Permit CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00339
TicA'RD DATE ISSUED: 8/15/2008 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S104DB - 05500
SITE ADDRESS: 13229 SW MAPLECREST CT ZONING: R - 4.5
SUBDIVISION: MAPLECREST LOT: 002 JURISDICTION: TIG
PROJECT: MAPLECREST
Project Description: Installation of residential 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
WINDWOOD CONSTRUCTION INC
12655 SW NORTH DAKOTA Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 8/15/2008 $36.25
[TAX] 12% State Surcha 8/15/2008 $4.35
Phone : 503- 780 -4375 Total $40.60
Contractor:
BURNESS LANDSCAPE
9330 SW LEHMAN ST
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 432 -8525
FAX 503- 432 -8525
Reg #: PLM 8677
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 OU NC b .246.6699 or 1.800.332.2344.
Iss ed By: Permittee Signatu :
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.
A;1G -15 -2008 12:24 PM THOMAS. S. BURNESS 5034328525 P.03
l Permit ADnlication
Building Fixtures ! , ,12 „I ! 1 i ,I ,
City of Tigard RECEIVED ."", //,�''
13125 SW Hall Blvd., Tigard, OR 97223 /frl / ,L di , „33
:PI L Phone: 503.639,4171 Fax: 503.5911.1Qt 1 5 2008 • Other Permit Nu.;
Inspection Line: 503.639.4175 N U u Date /By: 81 See Page 2 for
Internet: www,t(gard- or.gov , h Notidod/Mothed; Su y . enrol Information
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. ition For tper1a11eJarnerttlon ase checklist
Description ' I Qty. i Ea. 1 Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwelling (includes 100 ft. for each utility connection)
e * !• ; '' r
; i ' +4 " '41117.'.4';',. . s� f! ` !h '..^4.i
1i'' SFR (1) bath 24920
® 1- and 2- family dwelling 0 Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- fbmily SPR (3) l 399.04
P,ach additional bath/kitchen 45,00
❑ Master builder �t ���t 0 Other. x Fire sprinkler ( sq. ft.) Page 2
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Job site address: 13229 sw maple treat ct Catch basin or area drain 16.60
City /Statc/ZIP: Tigard, OR, 97223 Drywall, leach line. or trench drain 16.60
Suite/bldg. /apt. no.: 1 Project name: Maple Crest Court Footing drain (no. linear ft.: Page 2
Manuthetured home utilities 110.00
Cr, nsa ntreet/direetirms to joh Kite: aw greeafield
Manholes 16.60
Rant drain ceumector 16.60
W
Sanitary sower (no. linear ft.: _ Pagc 2
Storm sower (no. linear 8,: _J Page 2
Subdivision: Maple Crest Court f Lot no.: 2 water service (nn. linear ft,: ) Page 2
Tax ap/pareel no -: Fixture or firm
tn
w Absorption valve 16.60
?r#kr' i rt n,>a+ 1, , G:r n.' l y ,, nacxnow prevenrer
landscape irrigation Backwater valve 16.60
Clothes washer 16.60
- - Dishwasher
1 1 ' �. � i' � i !,1 f y p� t r, d� y • , Drinking fountain , 1
: , .f iY . l , , ,. I ,;1,. ; . : t ill ,i ,. ;e4, ,� Ejectors/sump 16.60
Name: Windwood Homes Expansion tank
Address: Fixture/sewer cap 16.60
City /State/Z1P: -- - Floor draWtloor sink/hub 16.60
Phone: ( ) Fax: ( )
Garbage dia e
KCi ! Hose bib e
I maker 16.60
Rosiness name: Bnraese US Interceptor /grease trap 16.60
Contact name: Tom Barnette Medical gas (value: $ ) Page 2
Address: 9330 SW Lehman St Primer _ 16.60
City/State/ZIP: Tigard, OR 97223 Root drain (commercial) 16.60
Phone: (503)432 -8525 f Pax:: (503) 432 -8121 Sink/basin/lavatory 16,60
Tub/shower /shower pan 16.60
E-mail: Urinal 16.60
: '-' I lt.^O1N' W 1O;, ; , r nS t i ° i l ,P/ 1. k4;" Water closet 16.60
Business name: are above Water heater 16.60
Address: Other: T
City /State/ZIP: Subtotal
Minimum permit tbe: $72.50 36.25
Phone: ( ) Zr • r Fax: ( ) Residential l backflow minimum permit fbc: S36.25
G ' Plan rev iew (25% of *c)
CCA i.ic -: 1 0�7 /A � � Plumbing lac, nu.:
State surcharge (12% of permit fie) 4.35
Authorized signature: A, _ _ _ TOTAL PERMIT FEE 40.60
A .
Print name: Thomas B ess Date: 8-13 -O8 J This permit application expires If a permit is not obtained within
180 days after it bas been accepted as complete.
*Pee methndnlnpv art by T rifinumv Rnildine tnrinvtry Servien Rnard
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: " a 3 REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection Description I PASS Date I By I ✓ Code Inspection Description I PASS Date I By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service •
205 Footing 120 Electrical rough -in
805 MFG- Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
- 220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225. Post /beam structural • 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
•
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 , Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final • 625 Duct work
498 • Grading final 630 Fire damper
299 Final inspection 635. Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
• 210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I:\ Building \Forms \InspCard- AOP- Blank.doc 02/02/07
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AWWA 0 EXISTING
PNWS:
. BACKFLOWASSEMBLY ❑:REMOVED '
PROPERTY' - _‘,.-1 . � ❑ REPLACEMENT
OWN ER, ., W . .r) GP."' Nt .n ,
b ` PHONE:' - - 44+.
MAILING /I _ ( - 1
ADDRESS: , . . /' L 67 C� S::D_ _ K .1311, i` k+ ‘40 — - -
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ASSEMBLY J �� -�
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PRESS DROP • - (A) CHECK #I INLET, ` FAILED -QC.
INITIAL RELIEF VALVE �'
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TEST - - - - MIN :2 PSID I .. r PSID. DATE:
R ESULTS ;BUFFER• ( LEAKED�D a :: . " .%/ 1 t{ /" , '
:A -. B.= I 'CHECK #2 PSID . PSID
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- - - REDUCED. PRESSURE ASSEMBLY —> P,V:BA!$.V:B.A.- AFTER REPAIRS
PRCHECK , �"-£ Sj A.a. ? - .
PRESS DROP () " � -. � _ - DATE:'
TEST . RELIEF
I .CH ECK #1 ] �- OPENED AT PRESS DROP '
AFTER OPENED (B) TIGHT ('� •PSIO; - �� +� IU -
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'REPAIRS BUFFER CHECK #2 _ g'
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r� !TIGHT o1 , P,SID ' ..PSID' PSID PASSED � `
. ? - IN COMPLETING AND SUBMITTING THIS TEST REPORT. THE TESTER CERTIFIES THAT THE t -. _
• ' . - (. •ASSEMBLY' HAS -BEEN TESTED AND MAINTAINED - IN ACCORDANCE'wrtn ALL. APPLICABLE ° --
" • .RULES: • AND REGULATIONS OF -THE -' WATER •.' SYSTEM.. AND STATE REGULATIONS. - _ -
GAUGE.'CALIBRATION::.DATE - t%4-. , l 1 : 4 ,DETECTOIrMETER ; READING • ,- • • - " '
TESTER SIGNATURE - :47 �. • r - ,` m;-.` w - CERT . i
1xt : . � 'ma *Ea :far - aa l ' - �OVb
TESTERS NAME PRINTED' 3 i 1 u_ c.T i ;..° S' s'2 ! a r. av6,a.�, GAUGE N
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TES A _ - - - PHONE. II
- ,NP. 97191 -n1 i 1 `
COMPANY N A M E _'• j ° "� - - - ''
(D-: . v —. O . d . . . 1A SERVICE :.RESTORED..
'REPORT RECEIVED BY `, (REPR E NTATIVE OF_ OWNER)" ' - �.
- ' WHnE•= Water System Copy PINK • Customer:Co • YELLOW ;Tester Copy