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Permit V r CITY TIGARD PLUMBING PERMIT I DEVELOPMENT SERVICES PERMIT #: PLM2006 -00212 ,.147:1 - I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/15/2006 �� - PARCEL: 2S114AD -02500 SITE ADDRESS: 08852 SW WAVERLY DR ZONING: R -12 SUBDIVISION: WAVERLY ESTATES LOT: 024 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 JERRY O'NEAL 8852 SW2 WAVERLY DR Description Date Amount TIGARD, OR 97224 [PLUMB] Permit Fee 5/15/2006 $36.25 [TAX] 8% State Surcha 5/15/2006 $2.90 Phone : 503 -598 -1939 Total $39.15 Contractor: OWNER REQUIRED ITEMS AND REPORTS Contact # : Reg #: 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: AvjvQ,ln- . 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. • ! . w . ,y Plumbing Permit Application City of Tigard o e" � :N D y..�) -/5---17 4 Permit NU � 1 `IV �/ c'W ��� u 13125 SW Hall Blvd., Tigard, OR 9722 Plan Review Phone: 503 639.4171 Fax: 503.598.1960 l ` 0 ' arv,, t \ Other Permit No : 24- Hour Inspection Line: 503.639.4175 ' 1,1- i Date ReadyBy Jul ..... ® See Page 2 for Internet: www.ci.tigard.or.us _ R(7 Notified/Method. f / V � Supplemental Information TYPE O � QRf C l k�. FEE* SCHEDULE 1:1 New construction $U1 �b emolition For special information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 249.20 al 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 El Accessory building ID Multi-family SFR (3) bath 399.00 I=1 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: R 4 ? SO? S. . W GV U. l . Catch basin or area drain 16.60 City/State /ZIP: 7145 a►r o R . 9-10.9_ Y Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: 9a • ,� j Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: yv aLverl E S 1-4.4e) I Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: `� Fixture or item Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer 1 Page 2 S ri NKI ar J I N cl t�.t el Backwater valve 16.60 J Clothes washer 16.60 Dishwasher 16.60 g PROPERTY OWNER I TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: Te r r 4 0'Ne6 I Expansion tank 16.60 Address: 8 $ a s -, w s W atier4 y aa /t j • Fixture /sewer cap 16.60 �' City/State /ZIP: yi,r d o R . 9 � , v Floor drain/floor sink/hub 16.60 Phone: (So3) 57 6- f 93 9 Fax: (5 ‘39 - 1l3 Garbage disposal 16.60 ($4 APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: T1 ()wee. I Medical gas (value: $ ) Page 2 Address: 37 Sa Sw, W6,te! D{ r Primer 16.60 City/State /ZIP: Tl�q GAY O2. 9 Si Roof drain (commercial) 16.60 Phone: (5 g 3) .S9 . 19 Fax: : ( SO3) $9 $ _ 1 93 9 Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: J e,_( 4. al • Gavin Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: Water heater 16.60 Address: Other: City/State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) Authorized signature: State surcharge (8% of permit fee) ' {� TOTAL PERMIT FEE 5 9 r� 5 Print name: ,)A r�2 Date: S - /S , 6 This permit application expires if a permit is not obtained within I80 days after it has been accepted as complete. *Fee methodoloev set by Tri- County Buildine Industry Service Board. CITY OF TIGARD . . BUILDING DIVISION PERMIT #: PLM2006-00212 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/Th/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/26/2006 TIME: 7:05AM PAGE: 56 SITE ADDRESS: 08852 SW WAVERLY DR CLASS OF WORK: • SUBDIVISION: WAVERLY ESTATES LOT #: 024 TYPE OF USE: PROJECT NAME: O'NEAL DESCRIPTION: BackfIOW preventer for irrigation. OWNER: O'NEAL, JERRY PHONE #: 503 - 5913.1939 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/26/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 032314 -01 503 - 598-1939 N • Corrections /Comments/ Instructions: • • 161—P-ASS ❑ PARTIAL APPROVAL ❑ CANCEL' ❑ NO ACCESS • ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: r Date: Phone #: (503) 718- liV CITY OF TIGARD BUILDING DIVISION PERMIT #: PLlvi200S -00212 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/16/2.006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/17/2006 TIME: 7:06AM PAGE: 68 SITE ADDRESS: 00852 SWWAVERL'i DR CLASS OF WORK: SUBDIVISION: WAVERLY ESTATES LOT #: 024 TYPE OF USE: PROJECT NAME: O'NEAL. DESCRIPTION: Ba kflow preventer fo . i9riQt ticn. • OWNER: O'NEAL, JERRY PHONE #: 503 -a90 1938' CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/17/2006 Pour Time: • Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 029987 -01 503- 598 -1939 N • Corrections /Comments /Instructions: • r►1 b- -�C�t r1.0 ©J Pit • — 4_6r-woe ( E_T -Y l f 0te PASS .- 'PARTIAL APPROVAL CANCEL NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ,� Date: -5) ►7 l 0 G Phone #: (503) 718 - 29 , 3