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Permit ipi n I PLUMBING PERMIT , , COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00376 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/23/2008 PARCEL: 1 S 136C B -06000 SITE ADDRESS: 11200 SW 83RD AVE ZONING: R-4.5 SUBDIVISION: STEVE + HUGHIE'S PLACE LOT: 032 JURISDICTION: TIG PROJECT: SCHAFER Project Description: Backflow for irrigation. CLASS OF WORK: ALT 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 STEVEN SCHAFER 11200 SW 83RD AVE Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 9/23/2008 $36.25 [TAX] 12% State Surch 9/23/2008 $4.35 Phone : 503 -539 -4760 Total $40.60 Contractor: FOREST LANDSCAPE, INC 40437 NW VERBOORT RD FOREST GROVE, OR 97116 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 357 -3808 FAX 503- 359 -1908 Reg #: PLM 8253 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: Permittee Signature: % i� Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building Fixtures OVS 1.012 til rlt i 1 51: ONl.1 City Of Tigard '� :jj '1 Plan Dateiret 9 _ti 8 ( _ PermitNo,: ��� �( IN ,,_ ' 13125 SW H Blvd., Tigard, O ��7223 tl 0 I �/ P Plan n RCN cv �c�v Phone: 503.639.4171 Fax: 503.598� N �Q pate/gy: Other Permit No.: l ;■ x [ Inspection Line: 503.639,4175 ec .,G �S� Data Re /13y. ken: la See Page 2 for Internet: www.tigard- or.gov O Notifi „ ethoct - /,L Supplemental In i 1 E# :$CHEDV 0 New w construction 132 oliuon For special i►tj ormntl on use checklist. - •-- Description 1 Qt 2 a. 'Total la,Additionfalterationkcplacement 0 Other: New I - 2 - family dwellings (includes 100 IL for cash utility connection) CT'EC,)YtS'" OF; ,O`ON15TRUM7QN SFR (1) bath 249.20 )11 and 2 - family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 0 Accessory building ❑ Multi- family SFR (3) bath 399.00 °- Each additional bath/kitchen 45.00 © Master builder El Other: Fire sprinkler ( sq. ft.) Pagc 2 l J,)s.$1I , N AM!'IE.t l)G Sit util Job site address: ` ` crp $ i .k) t-ds .(,t V Catch basin or area drain 1- City / State/ZIP: '� Drywcll, leach line, or trench drain 16.60 /' Footing drain (no. linear ft.: ) Page 2 Suitc/bldgJapt. no.: Project name: S ( 5,177 - - -- 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: _I Lot no.: Water service (no. linear ft.: _) Page 2 Fixture or item Tax map/parcel no.: Absorption valve 16.60 •D*SCRIP hON Of '* 11U ter m �`• •• B ac kfl ow prcvcnter 1 Pagc 2`'2 1(y) ;al; 1 ✓ e . . . 4 . (AAA ( r , r C \0( ) Backwater valve 16.60 Clothes washer 16,60 .. . "` ~ Dishwasher 16,60 .'' gl ; .01 V slE t i ''' : .Li TENANT Drinking u D ' king o tmt n ry ) jcctots/sump 16.60 Name: -te:.\xe \r, ,.∎�(,, -- i ( Expansion tank 16.60 Address: y 1 , Ji.0 V � [p e - Fixture/sewer cap 16.60 City / State/ZIP: r 0' l e). Floor drain/floor sink/hub � y 16.60 Garbage disposal 16.60 P3) -. �}'( ax ( ) • se Ho bib 16.60 • eApPtICk4= 1 - CICO1vt'ACi' P soi�1 . ' • ; - I ma 16,60 Business rime: j , t _U-.:, [ `;Y-� � + Interceptor /grease trap 16.60 _ Contact name: e.1‘.0 �'tt- .__, ____.-- _..- -- �° Medical gas (value: $ ) Page 2 _ Address: •y -49 3 v 6 1 Primer 16.60 City /State/ZIP: 1 r �l , 02_ G I l (0 Roof drain (commercial) 16.60 Phone: )) E ,^ SinWbasin/lavatory 16.60 ' 3 ,E� l t _ J Fax:: " 5 9 - 1 '` ) «∎ Tub /shower /shower Dan 16 "60 E-mail: Urinal 16.60 COh3'rit,4CCUg r Water closet 16.60 • Business name: � ^ g ' • _ > I Water heater 16.60 Address: Other: ! t_ t.)* "� N ' � -^ •, � r Subtotal City / State/ZIP: . c.2 - rry� II `-1 1 `` - 1 Minimum pe fee: $72.50 Phone:: • .! ) . j"} - I .w . Fax: " " ) • C q - 41 Residential backflow minimum permit fee: $36.25 NOPIF L.C.: b W Plumbing Lic. no.: 1 Plan review (25% of permit fee) '" , _ State surcharge (12% of permit fee) y . , Authorized signature: dav,vv-Lei �' A ,� s_iti,il I 1 4 ri / r TOTAL PERMIT FEE 0 ( () A � . Print name: -� .. ` - Date: + Ills permit application expires if a permit is am °blalard within • _ c '. is., -t>• 180 days after it has been accepted as complete. *F'ec methodology set by •I'ri- County Building Industry Smvice Board. t: lBuildinc).PernaePLMP- PermitApp.doc 12/27/06 - 1.10.4616T(16'021COM t) Z0 /Z0 39dd ONI 3dt7OSGNd1 1S360d 806T6SEEOS OI :ZZ 800Z/ZZ/60 CITY OF TIGARD BUILDING DIVISION PERMIT #: I l.M2UU0-C;O t l6 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 9/23/2008 Phone: (503) 639 -4171 .Al �� f Inspection Requests (24 Hrs.): (503) 639 -4175 ,_� •__ INSPECTION WORKSHEET FOR DATE: 1019/2008 TIME: 7 :O1AM PAGE: SITE ADDRESS: 11 yt1`t SW 133RD AVE CLASS OF WORK: SUBDIVISION: I ° V Iil�t�i IIf '4: PLACE LOT #: 032 TYPE OF USE: PROJECT NAME: SCHAFER DESCRIPTION: E3at :h(Iovw for irrigation. OWNER: t3CHAFf:R, STEVEN PHONE #: 603 6394760 CONTRACTOR: FOREST LANDSCAPE, INC PHONE #: ar)3357 38tgt3 Inspection Request Scheduled For: Date: i0101 X008 Pour Time: Code # Inspection Description Confirm # Contact # Message 395 Misc. insp$ct 076450 - 01 503. 357-3808 N Corrections /Comments /Ins uctions: / a , 'c.c. 4 A ) b G1/4_ feS-1 br* Io I i Leif WO r a-e4`ii/5 4:e....X , p i 6/2/4-- -- ak, s — °r-e-c____ OAV L ZA ,- PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED kt (j- b lq /o ( f/ Z N Inspector: Date: ( Phone #: (503) 718 - 7 !