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Permit e ir ' 'CITY OF TIGARD PLUMBING PERMIT I6 DEVELOPMENT SERVICES PERMIT #: P -00597 ,� - '. DATE ISSUED: 10/24/20/24/20 05 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S111AA -08800 SITE ADDRESS: 14235 SW 89TH AVE ZONING: R -4.5 SUBDIVISION: GREENSWARD PARK NO. 3 LOT: 072 JURISDICTION: TIG Project Description: Install 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 FOUR D CONSTRUCTION CO Description Date Amount PO BOX 1577 BEAVERTON, OR 97075 [PLUMB] Permit Fee 10/24/200E $36.25 [TAX] 8% State Surcharl 10/24/200E $2.90 Phone : 503 - 590 - 0805 Total $39.15 Contractor: LANDSCAPE SOLUTIONS LLC 7101 SW STEPHEN LN REQUIRED ITEMS AND REPORTS PORTLAND, OR 97225 Phone : 503 224 - 6549 Reg #: LIC 7429 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 5 3 -246 9 1- 00- 332 -2344. r A�//j�j te. Issued G Permittee Signature: 9 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. CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2006 -00597 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/24/2005 Phone: (503) 639 -4171 ��I Inspection Requests (24 Hrs.): (503) 639 -4175 „_. `__. INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 7:16AM PAGE: 20 SITE ADDRESS: 14235 SW 68TH AVE CLASS OF WORK: SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 072 TYPE OF USE: PROJECT NAME: GREENSWARD PARK NO. 3 DESCRIPTION: In:stali residential baclfiow preventer for irrigation. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 -580- 0805 CONTRACTOR: LANDSCAPE SOLUTIONS LLC PHONE #: 503-224-6549 Inspection Request Scheduled For: Date: 10/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 325 RP/backfloiiv preventer 019632 -02 503-970-7877 N Corrections /Comments / Instructions: -r ,44. I I - re ..pf r I ; fie Coo 0 .0 r` ,,J .a— •C- vit 1 � c ,��.. 1+r' T G-i Y ry e ✓ a 1k Ta , re c y o, ✓'1' 14 , L, PASS I I PARTIAL APPROVAL IPI CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 11 Date: /0)27 )0c. Phone #: (503) 718- Building Fixtures , . Plumbing Permit Application City of Tigard Received / a ile 23 5 DateBy G d pi/ Q Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 iGn ; ; . � Date/By Other Pennit No.: 24- Hour Inspection Line: 503.639.4175 rug . Internet: www.ci.tigard.or.us �' I-� Date Ready/By: 3. H See Page 2 for Notified/Method: // (/, Supplemental Information TYPE OF WORK FEE* SCHEDULE For special information use checklist. MI New construction ❑ Demolition Description I Qty. I Ea. I Total ❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 249.20 p 1- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building 12 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: , t..1 2 3 5 w LF c, r-n , et_ Catch basin or area drain 16.60 City /State/ZIP: '-k-, ea c' '7 �Z S -- Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2 Cross street /d to job site: Manufactured home utilities 110.00 Manholes 16.60 _ S v.l t4 C pc) 1J k...-t- Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft: ) Page 2 Subdivision: 6 r(- 3n�.ta P ,� I 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 I Page 2 4 US1 - 0..... (._. gl C "1 10i AsSC*' Backwater valve l 16.60 Clothes washer 16.60 Dishwasher 16.60 pr PROPERTY OWNER l ❑ TENANT Drinking fountain 16.60 � Ejectors/sump 16.60 Name: * - 1 - S he_ i ,_e_v, Expansion tank 16.60 Address: I Lt- -z_% c, S % 9 ir" A-‘1 Q Fixture /sewer cap 16.60 City /State /ZIP: 1-1 cgtclNab C C --1. ?.-S 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: I. QStkp Z S ri 41\1.1 , C Interceptor /grease trap 16.60 Contact name: Scutt E.-pp 1 t4 c., Medical ) Page 2 gas (value: $ Address: '-7 L0 ` Sv-. -t-Q pj,„,J -t..) Primer 16.60 City /State/ZIP: Pd,,`'k 111 C ©1 --1 -xs Roof drain (commercial) 16.60 Phone: Sink/basin/lavatory 16.60 ('' ) 1/a Z X7 1 Fax: ) E -mail: Tub /shower /shower pan 16.60 Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: L,a i -_,NS G xe t .-_- 0 1"laJ i LA__ C Water heater 16.60 . Address: '"l t O l S :n` { L�� L Other: City /State/ZIP: C?; Subtotal " .� CP CA'' Z 2 ` Minimum permit fee: $72.50 //- Phone: (Sol') ) L2 .6 tj�C Fax: ( }a' ),)-q -t • ,za�y Li Residential backflow minimum permit fee: $36.25 co-; Plan CCB Lic.: `7 4 Zq Plumbing Lic. no.: (zo `-1 Plan review (25% of permit fee) dziet State surcharge (8% of permit fee) c2 y d � ° ,� TOTAL PERMIT FEE 3 / � f Authorized signatur . Print name: curt c p r t v e C_ Date: i 2 i. / 0 5- 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 \Pennits\PLMF- PermitApp.doc 06/05 440-4616T(10/02/COM/WEB)