Permit 1
CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00328
.�,-. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/6/2006
PARCEL: 2S109AD -14100
SITE ADDRESS: 12896 SW WAHKEENA CT ZONING: R -7
SUBDIVISION: ARBOR SUMMIT NO. 2 LOT: 037 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 7/6/2006 $36.25
[TAX] 8% State Surcha 7/6/2006 $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: -- ) 7271L r���� /! Permittee Signature:
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.
•
t UL -05 -2006 WED 04:00 PM FAX NO. P. 02/03
0 w R
Plumb Per mit Application you OFFICE USE. ONLY
City ��1 m tavzd �. Permit No.:
13125 SW of Tigard and 91Blvd,, Ti Tigard, R 9 77 \ ' A atall3y: 7 ��Q� _ • �1�,.�0� t�
g 9 plan Review
Phone: 503.639.4171 , \ F �5 I1,3',9& 960 ;,rr;;,;lri,, a
+, Date/By: Other Pe
r rmin No,:
24- Hour Inspection Lin t, 6341 75 c al l - � 1! Date Read /B mre
Internet: www.ci.tl ard.or.us ` Ready /By: / k1 Sae Pent l Information
g I Notified/Method: Supplemental
° . ', ,.,•. `.., :. 1 a „ . ; OF WORK.. J - , ', '.�•_`' :' :I.::_;;FEE'` .SOUEDLILIv" '. ' , ,, '
`" rljorrnallon use checklist
® New construction � - y �Dcmolhion For special _
Description Qty, J Ea. i___ i___ Total
❑ Addition /alteretion/replacrat>ei�. �� r ❑Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
'CAT.EGOk lrOP CONST121:1CTIQN; • . , _ , n.,' SFR (I) bath 249.20
® 1- rind 2- family dwelling ` ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family
SFR (3) bath 399,00
Each additional bath/kitchen 45.00
❑ Master builder 0 Other: Fire sprinkler ( sq. ft) Page 2
. ,':, ' „'SOA;,SPIE INFORMATION`ND')T:OCA!IHOT(i' ;• .,,, ,,,;.;• ' Site amines
Job site address: 12.894 6W Wa h ke er, et. COUr t Catch basin or area drain 16.60
City / State/ZIP: T) GIItRb og /72_14 Drywcll, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 1 Project name:
Footing drain (no, linear ft : _ 1 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.: 1 Page 2
-
Subdivision: Arbor Summit I Lot no.: 7 Water service (no, linear ft.: ) Page 2
- Fixture or item
Tex map /parcel no.: ' .. , . . .. ..., ,, , , ,..,..- ,,, .. ,, , , ... , .. .. . . Absorption valve 16.60
. ; ' .;1., ^('' DFCRYI ''M)ION: - '' '': Backtlowpreventer J Paget
NEW CONSTUCTION -- •gam ICY 1 ow Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
T • Drinking fountain 16.60
Electors/sump 1 6.60
Nettle: 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
. • ;21 :A2RL1C4NT , ; ■i' tr CONTACT •PERSON • :':..r. - Hose bib 16.60
Ice maker 16.60
Business name: Same As Owner. Interceptor /grease trap 16.60
Contact name :iG Medical gas (value: $ ) Page 2
Address: ( SAME AS A P,DUF) Primer 16.60
Roof drain (commercial) 16.60
City / State/ZIP: Sink/basin/lavatory 16.60
Phone: (503 ) 643-7342 I Fax :: ( )
(. W ST H (U.S DEvELOPM ENT CDM Urinal owcr /shower pen 16.60
E -mail
R ANN � Urinal 16.60_
,CQNTRAC I'OR, - ' . _ Water closet 16,60
Business name:' t RADE MAc RIc LAIl c p1PE Water heater 16.60
Address:. To Box 214f0 Other:
a Su Moral _
City/State/ZIP. • ° RE�� C[TY r 0 Q 9 5 Minimum permit fee: $72.50
Phone: (503) 1 504- 2o 13 Fax Residential backflow minimum permit fee: $36.25 _
CCB I.ic.: ' 1 1 25'3 Ex,. I 31 oe 'di Mehl) . .47% , r Plan review (25% of permit fee)
State surcharge (8% of permit Fee) •
Authorized signature jJ , . _ t y TOTAL PERMIT FEE,3�f /5 , �
Print name: ! r / , .L.L.) J I Date :7/57 D6 1 This permit application expires if a permit Is not obtained within
180 dnya after it has been accepted as complete.
. *Fee methodology set by Tri- County Building Industry Service Board,
i:\BuIIdlnawenn I IPLM•PennuAnnder 12/03 99046 16T(I0/o2/COM,WE9)
CITY OF TIGARD f 6- 003Zc(
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 D' E ISSUED:
Phone: (503) 639 -4171 tli�l 2� 0 Inspection Requests (24 Hrs.): (503) 639 -4175 _ .. O
INSPECTION WORKSHEET FOR DATE: 1�I /b� TIME: / PAGE:
SITE ADDRESS: I - A 1Q v\ it_ Q-Q 1/\, 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
* VA Q\ 14/14/Vbc . t,)/IcLA. ' 'D l '
Corrections /Comm nts /Instructions: !
v a 6 "1n C r R--Q..4 4 0-12.-- ( a
. .
. q.,\AAr."
9 ,..
/0 „
..
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • \ti (i Date: t A ( 0 '7 Phone #: (503) 718-2-Y2-1