Contractor:
SUPERIOR LANDSCAPE INC
27127 MOUNTAIN RD
WEST LINN, OR 97068 REQUIRED INSPECTIONS
Phone 1: 503 - 655 -7377 • RP /Backflow Preventer
Reg #: LIC 6315 Final Inspection
EXPIRED
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: jjfJ Permittee Signature: W/L/ n %v
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
07 09/01 MON 12:49 FAX 503 598 1960 CITY OF TIGARD j002
le
PIumbing Permit ikpp 'cation
4
City of Tigard Date received: Q i Permit no.:?( d -- y pi 3q
.4.4 4 i � V Sewer permit no.: Building permit no.:
Address: 13125 SW hall Blvd, 73
CirvnjTigard Phone: (503) 639 -4171 2001 Prot ecdappl.Do.: Expire date:
Fax: (501) 598 -1960 AUG 2 3 2001 Date issued: By: 1 Receipt
Land use approval: Case file en.:. Payn3e h
EYELurMENT ,
1 61; 2 family dwelling or accessory O Comm =jai/industrial ❑ Multi- family 0 Tenant improvement
0 New construction 0 Additi • /alteration/replacement O Food service la Other.
}Tv, S('1rl'DUI.1 (for speri:tt in formation use cheekli,t;
Job address: f .3t.,9 Sul i- Jtl1P,A c-k-- a r��Bo 0211=511 Total
Bldg. no.: Suite no.: ` ew 1- and 1: --- dwellings o , p:
Tax map /tax lot/account no.: (�daadesit10f1• for emd utthty eonnedion)
Lot: !Block: Subdivision: SFR (l) bath
5FR (2)bath
Project name: SFR (3) bath
City/county: .. , . UP- • Ea additional b kilt n — --1
D - ription and = : tion of work on • • • es. She utilities:
5 • - _ ill _ . 1 _ Li • Catch basin/area drain -
erion/ins t
Est. dare of comp pection: DtywelLslleach line /vettc drain
Pi i 1 h l N L: UTi' f It A f "1 t) R Footing drain (no. lin. ft-)
Business name: �,p�2►o • Manufactured home utilities
Address: z 2')' ll Y`n A i/ U e anholes
City: � em 1 Ra in drain connector •
Nt3 State 212 - i 11 t Sa sewn S o. lin. ft)
Phone: * ei L' Fax: . _ - ti _ Storm sewer (na liar fr,l
Pa CCB no.: Plumb, bus, reg. no: N min "ater service no. lin. -
City/metro lip. no.. r th %A .: —4 nature or hats
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Contractors • resentative Si: nature: Absorption valve
III
Print name: 01;!r =ter Drte: i[�' B r 1111111161.V. Backwater valve
- CON 1.11`l PERSON'
Btt ias/lavato _
Name: i a othcs was er
Address: 2f 1,12n ri T� - •
Dishwasher III
fourini n(s)
City: „MIN State: • /a ZIP: / t ' . tors/sump —
Phone: , ■. R ,�'�,' d ai t ' -.: : N MUM F.z.: , •ion tank NIB
• . , MINER xture/stwer cap _
Name (print); V k , oor drains/floor sinks/hub I..
Mailing address: ��T� e/ s • ' '
ose laiksb =
City: L - 01111 ZIP ' i . _ Ix maker
Phone: . t— . .,_, ■ !E E- 1: . - Inteaceptor/grease trap _
Owner installation/residential maint- ante only: The , .: installation pri _
will be made by tar th 1 vae and MOM
e.• , oyee •.: the ii , 4!. ' • . , tenan �r , :.,s, 1 Y� 1 � Roofatatrt (rntnmercialJ • i1LYZh. i r• � n #��, , h . 1 , ' c k 1, 1 Siink %. basln(5�,, lays(sN, s � . . _!_ �� � ' •� , - Sum. NM
"' " 1 Nc 1 :117 3c Tu • shower/shower pan MN
•
Name: U • al
Address: Water closet
Water water
City: [State: I Z F. Other:
Phone: [ Fax: I E-mail: Total
O Visa
r Ma aece credit cards, please eau jurisdiction tar more infor maim Notice: This permit application Minimum fee $ 3�. pt 3 ard
expires if a permit is not obtained Plan review (at %) $
Credit card number F �pin s within 180 days after it has been State surcharge (89b) .... $ ' •`— U
Nagle of cardholder as drown on credit card accepted as c:omplele. TOTAL $ _'219
— � S
Cardholder eignau.re Amon a 44016 ( M)
EXPIRED