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Permit 4,,„‘ CITY OF TIGARD PLUMBING PERMIT PERMIT #: PLM2002 -00084 , DEVELOPMENT H B Tigard, ) 639 -4171 DATE ISSUED: 3/22/02 SITE ADDRESS: 12450 SW WALNUT ST PARCEL: 2S103BC -03900 SUBDIVISION: ZONING: R -4.5 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 2 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: 655 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of (2) backflow preventers and 655' of private water service. FEES Owner: Type By Date Amount Receipt WINDWOOD CONSTRUCTION INC PRMT CTR 3/7/02 $249.30 27200200000 12655 SW NORTH DAKOTA ST SPOT CTR 3/7/02 $19.94 27200200000 TIGARD, OR 97223 Total $269.24 Phone 1: 503 - 625 -6526 Contractor: MSI MECHANICAL SYSTEMS INC 21195 NW EVERGREEN PKWY STE 20 HILLSBORO, OR 97124 REQUIRED INSPECTIONS Phone 1: 503 - 642 -1234 Water Service Insp Final Inspection Water Service Insp Reg #: LIC 00070032 PLM 34 -183 Water Service Insp Water Service Insp Water Service Insp Water Service Insp Water Service Insp Water Service Insp Water Service Insp Water Service Insp RP /Backflow Preventer RP /Backflow Preventer 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 ay obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issu By: - L�J Permittee Signature: ' Call (503)- • • -4175 by 7:00 P.M. for an inspection needed the next business day • : & By: HP Laser•Jet 3100; 407 321 6969; Feb-22- 02 S:SaAtv1; Page 2/3 FRCr : NEW I.jES'f CONSTRUCTORS FAX INC. : 503 977 292E Feb. 22 2002 09: 35A(1 P2 / e:), Plumbing Permit Application ,1 I 1 . t 1 , r { s . 7 City of Tigard --- Da a Itllyived� o a Perm.' pro • ' Ffetoy�- : r' <: Sewer perin5 no.; Banditti; permit nn.: Address: 1 1125 S1 Bell Blvd, Tigard, OR 97223 Cni r,J' Phone. (503) 639.417 I Prejte appt. no : Expire date: r .m... Fax; S03) SOR - 1084 a Daw it hued' By: krcelrn In : Land use: approval: ab, e 1l - "t / C aW Cie nu: i olo: typ'. • .. s .'. :: : I 11 1 ( ;I 1 1 II„N!I1 s 'l r , '. :• "'I C� ,� 1 & 2 family dwelling or saeansory 13 t•,ommtruiavinduao•ial O Multi -Willy 0 Tenant 'movement " ' 1J\ \ New construction 0 AddltiortlalteradmVreptacoment 0 Food service 0 Other. _ I lit `I II 1ti1 (' l `... :Y Y r.( 1+l { i iI r , ! i ' ' Job addruu 'J 1 '.."7;4=1111..11111ErarIMI Total I Bldg. no : Soiro _ Tax map'ttrr lw)*:cuu_ m no (ieelt�eo t001L thread ralloo bn) III l loc J Subdivision: ._._ SI'li (l) ha .Pl: m P ci o me! P' 44. � f I m • (..,,, ,Mini • ZIP:_ _______ Edon aigdona l bath/kitc1ton L-2 D rips ton And Ocoilo. of work on promiltaa . _ rte ' _ Cslth bsaiNama drain Cs! disc of complextnrtfl churl ryw a10 Inc Irc nc , lain r• i t till l: : r - , ` . lN t l O I ' 1.••:T VOIln' drain(no. "" • @ ut i� : t atrodFio III n ea f7ta lnlsa name: . r lC + AddreM. „ ' .11A'A ' A A , M I rrL a0 •aln •nla eOnfirear MUM O' Ci l . it , . • State! • ' Zl . Q'( E: " I!'j'1" *" fl . NMI Phone . . Fox: is{.1 - ? 1 Ii•mail; 'armsearcr nu. lie, t1,) �Ci I no.: lie. no., M� Plumb, b.. no. Q[, �►',: P' i. Fixture or Item: III 1 C to I e � d ale 1 / • 1p • o „ . A • lion vulva Print name; cqt a'lr _ 00 ow ereventcr °' , �' Da te + ' Backwater valve t- . 1 ', 11\ 1'1� I .1' /1'.i '. - kiln ossuary * 0 :•._ ln av 10 r.' awiiJt r mill ' Addros6. , 0 11.41' vo If eeto f •Is WI or Cil i 1 to Steno: 111': J' . I' icde a tiro in ninneiii ti) �. — . 1 SUM Fax at ft- mail; Ex • nsiamtan 1111 , shunt Ipr,nl) a ..e, G alt! nor 'n oh — — M11il' address: I '!. ; - , • _ ": . = .1 tae b bb , e MI MINI ' CitYrile (2 •w ZIP:: 'Z"$ tern er + P hunP :jz.0 ' ' Z . E -mail: I nterco.eel,r(nlse:ra Owner illstallattontreaittenrial ma ammo. only: The actual irntallatinn • - mega) N _ 1 v.111 ho made by m or the maintenance and repair math; by my regular a rmployee on rho propwty, I own of per ORS Chapter d47. Sa75,'- late , lay s Ownlrye fi ■ ria bale Sump --,I Ell 1 ''emu • I • bins 111111.1111111 s r 11.-E-mi HIL"., .. t. Plume 1/ '.:;.. `ex: c -mil E-mail: V47 it (y+.$s.•thM Num mar wdt Minu cd rstisgf,ti 1, AV ql•N IOrlltlallwn ennn N once; This app li , Minimum fee, $ _ -Watt .a MIUIt ert1 { plr (wla Plea review (at _ • Stir) S .. I ; ,,,,. ,.. ret il' a penes is not ohmic! — L, (8%1- - s urds, 1 80 d al taro surcharge e..ilre, WIP1 YI{ after a �a boon \ua: a .+rsil►dd.r a a6.n... sp. Viv ,�arJ' acorpton As complex l OT14iia ................... 5 .I . �•` .u u M�'i y7suWrs �i`�.sWll'.�'� w +cussle.see.cr1M,