9749 SW OAKS LANE-2 a
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9749 OAKS 411
CITY O ri GA R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2005-00104
13125 SW Hall Blvd.,Tigard, OR 97223 503-6394171 DATE ISSUED: 3/17/2005
PARCEL: 2S 11'ICA-11900
SITE ADDRESS: 09749 SW OAKS LN ZONING: R-7
SUBDIVISION: SATTLER PARK LOT: 004 JURISDICTION: TIG
Project Description: Irrigation backflow
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW IIREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS
_ FIXTURES LAU'N'DRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUBiSHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
HOLLEN, MARY JA NE
9749 SW OAKS LN Description Date Amount
_ m
TIGARD, OR 97223 [PLUMB] Permit Fee 3/17/2005 $36.25
jTAX] 8%State Surcliarl 3/17/2095 $2.90
Phone: 503-598-7934 Total $39.15
Contractor:
BRAKES 7 DEES
16515 SE STARK ST REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97233
Phony: 256-2223
Reg#: PLM 5259
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ED 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 expi.-a if war is
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Ul 0 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: ec,, c ,u- -1 Permittee Signature:_ �_ y �� c
`C &L-,
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Call 503-639-4175 by 7:00 a.m.for an inspection that business day. �
This permit carts shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans arta required on the job site at the time of each inspection.
Plumbing Permit Appli n
Dativedz� d�, a Pemr.it no. 1Y _121�
City of Tigar r e rcce --
Sewer permit no.: Building permit no.:
Address: 13125 SW Hal1Blb igard,OR 97223
Cin-ofTigard Phone- (503) 639-4171 Project./appl. no.: Fxpire date.
Fax: (503) 598-1960 �!��\�, � �t
U Date issued: By Receipt no.:
Land use approval: t It 11V .��1 Case file no.: Paym-nt type: F
"Newy dwelling or accessory 0Commercial/industrial U Multi-family G Tenant improvement
uction Il Addition/alteration/replacement U Foo(! service C3 Other:
Job address. LIT/ I S(.J Cha L•n, Descr(ptlon Fee(ea.) Total
Bldg. no.: Suite no.: Net?1—and 2-f>arnily dwellings only:
(includes 190 ft.for each utillty connection) I
Tax map/tax tot/account no.: SFR(1)bath _
i ►nt_ Brock Subdivision: _ SFR(2)bath
Project name: ,a.' 74, SFR. 3)bath
City/county: ZIP: 7 2 Each additional bath/kitchen
Description and Tdcation of work on premises: — Site utilities:
Backflow for Irrigat o Catch basin/area drain
Est.date of completion/inspection: Drywells/leach lin"/trench drain
qiiiiiiiiiiili Footing drain(no. lin. ft.) —
Manufactured home utilities
Busir+ess name: Drake 's 7 Dees Manholes
Address:1 651 9 SE Stark St _ Rain drain connector
City: I-girt l andState:Oji T.IP9 7233 Sanitary sewer(no.lin.ft)
Phone:-,'*fig , p[ Fax. Email: Storm sewer(no.fin.ft.) _
_._ 5rr r
CCB no.: 5259 'LN)21 — __ Water service no.lin.ft.
City/metro lic.no.: per_ Fixture or item:
Contractor's representative signature: Absorption valve
Back flowreventer
Print name: Date: Backwater valve
Basins/lavatory
Name: Paul d✓ �I Clothes washer
Address: -9 SE Stark St Dishwasher
Ci Portland---- — Drinking fountain(s)
City: _ State:OR Z[P: 9 7 2 3 3 F�rctors/sump
Phone: ,:,ay Fax: _fS-j, vstr5 I E-mail: Fxpansion tank
Fixture/sewer cap
Name(print): Floor drains/floor si iks/hub
Mailing address: _Garbage disposal _
Cit Hose bibb
Y 3 _tate: ZIP: Ice maker
IL Phor�i )j Fax: IE-mail: Interceptor/grease trap
wner installation/residential maintenance only: The actual installation --er(s)
will be made by me or the maintenance and r pair made by my regular Roof drain(commercial)
to employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's signature: Date: Sump
J Tubs/shower/shower pan
to Name: Urinal
aWater closet
W Address: Water heater `
-J City. State: ZIP:
Other:
Phone: _ Fax: E-mail: Tota(
Na�idiction%accept credit cud,please call juriuli,tion for more ffirrmuion. Minimum fee................ S
Notice: This permit application
U Visa U MasterCard —� Plan review(at _. %) S
// // expires if a permit is not obtained —�-�-
Credit card number Expires within 180 days after it has been
State surcharge(8%n)....
---- accepted as complete. TOTAL....................... S __
—Name nl'cardholder et shown.m credit cud eP p
Cordholder ti`n Lure f Arnount-7j
NO IRIS I�OOrCOM)
CITY OF TIGARD
BUILDING DIVISION ` " PERMIT M: PLM;fO()r.,Ot11(kt
13125 SYJ "ail Blvd., Tigard, OR 97223 DATE ISSUED: 3117!2()()!,
Phone: (503) 639-4171
Inspection Requests (24 Hrs.). (503) 639.4175
INSPEC'rION WORKSHEET FOR DATE: 7/13/70 TIME: 7:03AM PAGE: /,S
SITE ADDRESS: ()4749;)W OAKS LN CLASS OF WORK:
SUBDIVISION: ,ANTLER PARK LOT#: O()4 TYPE OF USE:
PRO.1'71�T NA101: HOLLEN
DE RIPTION: Irrigation backflow 2limoc. THIS PERMIT IS REINS!ATL;D FOR PURPOW-Of FINAL
INSPECTION FOR A PERIOD OF 30 DAYS.
OWNER: HOLLE:N, MARY JA NE, PHONE
CONTRAC TOR: DRAKES /DE:Et_; PHONE #: 2%7213
Inspection Request Scheduled For: Date: 2/I3/?OOF, Pour Time:
Code # Inspection Description Confirm # Contact # Message
'17(+ Plumbing fin:ai 603-26621)4 I 1
Corrections/Comments/Instructions:
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(PA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL CLL FOR SPECTION ❑ ADDITI NAL F ES ASSESSED
Inspector: Date: ✓ Phone 4: 503 —ZAZ
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