Permit n CITY OF TIGARD PLUMBING PERMIT
. COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00224
DATE ISSUED: 5/20/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S110DD 13400
SITE ADDRESS: 15565 SW 109TH AVE ZONING: R -
SUBDIVISION: SUMMERFIELD NO.14 LOT: 704 JURISDICTION: TIG
PROJECT: MANNING
Project Description: Installation of 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
ROSE MANNING
15565 SW 109TH Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 5/20/2008 $36.25
[TAX] 12% State Surcha 5/20/2008 $4.35
Phone : 503 747 - 4617 Total $40.60
Contractor:
JOHN DAR BY LANDSCAPE INC
13867 SW BENCHVIEW TERRACE
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -579 -5298
FAX 503 -524 -6613
Reg #: LIC 7110
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.
Thos es are set o • OAR 952 - 0001 -0010 through OAR 952 -0001 -0100. You may obtain copies of these rules or direct questions to OUNC
by (ling 503.246.6699 or ► ; . 344.
I sued By: - 0 �/_ / Permittee Sig � � j�—
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.
FFOM JOHN DARBY�tANDSCAPE INC FAX NO. : 5035246613 May. 19 2008 01:40PM P3
Buildf g ttures l , _____ ECE
Plumbin .Permit A tic t1
City of Tigard MAY $ f ; > x,r
200 Recdved _ FOR 4F,�IF 9 A1$ Q 1 ` , � z� • 13125 SW Hall Blvd,. Tigard, OR 97223 ae. ",.. , C S C apt r � t }
Phone 503.639.4!7! Fax; 503.598.1 960 CITY bere/q ` '� p ann,i,ti ' o, fl � ` ��
24- Hour Inspection Linn. 5 Phn Review r �
0109 ���� `� d+ � \ r
e www BUILDING ]fit u ■.° Date/By; --
ei.tigard,or.us B UILDING pAR-0 IF '4 11 R end /6y: - Other Pc n r NO
In terne : y? x 4 3 Date — --�
r y.�f �''r r,�4Trr (��tr� �; {. W!� `a`4 K+yT1 n. 'r�W � p. OliPod/tgothod: d ae Y,,_" 2 fir -.�
♦
g. t`^". t :: 4 5 f ii t i∎ Vyr le a e !rt ;t••? ISr, i 1 r ^,„ r . . Supp ltm 1'it . !„.. ; ,
❑ New corunvction f . i r , d cd;.,. �'�; , 't• o " -"' SCill:' UCi1 ..
❑Demolition r; _ ~ ' _
1 For 3776'04%injorrnal,v,rd e' ri:ra.hlr. - - -
P Add iuonlalteration/ re la _
r cement ❑ Other: D escri. tion � - - -`_ -- -- _
a`^'? "^%:;a�;�,. . .. �A St's• Q I � •
�• .� ��t7j� Y yy r( UI•��yy �}p rl Ohl New I- 2 tt I dwell; n (nclt,da 10 -- - - -'�.- Ti
.L•.7 ," . r..2. i c i k �r ul,¢f. WT 13'y 0.41 ' Ln ' y .`- 5 Olt. !Ur Ce 'J;11:'.'�.
' c<or i ._ s 73�r.v�. + �!�1 1 t:J n . Ft n'l. ,•.�; �t �— ::l : t : ,r
w� :o ;. ryY :'t SFi?(I)bath �T'� —�
► 11 - and j 2:9
�] Commercial/industrial SFR (2) bath - --• -- - --
❑ Accessory building
❑ i ' �G '� i
Multi•faritily SFR (a) bath -
ii Master bui _ 3v9 % i�
ldcr ❑ Other: Each additional bath/kitchen t �� - -` --
PF
. :01.57,2 - ;: -. 7'7.7•;:i.-0, r r j r . �. lam_ -
� =i>t r' :i:;; 4 , o ` pE a a ' �•, ..u.,,,.t. '^ ty r Fire spr sprinkler q r
+.,ei - L in 4; T t ' , Nee V , S B r ' � -S« : i• i ki t e s �� 5 1.) P1q-
'IL, ri " Site utilities
Job site address: O. : t -------'
G
IV' , Catch basin or a drain ; c I I
Ciry/State{ZIP: + - - -' � _
` . ► y �j]� Drywell, leach line, or trench drain -7- 6 = -------'
Suite/bldgiapt. no.: III Proj ct name: Footing drain (no. linear ft.: 2 1 — "—
Cross strcctldirections to job site; Manufactured }tome utilities - --
:G J •
Manholes t,p -- - -'-
.. — _
-
Rain drain connector - - T - - , v v) ' - - - -. - —
• Sanitary sewer (no, linear ft.: ) F, , 1 ,.,_
- - —;
Storm sewer (no. linear ft.: ) F'ag 2 _ � - - - - '
Subdivision: Water $rrvi '
ce (no. linear it. T Pa g.: 2 _
Lot no.: ( - F_S: 2
Tax map/parcel no.: —" Fixture or Item M ~ ' - ��" "`
i err,- .c r Absorption valve j IG - :
i :-1 a:7 ;' .� r 1ifiN: E YIEME€ ' 1 Back fl ow p rcventer '- °_ - - - -.
__ �2 - _ _- � ___
I t i. Ili • Backwater valve U .eO I
Clothes washer 16,60
Dishwasher .__. --- - O _
-*:9X'' .v1.1 • ,�,� , r Zr/4 'l- -r� a • �r i. ^•' t^�nr 1Rkln CO U,1C31t1 �••, - -- - ...•_ - --
1 : r �' iE P�.� Y4 )�1 '•Y3p4 G r � i Y L'. 4 ,,p A j ��n ` 'e,4� (� Jar b' G -0
]r. i iIV�'3_:L - tee;aR : #41 0`I l� :t a t,{t1 • i.'.r liiikr��t i. - :l�Y12 'a;#�1iY_+ — ---7:7t --- -' - --- .
Ejectors /sump --
��('}
Name: , �.. -I ....
,- ��rvl�U (k' � Expansion tank (, f) - -
L .
Address: ,_ f t I � • ! r r
/ Fixture/sewer cap 6 00 ` - --
CirylStateJZTP Floor drain /floor sink/hub �� 16 c I
Phone: A sg-') - ild Garbage disposal � ;,.0 ;
p
� y l C r " % r
_3 � i : ' :6 !:?CE �. .. i ^r' _ w .; ^� 'SN. ' o bib
.� � `,7; iGOJ
Ice mak:r lb 60,
Business name: 1(1 A k 4 G FAA It a ,.! ! -- — -- .
Interceptor /grease n'ap of
Contact name: a fit / gas ( Page
11 r ! Medical as value: $ )
Address;
MW Primer {~ ' .6 J - -
City /State/ZtF'. Roof drain (commercial) i 00 T _ "
Phone: ( ) Fax:: ( )
Sink/basin/lavatory X 10 _ „F- - --
Tub /shower /shower pan 16.60 '
E•maiL ��. __.._
s� e :• a t R. r Urinal ■ t G')
.f.` °y%;tr f���aG I r �
� . ��t^ � a � Water closet '1ti60
JIII ',LI 1. / `� `�'[i� Water heater -- ..� ti 62 - -
Address: "` / ♦ .. Other:
5 r'
CityiStat�z�; p 5;
j m. -_ to:::l
- - - Minimum permit fee. 572
I Phone: ( .v, ) 0. - - Fax: ,i ) oc - . _ Residential backtlow fninIYnu pe'rmnt fen: S;u :; �
I CCS Lie.: 1 4 / 34, p? Plumbitrg Lie, no.. J � Flan review (25 %ofper:n:t fee)
�. ( Gam,(/ Stste iurcharge o prrmnit ; .., .. . .
Authorized sippatwe: ! - --- r -
TOTAL PERMIT 1-c4 ,' •
Print name: ( x(} 11n (� ( Date: ��Q`•6 K This permit applivntion expires ,f a permit is !WI aoecii."a ri;,
�" rJIt 1J Ll 180 days aflei. lr has beet, acts, ien sz co:,:cl•.t:.
"Fee methodology set by Tri -County Fsu:lcing b : d , i s t r / r:.et 1 <.c
CITY OFTIGARD ...
A
BUILDING DIVISION PERMIT #: PLIV12008-00224
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/20/2008
Phone: (503) 639-4171
4,, v1101 . 1j , 1 \
Inspection Requests (24 Hrs.): (503) 639-4175 41 r ' 7 -....
INSPECTION WORKSHEET FOR DATE: 5/22/2008 TIME: 6:59AM PAGE: 39
SITE ADDRESS: 15665 SW 109TH AVE CLASS OF WORK:
SUBDIVISION: StilviMERFIELD NO.141 LOT #: 704 TYPE OF USE:
PROJECT NAME: MANNING
DESCRIPTION: Installation of residential barkflow preventer for irrigation.
OWNER: MANNING, ROSE , r . PHONE #: 503-74741617
•
CONTRACTOR: DARBY LANDSCAPE INC, JOHN . PHONE #: 503579-5298
Inspection Request Scheduled For: . Date: 5/22/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 070240-01 503-579-5298 N
• .
Corrections/Comments/Instructions:
0 .1, L.ri c Cte A
•
•
X PASS fl PARTIAL APPROVAL El CANCEL n NO ACCESS
I I FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: OM kivm.--A \ Date: SI 2/24/ Phone #: (503) 718-
, .
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