Permit CITY TIGARD PLUMBING PERMIT
i DEVELOPMENT SERVICES PERMIT #: PLM2006 -00126
' I I-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: PARCEL: 15136
1 S 136DA -02600
SITE ADDRESS: 11140 SW 68TH PKWY ZONING: C -
SUBDIVISION: MLP1999 -00011 LOT: 002 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
WEBSTAR VI, LLC
610 GLATT CIRCLE Description Date Amount
WOODBURN, OR 97071 [PLUMB] Permit Fee 4/7/2006 $36.25
[TAX] 8% State Surcha 4/7/2006 $2.90
Phone : 503 -981 -0155 Total $39.15
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 682 -6076
FAX 503- 682 -2872
Reg #: LIC 8079
PLM ALL PHASE &
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.
QQ
Issued By. Permittee Signature: _slue- ��U
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 Ap6ilNC FOR OFFICE USE ONLY
City of Tigard / `2�0 Received r- 13125 SW Hall Blvd., Tigard, OR 97223 K Date/By: , - l.� = Permit o.:' N o,. ,, � t (
Phone: 503.639.4171 Fax: 503.598.1960 /�, ' Plan Review v
„ � r . ' �I Date/By: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 tiG1
Internet: www.ci.tigard.or.us v i C 1 � G� J. t. - � Date Ready /By: Juris: /�,. 0 See Page 2 for
4ass G D`Vi Notified/Method: 1)V Supplemental information
TYPE F W ORK FEE* SCHEDULE
X New construction ❑ Demolition For special information use checklist.
Description 1 Qty. 1 Ea. 1 Total
❑ Addition/alteration/replacement 0 Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ I- and 2- family dwelling X Commercial /industrial SFR (2) bath 350.00
El Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ 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: ' It 40 S(\1 • l( B1" 1) Catch basin or area drain 16.60
City /State /ZIP: Ti _A R'-), og q 223 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: /Lc tat \ l L V. a� Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: 4 Y 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: l 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 Page 2 25
g 3(o,
Backflow for sprinkler system. Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name:
Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City/State /ZIP: T L , yi 2 p , pg Floor drain /floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ® CONTACT PERSON Hose bib 16.60
ice maker 16.60
Business name: ProGrass, Inc.
interceptor /grease trap 16.60
Contact name: Tom Eberlei Medical gas (value: $ ) Page 2
Address: 29895 SW Kinsman Rd. Primer 16.60
City/State/ZIP: Wilsonville, OR 97070 Roof drain (commercial) 16.60
Phone: (503) 682.6076 ext 217 Fax: : (503) 682.2872 Sink/basin / lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: TomE @ProGrass.com
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: ProGrass, Inc. Water heater 16.60
Address: 29895 SW Kinsman Rd. Other:
City /State /ZIP: Wilsonville, OR 97070 Subtotal
Phone: (503) 682.6076 ext. 217 Fax: Minimum permit fee: $72.50 2
( ) 682.2872 Residential backflow minimum permit fee: $36.25 S(.y • 5
(503)
CCB Lic.: 8079 Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (8% of ,`3 Authorized signat ..� J • -- g ( permit fee ) 2 •
TOTAL PERMIT FEE 39 , i5
Print name: Tom Eberlei Date: 014101 ci, This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
i:\ Building \Permits\PLM- PermitApp.doc 12/03 440- 46t6T(l0 /021COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PL.tdf: }006- 0i7'i7.G
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/7/2006
Phone: (503) 639 -4171 s� a : ,1 11
Inspection Requests (24 Hrs.): (503) 639 -4175 4 :_
INSPECTION WORKSHEET FOR DATE: 5130/2006 TIME: 7:15AM PAGE: 2.6
SITE ADDRESS: 11140 SW 63TH PKW{ CLASS OF WORK:
SUBDIVISION: IVII._P1999- 00011 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: 13ar:lflovv preventer for irrigation.
OWNER: WEBSfAR VI, LLC. PHONE #: 503- 901- 0117
CONTRACTOR: PROGRASS LANDSCAPE SERVICES PHONE #: 503- 632- 6076
Inspection Request Scheduled For: Date: 5/30 /2006 Pour Time:
Code # Inspection Description Confirm # - Contact # Message
399 Plumbing final 030752 -01 971. 235 -1353 N
Corrections /Comments/ Instructions:
f e r7/7)-2 /
L7D 1
■
gf -FaAgs ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ' r! ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
r
Inspector:
117117. j� Date Ai Phone #: (503) 718 - `£/i