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Permit IN CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00383 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/23/2007 PARCEL: 1 S134CA -FB012 SITE ADDRESS: 11234 SW 118TH TERR ZONING: R -4.5 SUBDIVISION: FEHRENBACHER NO. 2 LOT: 012 JURISDICTION: TIG PROJECT: FEHRENBACHER NO. 2 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 PAYS CUSTOM HOMES INC. 17278 SW SONNET WAY Description Date Amount KING CITY, OR 97224 [PLUMB] Permit Fee 8/23/2007 $36.25 [TAX] 8% State Surcha 8/23/2007 $2.90 Phone : 503 - 475 -5041 Total $39.15 Contractor: BLAZER LANDSCAPE 13995 SW FERN ST. TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 998 -1507 Reg #: PLM 6872 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. Yn may obtain opies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. / Issued B ' g k d y . — _ _ _ ; �� Permittee Si nature: ir .- r r 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. Plumbing Permit Application Building Fixtures RECEIVED FOR OFFICE USE ONLY City of Tigard , 33 111 = 03 Plan Review + a 0 Permit f t��7gy�'2_ v 13125 SW Hall Blvd., Tigard, OR 97223 2001 A"` w'v Plan Review• Phone: 503.639.4171 Fax: 503.598.19 Other Permit No • Inspection Line 503.639.4175 CITY OF TIGARU Date/By: Ready/By VIT� Date Ready /By J �® See Page 2 for Internet: www.tigard- or ��J • ON Notified/Method: ! Supplemental Information TYPE OF WORK 1L � FEE* SCHEDULE ` . New construction ❑ Demolition For special information use checklist 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 t 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 El 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: 1 f Z 3 //g"' 'raw. Catch basin or area drain 16 60 City /State /ZIP: I t ✓ �ja/`� 0 R ern-2i./ Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: 1 Project name: r n� La .e. - Footing drain (no. linear ft.: _) Page 2 NO � � 1-L s )I g ri yr, Manufactured home utilities 110.00 IV Cross street/directions to job site: (` (/ I Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.' _) Page 2 Storm sewer (no. linear ft.: _) ' Page 2 Lot no.: Water service (no linear ft.. Subdivision: ( _ ) Page 2 Tax map /parcel no.: Fixture or item Absorption valve 16.60 DESCRIPTION ) OF WORK Backflow preventer / Page 2 _ �. G. T r ���i `art ( -,t�I QkJ Backwater valve 16 60 cif Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 ❑ PRO - ERNER TENANT /,; \� [D Ejectorslsump 16 60 -r, C∎ TY OWNER ` l Expansion tank 16.60 Address: 7 2;7 oii4 �.1/ U Fixture /sewer cap 16.60 City /State /ZIP: 'K � � v'i q7-2,2)/ Floor drain /floor sink/hub 16.60 Phone: ) Z / 00 Fax: ( ) Garbage disposal 16 60 ❑ APPL CANT ❑ CONTACT PERSON Hose bib 16 60 n 1,67,7 Ice maker 16.60 Business name: e -P I� [ / r C` Sc �(f e Interceptor /grease trap 16 60 Contact name: 6. s Li 5 c.-14 M edical gas (value: $ ) Page 2 Address: I 0 i () 5 LJ (, cis - Ct CI- . Primer 16 60 City /State /ZIP: 6 eCe(Je /�\- CC G17DO R Roof drain (commercial) 16 60 Sink/basin/lavatory Phone: ( })) �L�y J �- � s 3 Fax: ( ) 16 60 1 Tub/shower/shower pan 16.60 E -mail: Urinal 16 60 //11 CONTRACTOR Water closet 16 60 Business name: /3 1�2 er '1C C `it Water heater 16.60 Address: I 7°1 () S �^ ( S 0 ti / Other City /State /ZIP: i� z) - O` j� cl E tX � U : A Subtotal 17 Minimum permit fee. $72.50 Phone: 6t3 q , , L 7 Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: V s-2 Plumbing Lie. no.: Plan review (25% of permit fee) / Authorized signatur•: State surcharge (8% of permit fee) TOTAL PERMIT FEE • 1 5— Print name: Date: - This permit application expires if a permit is not obtained within L 'av `" - 180 days after it has been accepted as complete. *Fee methodology set by 'Fri-County Building Industry Service Board I' iBuildmg \Permits'J'LMF- PerinitApp.doc 12/27/06 440- 4616T(10 /02 /COM/WEB) i CITY OF TIGARD 4, '' BUILDING DIVISION PERMIT #: PLM 007 -003a3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2007 Phone: (503) 639 -4171 4roiu >d�9 Inspection Requests (24 Hrs.): (503) 639 -4175 'L I.. INSPECTION WORKSHEET FOR DATE: 11/15/2007 TIME: 7 :01AM PAGE: 14 SITE ADDRESS: 11234 SW 118TH TERR CLASS OF WORK: SUBDIVISION: FEHRENBACHER NO. 2 LOT #: 012 TYPE OF USE: PROJECT NAME: FEHRENBACHER NO. 2 DESCRIPTION: E3atidlow preventer for irrigation. OWNER: PAYS CUSTOM HOMES INC., PHONE #: 503- 476-6041 CONTRACTOR: BLAZER LANDSCAPE PHONE #: .60m90.1507 Inspection Request Scheduled For: Date: 11/15/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 0607 27 -12 503.840.7332 N Corrections /Commentss/ /Instructions: _/�_,_ '-� \ - r..( \ , N V " L r se____e,i, 3 n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: \ 4 ; ( k Date:. ` l/ I C/ 6 / Phone #: (503) 718 - ."2-- Z L' — - , CITY OF TIGARD , ` BUILDING DIVISION PERMIT #: PLM20O7.O0,.3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2007 / Phone: (503) 639 -4171 aµ ��� iiA Inspection Requests (24 Hrs.): (503) 639 -4175 A- Al. INSPECTION WORKSHEET FOR DATE: 11/20/2007 TIME: 7:00AM PAGE: 21 SITE ADDRESS: 11234 EMI' 118TH TERR CLASS OF WORK: SUBDIVISION: FEHREN 3ACHER NO. 2 LOT #: 012 TYPE OF USE: PROJECT NAME: FF_HRFNBACHER NO. 2 DESCRIPTION: Backflow preventer for irrigation. OWNER: PAYS CUSTOM HOMES INC., PHONE #: 503. 475 -5041 CONTRACTOR: BLAZFR LANDSCAPE PHONE #: 503-99B- 1507 Inspection Request Scheduled For: Date: 11/20/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 303 Plumbing final 0500100.01 503- F40.7332 N Corrections /Comments /Ins ructions: 2>l� i " o Z.P. -© efrell At ' c MPS PARTIAL APPROVAL ❑ CANCEL NO ACCESS , ;CAP a • FAIL I ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: .� Date: Ilk Phone #: (503) 718- z 972(