Permit . - ' v
CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00494
An, I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/23/2006
PARCEL: 1 S 134DB -09300
SITE ADDRESS: 11079 SW 113TH TERR ZONING: R -4.5
SUBDIVISION: STONECHASE LOT: 017 JURISDICTION: TIG
Project Description: Residential backflow 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
GERRITZ BIGGI CUSTOM HOMES Description Date Amount
9550 SW BEAVERTON HILLSDALE HW
BEAVERTON, OR 97005 [PLUMB] Permit Fee 101231200E $36.25
[TAX] 8% State Surchar! 101231200E $2.90
Phone : 503 619 - 4668 Total $39.15
Contractor:
MARK BROWN LANDSCAPING
PO BOX 744 REQUIRED ITEMS AND REPORTS
VANCOUVER, WA 98666 -0744
Contact # : FAX 360 - 993 -5993
PRI 503- 234 -2667
Reg #: LIC 5192
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 rule or direct questions to OUNC by
calling 50 24 6 9 1
..
Issued B.f,�" ,> v Permittee Signatu er :__ ? / %:
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.
r g r 1/4- Pi 605 - - 00 "I I (
Plum bin Permit Application . ..
- - FOR OFFICE ESE
City of Tigard Received ; A h
Date/By: / ,... i UV „ Permit No.: lj , / '
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639 4171 Fax: 503.598.1960 //x Jr •
Date/By: Other Permit No..
24- Hour Inspection Line: 503.639.4175 • nal I/
Date Ready/By: ,,,,, ED See Page 2 for
• Internet: www.ci.tigard.or.us Notified/Method: /( J Supplemental Information
■
. '?X4:‘'.
[Prew construction El Demolition For special information use checklist
Description I Qty. I Ea. I Total
1=1 Addition/alteration/replacement 0 Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTIONa;:,)'Agg&;; SFR (1) bath 249.20
rr- and 2-family dwelling 0 Commercial/industrial SFR (2) bath 350.00
SFR (3) bath 399.00
0 Accessory building 0 Multi-family
Each additional bath/kitchen 45.00
0 Master builder 0 Other:
. , .. Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION,,,,:g:,:Y).:,,,,!','*f Site utilities
il
Job site address: i I 0 7 C .113 avo Catch basin or area drain 16.60
City/State/ZIP: - rici rx . a 0v ei - , igi--1 Drywell, leach line, or trench drain 16.60
Suite/bldg./apt. no.: I 1 Project name: f y .A,_,,,.., ,, Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Athr-/-h DC(/) 9-,/;,.15/ %,..5/5,
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2 •
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: ,.../0,,e.d..„1 i Lot no.:
Fixture or item
Tax map/parcel no.:
• , ,,.,, _ ., , ., Absorption valve 16.60
, • :DESCRIPTION OF' Nvidqiicp' , .= , ;4,:.. , 1 ,, ,'-. 1,, , ,,, ,:l. , , , ,, , '? , ', , :i.
/ ' . , .y. .• Backflow preventer / Page 2 3 A
/4 0 D i. 21 6 , -/ 4-176 r 1 . .6.etejeP ow Piee67( 411,-- Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
... Drinking fountain 16.60
0 PROPERTY OWNER . . . 4 . - 0. TENANT.„:.. .: . .,..:,;....
'• '• - ' - • Ejectors/sump 16.60
Name: ( i - 0 1- L ., <Aj 1 (2t5.7 . /nes LI-C'.: - Expansion tank 16.60
Address: 6,4%,_„4 c , 6? a ve"-..1-0 ( - ) Hi/is N Fixture/sewer cap 16.60
J 3 (2 City/State/ZIP: r 0 ‘ ref-1-0 n 0 /(-) 970a5 Floor drain/floor sink/hub 16.60
Phone: L &/'.-- .e& 6 Fax:,...)
'03 )56 ,2 - ,fi ?/-/ Garbage disposal 16.60
Hose b 16.60
0 APPLICANT. ,:.;.::,.: :. • . ,::.[Ititif■4et*i**AD ib
,Tg
(2 - - ,-- - Ice maker 16.60
am
Business name: (2 c6 0 ? ,_. --, C i / - u
.z.__ h (--t J d
A.4. i / •vt f tc/uvI ,‘ / Interceptor/grease trap 16.60
Contact name: ,....i A n ( 4. Medical gas (value: $ ) Page 2
Address: i l t S() 6averion, 74 &daft. gd Primer 16.60
City/State/ZIP i - ,07e,r n k 6/7 y ca5- Roof drain (commercial) 16.60
Phone:60/) 6 / ‘ 9 Fax: : (55,7h ...... y Sink/basin/lavatory
Tub/shower/shower pan 16.60
16.60
E-mail:
Urinal 16.60
. • • • . „,i; ::,.-,. ';.,'--, r...,.,PC.q . :':--,;Qa . ;NW....i. Water closet 16.60
Business name: 171 6„..„„, ,,,,,,, Water heater 16.60
/ '7 gq
Address: Po. i30 Other:
City/State/ZIP: ( mly taw 14) /4- 9' R6,‘ 4 ...„ F./Li
, Subtotal
Minimum permit fee: $72.50 1..• , .2; .."''''
Fax:3 (00_ 9 9 3 __.5 3
- Residential backflow minimum permit fee: $36.25 _7
CCB Lic.: 4:0....-2fir , lei 9- a Plumbing Lic. no.: Plan review (25% of permit fee)
,
' .
' State surcharge (8% of permit fee)
,
Authorized signature: ' / ,,/,./6
TOTAL PERMIT FEE ,.0
E , i i f)
Print name: ir (1 r g_ .1 2006/1 Date: 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.
C
CITY OF TIGARD
• . BUILDING DIVISION PERMIT #: PLM200 &00404
13125 SW Hall Blvd., Tigard, OR 97223 s DATE ISSUED: 10/23/2006
Phone: (503) 639 -4171 µin �`
Inspection Requests (24 Hrs.): (503) 639 -4175 ,.:�.:�
INSPECTION WORKSHEET FOR DATE: 12/14/2006 TIME: 7 :02AM PAGE: 53
SITE ADDRESS: 11079 SW 113TH TERR CLASS OF WORK:
SUBDIVISION: STONECHASE LOT #: 017 TYPE OF USE:
PROJECT NAME: STONECHASE
DESCRIPTION: Tfi trtt0;4501,4 ,tprirE`i9ala :S .
OWNER: GERRITZ BIGGI CUSTOM HOMES, PHONE #: 503 - 619-4666
CONTRACTOR: MARK BROWN LANDSCAPING PHONE #: 503. 2342667
Inspection Request Scheduled For: Date: 12/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 0410555 -01 503-718 -2433 N
Corrections /Comments /Instructions:
, 412"Z'—gli"--
. 7 7 (2- i
• (:. . . - - - 7 G/v
i
ASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION l 1 ADDITIONAL FEES ASSESSED
Inspector: Date: Id- I i Phone #: (503) 718 -
ni (