Permit CITY TIGARD PLUMBING PERMIT
/*� I °� DEVELOPMENT SERVICES PERMIT #: PLM2005 -00586
�� 13125 SW Hall Blvd., Tigard, OR 97223 .503- 639 -4171 DATE ISSUED: 10/20/2005
PARCEL: 2S112CD -12300
SITE ADDRESS: 16018 SW 77TH TERR ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 021 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
LEGEND HOMES Description Date Amount
12755 SW 69TH
SUITE 100 [PLUMB] Permit Fee 10/20/200E $36.25
PORTLAND, OR 97223 [TAX] 8% State Surchari 10/20/200`. $2.90
Phone : 503 620 - 8080 Total $39.15
Contractor:
MARTIN SANDERS GROUNDS MAINTEN
PO BOX 307 REQUIRED ITEMS AND REPORTS
NORTH PLAINS, OR 97113
Phone : 503- 647 -5567
Reg #: LIC 5742
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 -•: •9 or 1- 800 - 332 -2344.
Issued By: 1 ,,7y Permittee Signature: .Glcx.C.r�7YI�
Cali 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.
Oct 19 05 11:41a Martin Sander 503 - 647 -9151 p. 4
G �.� �� t•tllt U1 11( is t ,1 t1\1.1
plumbing Permit Reccit' tl d
pi of og � g P` mitNo :P ) vas -00 , ca ,
City of Tigard
[3125 SW Hall Blvd., Tigard, OR 97223 e Plan Review Other Permit No.:
Ti
'hone: 503.639.4171 Fax: 503.598.19 T 1 1 '''''' %= DatclB
1 I Date Rmdy/ny: % 2i See Parr 2 for
14- Hour Inspection Line: 503.639.4175 - a -- NolifecdIMethoJ, , Supplemental laroretation
ntemct: www.citigard.ot:as WY OF TIGARD "M fig .. tux
t�IISIC�N
For special infonnadue use dreddus
New construction
Demolition Description I Qty. 1 Ea. 1 Total
] Addition/alteration/replacement , Othce New 1- 2-family dwellings (includes 100 ft. for each utility connection)
SFR (1) bath [ � 24930
CATEGORY OF CONSTRUCTION SFR (2) bath 350.00
] 1 -and 2- family dwelling Q Commercial/industrial SFR (3) bath 399.00
] Accessory building ❑ Multi- family Each additional bath/kitchen 45.00
] Master builder
0 Other: Fire sprinkler f______ s4. ft-) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities 16.60
t � 1(g SW 1 l "C Irk 1 e,e Catch basin or area drain
�b site address: 1601(g 16.60
f, DrynvcA. leach lino or trench drain
ity!Slale W: ; ', 10 , 1 -0, R q Z Z �[
T (� t � Fooling drain (no, linear ft.: ) �'-
uitc/bldg_/apt. no.: I Project name: lia-i'1'1 W ,i Manufactured hone utilities 1 10.00
Toss street/directions to job site: Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear R: __J Page 2
Water service (no. linear ft.: �� } Page 2
�kr"T1 bo (4, j
t,bdivision: LI(5] $S iln ( Lot no.: Fixture or stern
ax map/parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backtlow preventcr Page. 2 ( �t "1
Backwater valve 16.60
Lk ' J Clothes washer 16.60
�( SCE t ���1(� CC , � Dishwasher 16.60
Drinking fountain 16.60
PROPERTY OWNER TENANT Ejectors/sump 16.60
lame: I_e4� i, vv
d 1 ) f e . cc Expansion tank 16.60 l
tddress: U1/4.-.1 Th cx Are 1 L�') Fixture's-- cap 16.60 I
( Z� �� Floor drain/floor sink/hub 16.60
sty/stawzlP: 1F'or k ‘� n 0 IA `'Z3 16.60
Garbage disposal
'hone: 603 ) (0 2,0 - u RD I Fax: (6-15.' Sig - g9 c <> Hose bib 16.60
API('I.ICANT 1] CONTACT PERSON Ice maker 16.60
lusiness name: 4l-{ -t- S ° ./-{ (7)yr)L 1 S .t. Interceptor/grease trap 16.60
p Medical gas (value: S ) Page 2
:.'on tact name: t � f - }-lN/'( -,CenrJlo�� � 16.60
f Primer
ddre� �- � /A - �� Roofdrain (eotnmexcial) 16.60
;ityismtdzm: �1 0 „,,....4.4, ‘ e ! G_=�'tS o ►� q"?! 31 ' 16.60
- Roof ra (co Cory
'hone: (503) Ll! Y - 7 - S 5 6, -7 • J Fax:: (cs tp L77 - yf.Sl Tub/shower /shower pan 16.60
-mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Water heater 16.60
)usincss name: MA - r h Imo) S.-, ,, -y5 62 roc./)...1, `S 1
Other
tddress: . O , ig p )C "tom _ Subtotal
r r �
:ity/State)ZIP: p ( )Y d" .10 L Gc_. ; \' S / 7 r. - Minimum permit fee: 572.50
bacicfow minimum permit f
C Fax: `` r - 9 , esidential fee: 53625
hone: (509 � � '7 " 5� 6 � Fax_ D ) 5 � R pl review (u %oCpexmit fee)
CB Lic.: Z Plumbing Lie_ no.: State surcharge (8% of permit fee)
.uthorized signaturm l 0 - f " 0 TOTAL PERMIT FEE „2.5
r Date: This permit application expires if a permit is not obtained within
Tint iramc i4/7 a J/ fi� (� 54 ;, �X Gy m 180 days after it has been accepted as complete.
*Fee methodoloav set by Tri- Countv Buildine Industry Service Board
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: PLM2005.00586
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2005
Phone: (503) 639-4171 -14414tit
Inspection Requests (24 Hrs.): (503) 639-4175 A14-
•
INSPECTION WORKSHEET FOR DATE: 11/15/2005 TIME: 7:0201 PAGE: 63
SITE ADDRESS: 16018 SW 77TH TERR CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 021 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: Backilovv preventer for irrigation.
OWNER: LEGEND HOMES, PHONE #: 503-620-8080
CONTRACTOR: MARTIN SANDERS GROUNDS MAINTEN PHONE #: 503-647-5567
Inspection Request Scheduled For: Date: 11/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3) RID/backflow preventer 021279-05 503-647-5567
Corrections/Comments/Instructions:
lig PASS EI PARTIAL APPROVAL fl CANCEL 111 NO ACCESS
I FAIL 1 I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
,11c/C
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD -- -
BUILDING DIVISION PERMIT #: PLM2005- 00686
13125 SW Hall Blvd. Tigard, OR 97223 DATE ISSUED: 10/20/2005
Phone: (503) 639 -4171 .tea 'ipm�Hll1��I+
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 11/15/2005 TIME: 7: 02AM PAGE: 57
SITE ADDRESS: 16018 SW 77TH TERR CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 021 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: Backflow preventer for irrigation.
OWNER: LEGEND HOMES, PHONE #: 503 - 620.8000
CONTRACTOR: MARTIN SANDERS GROUNDS MAINTEN PHONE #: 503 -647 -5567
Inspection Request Scheduled For: Date: 11/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 021279 -06 603-647 -5567 N
Corrections /Comments /Instructions:
•
►I. PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � �-� Date: ' l / t \/ U Phone #: (503) 718 -
. / /4.4 <i-------1