Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00584
- II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 4171 DATE ISSUED: 10/20/2005
PARCEL: 2S 112CD -12500
SITE ADDRESS: 16050 SW 77TH TERR ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 023 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 AVE # 100
PORTLAND, OR 97223 [PLUMB] Permit Fee 10/20/200E $36.25
[TAX] 8% State Surchan 10/20/200E $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 #: LTC 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 -66' -• r 1- 800 - 332 -2344.
Issued By: I Permittee Signature: ___c7y7 /
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.
)5 11:41a Martin Sander 503 - 647 -9151 p.2
Permit BWICaFtfW ED I cn t)F1 1( 1•: t NI 0\11 •
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clan 61 r 9 �QO Datets :(b 1 1, 1 \a5 h -�� �-
Bard, OR 9722A C Plan Review
03.639.4171 Fax: 503.596.1 = +. '.� Date/By: Other Permit No.:
r Inspccticn ne 03.
Li 5639.4 �, 1 5 TY OF TIGARt� V,_! JP • _.. Date Rcady/By: to See Page 2 for
.net: www.ci.tigard.or.us Notified/Method: Supplemental Information
miull, III V 7 /1 `' FEE` SCHEDULE
( 1New construction ❑ Demolition For spaded inJorn�iirtt use check :Esc
Description Qty. a T
E oral
❑ Addition /alteration/replacement ❑ Other Nov I- 2 -family dwellings (includes 100 !t for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 24920
❑ 1- and 2- family dwelling ❑ Conunerciallindustrial SFR (2) bath 350.00
SFR (3) bath 399.00
❑ Accessory building [] Multi - family Each additional bath/kitchen 45.00
❑ Master builder ❑ Other= [Fire klcr s ft.) Page 2
sprin Cr_ 9• t
.IOB SITE INFORMATION AND LOCATION Site utilities
Job site address: (tea) 5 p S L,J 1 Ttl T R-1A- - Catch basin or area drain 16.60
City /State/ZIP: 'T i Gard Z Z p 9-1 Diywell, leach line, or trench drain 16.60
Suitearldg_/apt no.: tiara.
Project name: j-j-Q n a t,lk Footing drain (no. linear R: ) Page 2
Manufactured home utilities 1 10.00
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
l L
Water service (no. linear ft..: _ ) Pace 2
Subdivision: Haim bG (Ail Lv S i'Y Lot no.:
.3 3
Fixture or item
Tax map/parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflowprcventer Paget -_,0
�
Backwater valve 16.60
bcindscet r_ n34 / , 0 n Clothes washer 16.60
J Dishwasher 16.60
PROPERTY OWNER ' ❑ TENANT Drinking fountain 16.60
El. Ejectors/sump 16.60
Name: Le el e (E).-e---u - Expansion tank 16.60
Address: i 7" 1 SS S j ('1 Th -Nq . ire- i j ) Fixture/sewercap 16.60
2ity /StateJZIP: ro - j.. kcx_r-) A 0 vck 9 Z-7-3 Floor drain/floor sittldhub 16.60
?hone: boa) ( ) - u b KD Fax: (6-6-' S9 g - gC( co. Garbage disposal 16.60
n APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
a usiness name: tL,(Ct. - s � 6 S Mt. interceptor/greasetrap 16.60
::ontact nntnc: M 0, f 4 4 0A0_,---'5- Medical gas (value: S ) Page 2
\ddress: to 0 . 1 , p
3- Primer 16.60
9-7 Roof drain (commercial) 16.60
;ity/5ta1cILIP: �1 ��(n (Pi ��;» S 1 3� Sink/hasinllavatory 16.60
'hone: (5023) to 1-17- 5 S v 1 Fax :: (5'j) 6 y7 -- 7 /3-/ Tub /shower/showerpen 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet 16.60
tusiness name: i5 ed_ Water heater 16.60
�y�v !� � �r rot'e
,ddress: P. D , 6 o k -a . - _ Other -
� Subtotal
'ity/Slate ZIP. N 0.,„4-1,-, 4 [ e. _ ,., nP. , c� ! / I_? 7 Minimum permit fee: 572.50
hone: (50& ( Lt -7 - 56 6 -7 Fax: (5(9) (O `r - 7 ... c,l 5 / Residential ba:know minimum permit fee: 536.24
13 Lic.: Plum bing Lie. no.: Plan review (25 %ofpermit fee)
C
5 7 y z J state surcharge (s %ofpetmit fee)
ulhoti>7ed signature: ` ` 0 /G 1 D • U TOTAL PERMIT FEE • 2-5
Tint name Da te: �� i This permit application expires if a permit is not obtained nithin
tA4 u !/ 7- V Li LSD r. - e- , 180 days after it has been accepted as complete_
*Fee methodology set by Tri- County Building Industry Service Boani
•
CIT OF TIGARD
BUILDING -DIVISION PERMIT #: PLM2006- 005t34
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/20/2005
Phone: (503) 639 -4171 i u ^�NNuvo(
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/16/2005 TIME: 7:02AM PAGE: 39
SITE ADDRESS: :16060 SW 77TH TERR CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 023 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: Backflow preventer for irrigation.
OWNER: LEGEND HOMES, PHONE #: 503 - 620.8080
CONTRACTOR: MARTIN SANDERS GROUNDS MAINTEN PHONE #: 503- 647 -5567
Inspection Request Scheduled For: Date: 11/1512006 Pour Time:
Co e # Inspection Description Confirm # Contact # Message
325 RP /backf ow preventer 021295 -01 503-647-5667 N
Corrections /Comments/ Instructions:
c f
i
1 .
1
_ PASS n PARTIAL APPROVAL ❑ CANCEL I f NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( Date: l V I / hone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005-00584
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2005
Phone: (503) 639-4171 �^ Pi�r� @I ��I t`
Inspection Requests (24 Hrs.): (503) 639 -4175 :� �' `__
INSPECTION WORKSHEET FOR DATE: 11/15/2005 TIME: 7:02AM PAGE: 38
SITE ADDRESS: 16050 SW 77TH TERR CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 023 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: Backflow 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:
de # Inspection Description Confirm # Contact # Message
389 Plumbing final 021285 -02 503 -647 -5567 Y
Corrections /Comments / Instructions:
7 1PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: l `/ ���� hone #: (503) 718 -