Permit CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00334 •
DATE ISSUED: 8/12/2008
Ttcnk�; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S1 8/12/2008
02600
SITE ADDRESS: 11705 SW 68TH AVE ZONING:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 009 JURISDICTION: TIG
PROJECT: MOUNTAIN PACIFIC MACHINERY
Project Description: Install commercial backflow for irrigation system.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: B 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
DEAN SMITH
17880 SARAH HILL LN Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 8/12/2008 $72.50
[TAX] 12% State Surcha 8/12/2008 $8.70
Phone : Total $81.20
•
Contractor:
ASHLAND BROTHERS LANDSCAPES
2153 MOLALLA HIGHWAY •
WOODBURN, OR 97071 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 - 981 -6131
FAX 503-981-1058
Reg #: LIC 7174
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable
laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if
work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification
Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions
to OUNC by c- , 503.246.6699 or 1.800.332.2344.
Issue. y: j - / � �, Permittee Signature
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: rti- -D . ,53 4 / REQUIRED ON GREEN INSPECTION CARD.
cNX�$ 7
✓ Code I Inspection Description I PASS Date I By ✓ Code I 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
910 Sprinkler rough -in PLM - Plumbing Permit
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
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
08/11/2008 16: 5039811058 ASHLANDBROTHERS PAGE 02/04
' Plumbin Permit A • ' ,1VED
) � X
Building Fixtures - ru is ti li RI: 1 ti c. c 1s i . l
City of Tigard o 1 200 3 = L i 13125 S W Hall Blvd., Tigard.
Phone: 503.639.4171 Fax: 50O3.J98.196p • ,� u n Other Permit No.:
71, ; ,, 1 Inspection Line: 503.639.� f 1 \ C ." ` i � �, fi ri' U Date Ready/By: lens: ® See Pagel for
Internet www.tigatd -or,I v k t /; ()ill! I $ \ Notified/Method: Supplemental infore oboe
! w hJll
I I New construction ❑ Demolition For special information use checklist
Description 1 Qty. t Ea. 1 Total
0 Addition/alteration/replacement ❑ Other. New 1- 2-family dwellings (includes 100 ft for each utility connection)
CATEGOR'I` OF CONSTRUC PI ( ' f! , , SFR (1) bath 24920
® 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family S (3) bath 399.00
Each additional batb/kitchen 45.00
D Master builder ❑ Other:
JOB,si LNFORM UON A'ND,;LOC ATIOPi g 2
Fire apri s , ft Page
Site utilities
Job site address: 11705 S.W. 68 Catch basin or area drain 16.60
City/State/ZIP: Turd, OR 97223 Linn 00 ARd eG10. tiwiday Dryweli, leach line, or trench drain 16.60
Suite/bldg- /apt- no -: I Project name: Mt. Pacific Machinery Footing drain (no. linear ft.: _, Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: -
Manholes 16.60
Haines Road Rain drain connector 16.60
Sanitary sewer (no. linear ft: ) Page 2
Storm sewer (oo. linear ft.: ) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: _J Page 2
--- Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
X3FSCRII'T10 1, OF' wO Backflow prcvcntu f Page 2 r
Install bacldlow, plus sprinkler SySteian Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
D rinkin g fountain 16.60
I, r10, bPERTY; OWNER'... I : ',. ❑ : rF4 c q
• Ejectors/sump 16.60
Name: -- IDE.F} p- 50--f 1 114 Expansion tank 16.60
Address: 1 7 $ Q,4.µ � LL Fixture/sewer cap 16.60
Lit st t/\f_ o n e q 33 s Floor drain /floor sink/hub 16.60
Phone: ( ) Fax ( ) Garbage disposal 16.60
�' Al4, , , `;, n t'O1 ifiC1t F'E1L.SOPI : Hose bib 16.60
:.,
Ice maker 16.60
Business name: same as contractor
Interceptor/grease trap 16.60
Contact name: Medical gas (value: $ ) _ Page 2
Address: Primer 16.60
City/State/LW: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E-mail: r im 16.60
CONTRACTOR t '
. water closet 16.60
Business name: Ashland Brothers Landscapes Water heater 16.60
Address: 2153 Molalia Highway tither. 1
City/State/ZIP: Woodburn, OR 97071 Subtotal L J14Q
inimum m $72.
tit fee:
Phone: (503) 981 -6131 Fax: (503) 981 -1058 Residential backflow minimum perms : 36.25 7Z
CCB Lic.: 7174 4(30/0 9 Plumbing Lic_ no_: Plan review (25% of permit fee)
Authorized signs si Lie j..�' State surcharge (12% of permit fee) 1.10
(� TOTAL PERMIT FEE si , to
Print name: .i (r�, Date: $ f II /0T This permit application expires if a permit h not obtained vrithin
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1 :a l :100enp* PUK -Penn t4pp.doc J 212710 4a0- 416TOO/O71C0MM'En)