Permit 4,. CITY OF TIGARD PLUMBING PERMIT
P ERMIT #: PLM2006 -00250
I �� DEVE H BMEN9 OR 2CES -639 -4171 DATE ISSUED: 6/2/2006
PARCEL: 2S 109D D -07400
SITE ADDRESS: 12822 SW REMBRANDT LN ZONING: R -7
SUBDIVISION: BELLA VISTA LOT: 004 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
RIVERSIDE HOMES, INC. Description Date Amount
1925 NW AMBERGLEN PKWY #200
BEAVERTON, OR 97006 [PLUMB] Permit Fee 6/2/2006 $36.25
[TAX] 8% State Surcha 6/2/2006 $2.90
Phone : 503- 645 -0986 Total $39.15
Contractor:
STREAMLINE PLUMBING
2505 SW AUGUSTA DR.
ALOHA, OR 97006 REQUIRED ITEMS AND REPORTS
Contact # : FAX 503- 379 -9543
PRI 503- 888 -6657
Reg #: LIC 142111
PLM 34 -370PB
•
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: tp Permittee Signature: _S, .. O Q
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.
• Plumbi Per mit Ap, C VED FOR OFFICE USE ONLY
City of Tigard I'� Da y : f -/ � Permit N \ �,�p06 V�d
13125 SW Hall Blvd., Tigard, OR 97223 I U N 1 2006 (,
0 Plan R eview
Phone: 503.639.4171 Fax: 503.598.196 Date/By: Other Permit No.:
24- Hour inspection Line: 503.639.4175 �" � i L. Date Read B pOi ®See Pe e 2 for
Internet: www.ci.tigard.or.us CI OF TIGAR __ v r: g
OUILDING DIVIS10 Notified/Method: Supplemental Information
TYP OF WORK FEE* SCHEDULE
For special information use checklist
J`:' New construction ❑ Demolition
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 (1) bath 249.20
511_ and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
1:1 Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: I 2 g ZZ S w Rio 5 P0 y; k j- e•� Catch basin or area drain 16.60
City/State /ZIP: --T, 5 i O E., 0 1, a aL.i Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: „a vk%Jro•, 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: Lot no.
e i% V F p I t{} Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK 3 y jr
Backflow preventer 1 Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER I ❑ TENANT Drinicing fountain 16.60
` ' 1 Ejectors /sump 16.60
Name: 2.,i vei - i (it.e._ t10 . --) _ • Expansion tank 16.60
Address: 11 5 /VW km h 1 e _ _ I # PI t o n Fixture/sewer cap 16.60
City/State/ZIP: 13, v ,e,y p 4/00 Cc Floor drain/floor sink/hub 16.60
Phone: (5 ) L (.4..5 _ b $ ( Fax: (SePj) 1 C ) -2_q c.1 2. Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: y,QX51 at Hpn,te S I PY►L • Interceptor /grease trap 16.60
Contact name: � (A 8ei2 , Medical gas (value: $ ) Page 2
"; , "I "
Address: j q 25 NW Aryl prc, u�ily # zoo Primer 16.60
City/State/ZIP: -J Roof drain (commercial) 16.60
Phone: Sink/basin/lavatory 16.60
( ) Fax:: ( )
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: r i
J`f' Hw Vri VI C tZ4 V t/Hb, ►'IS Water heater 16.60
Address: 2 S Qc . S • (A . A u s 4-c_ b. f. Other.
/� 1 ` 4
City/State/ZIP: 7 - 1 L 0 g. 6 ) 7006 Subtotal
Minimum permit fee: $72.50
Phone: (5-43) 088 - b 6S 7 Fax: (50-3 ) 7 j`A 2. - 95 3 Residential backflow minimum permit fee: $36.25
CCB Lic.: (y 2 ( I I Plumbing Lic. no.: 3 H - 370 p 6 Plan review (25% of permit fee)
Authorized signature+ G s '� State surcharge (8% of permit fee) j 9, e
• TOTAL PERMIT FEE 39 0-s
Print name: 3 8 f l I I Date: 2 - e- 03- 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:\ Building \Pamits\PLM- PermitApp.doc 12/03 440- 4616T(I0 /02/COM/WEB)
Al hi CITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2006 -00250
- 4 DEVELOPMENT BM r SERVICES 23 503 - 639 -4171 DATE ISSUED: 6/2/2006
13125 PARCEL: 2S 109DD -07400
SITE ADDRESS: 12822 SW REMBRANDT LN ZONING: R -7
SUBDIVISION: BELLA VISTA LOT: 004 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 _
RIVERSIDE HOMES, INC. Description Date Amount
1925 NW AMBERGLEN PKWY #200
BEAVERTON, OR 97006 [PLUMB] Permit Fee 6/2/2006 $36.25
[TAX] 8% State Surcha 6/2/2006 $2.90
Phone : 503- 645 -0986 Total $39.15
Contractor:
STREAMLINE PLUMBING
2505 SW AUGUSTA DR.
ALOHA, OR 97006 REQUIRED ITEMS AND REPORTS
_
0
V
Contact # : FAX 503- 379 -9543 �� ®��
PRI 503- 888 -6657 �:. R
Reg #: LIC 142111 /7/(4 / a O PLM 34 -370PB i
fbi
14 ,,.
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: ' / 6 9 4 �. �__- Permittee Signature: _ ) .e_ ( vi
Call 503 - 6394175 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.
Inspections Required for: PLM2006 -00250
✓ Code I Inspection Description PASS Date I By I I ✓ Code Inspection Description I PASS Date I By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground/slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - S tructure grading/footing 125 Wall cover
210 Foundation walls 130 _ Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing MEC - Mechanical Permit
810 MFG- Structure set -up
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG- Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 _ Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
•
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinlder rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post/beam plumbing
995 Misc. inspection: 320 Plumbing rough-in
g � -.
998 Alarm final 322 Shower pan
999 Sprinkler final 330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing X 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit •
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I: \Building\Inspection Cards \Forms\AOP - InspCard - Blank.doc 12/09/2005