Permit r j Il
CITY TIGARD PLUMBING PERMIT
j� DEVELOPMENT SERVICES PERMIT #: PLM2005 -00157
4 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/25/2005
PARCEL: 2S 109AD - 03400
SITE ADDRESS: 14547 SW 130TH AVE ZONING: R -7
SUBDIVISION: WOODFORD ESTATES LOT: 026 JURISDICTION: TIG
Project Description: Backflow device.
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
HIRCSHMANN, GUNTHER JR + MARISOL
14547 SW 130TH AVE Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 4/25/2005 $36.25
[TAX] 8% State Surcha 4/25/2005 $2.90
Phone : Total $39.15
Contractor:
JOHN DARBY LANDSCAPE INC
13867 SW BENCHVIEW TERRACE
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Phone : 503 -579 -5298
Reg #: LIC 7110
PLM 12319LCL
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 -6699 or 1- 800 - 332 -2344.
Issued By: f`�t Permittee Signature: , cN)
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.
FROM : JOHN DARBY LANDSCAPE INC FAX NO. : 5035'246613 Apr. 24 20O5 12:37PM P3
• to •
building Fixtures .
G n r r ar t r l{ 14 x Y
tr `V 1- v FOR OF v FO '1 E U.S Oj� 1 0, 1 v +6 L
Plumbing Permit 10 1• 1i. t ' .. •
City of Tigard � lteceivcd , -;'e ?ernes tie. � D( �
13125 SW
Pfd 2 5 20 Plan Review Davy: .
Mall Blvd.,'figard, OR 9722 0" � Other Permit Na;
Phone: 503.639.4171 Fax: •503.598.196 � A QD � / 1 ,, urp l tl{$1'`r t � Date/By: " -1
24- Hour InSpeotion Line: 503.639.41'6y ? OF T ,.a" v ^� i '� A ' + • Date Ready/Br • Suns: r _ 0 See Pace 2 Cur
1ntemet: www.ci.tigard.or.us 9 NISI(' NOtifkd/Mathod: Y� • { r r � Suppltmc,t y tal:nioriu itioi,
��'ec - ?e' •i iL ' ii': ai'.� )1 L • , R �D.t 1 . �k.f teYlClfiw''4 2� , i 9 tth!•;:{ ;.YS }1 i' .{!k' , x ` 4't`7 "�°� R. ,i'� y �:I . a• ` ' ^5:. � ; 4t � - • ` 1 2z : i. % . y st . f ., 4.,. ',., , •, 3 ' . . . 1'aw'?r� In.,.t7 itb�".t if n u t,,
Demolition For pedal information usr ctucKGSr.
❑ New construction Description I Qty. l ... Ea I =Iota!
74 Addition/alteration/replacement .0 Other. . New 1- 2 - family dwellings (includes 100 ft. for cach_;
{� y y ality .onncct;or)
M. t 11. 1�'w 9�' c ,, Pt � ry� f }" � y4.'4,F i4 1 ._
eii�i c 5 r,t�� a 5 944; 1 941 -F t ut , y� , , ''I` N _q F? �L � SFR(1)bath 1 . .249.20
(2) bath 350.00 •
�, : and 2-family dwelling [] CotTSmercia]/industt'ial SFR -.
multi-family SFR (3) bath 399.00 r •
• Accessory building Mu
❑ y
Each additional bath/kitchen 45.00 i
Other:
❑ Master btrilder ❑ ... . Fire sprinkler ( sq. ft.) Pages 2 I
n � '� � ^1 '" i 1 �,y t' 7r^ ;? °s a / '�7 �rr�r�l
't r r i x T • 0 �! l 0 ,', l9 Gb y9A ti .r. s !( r .
�";_ �? .,r :' :_,ru� � ��' `i �� f �����.Lr C 1 4 �' 3 . ?: Site utilities
1 4 7 • g ( 1 3 i . , . . Catch basin or area drain f 16.60 . I '
Job sits address: v .
dry /Stare/ZIP: , (� 7 ••`'? t''. . Dryweil, leach line, or trench drain _ Y 16.60 - -
1 � Footing drain (no linear ft.: ) Page 2
Suiteibldg./apt..no.: Project name: •
- ^ Manufactured borne utilities I 1 U U
Cross strect/directions to job site: -
Manholes _ I 6.60 I
Rain drain connector 16.60
Sanitary sewer (no. linear ft.; ) 1-' age 2 I
Storm sewer (no. linear ft.; ,) 1 Page 2 I -
Water service (no. linear It; ) Page 2 jI - -
Subdivision: Lot no.: _
Fixture or item I •
Tax. map/parcel no.: ' ' r . , r „Rr -r� '"'DFt'z vEF� (, O' s r e! • Absorption valve 16 6�
tr. ,. &:3 S' -y ..a� ..t:_„ ^r ` , , °�a ` '�- 1t �i . „4+1 tI 'i4fit il;i1'k_. a 16. Baekflow preventer Ng.: 2
..., r r s r i :n' iT:(:1 . 1 , 1 .: i �u S 1$! ' k� ti'1r'1' 4 q '�' k'+ 4 Vnx tis :4' M � a . tEnt ul.c .cq1l ' Ejectors /sump 16.60 ! •
I
Name: __
V t � - r • ■ t 1 � ■ E xpansion tank 1(i 60 _
` I v \ i 'il Fixture/sower cap I 16.60 I T -
City /Srate'LII'': �!: ' • .. Floor drain /floor sinklhub 16 60
Phone: $4:5) � V ; Y Fax: ( ) Garbage disposal I� 16.60 I
"r . c ri� " w �rti» �s.7 - • 1Iose b;b . 16.6
T•` k x q yi t / v ` '1 , Sq tr �L �,{� ,9• T •�it , i P t v K . 111
: .. ° `-vAl Vii ,+ .4,, ^1" '�a..v ,, El . x " 1-0„1 i ,1._ ��' 1.4. ° ana! 4 lee makes _ l6 60 - 1 • '
Y
Business Hams: 1.4.1 A /,/ t G i I la g , • ° _ . . . h /grense hap ! 6 60 i _�_
Contact name: 4 . � Medical gas (value: $ - . ) . l'ae 2 i ^ I
Address: • • Primer . . I 16.60 I 1
City/State/ZIP; . . , . • . . . , Roof drain (commercial)' 16.60 I
Sink/basin/lavatory 1 6,60
Phone: ( ) Tub /shower /shower pan _ 16.60 I _
&mail: \ tt ' Urinat i' . 16.6o 1
R s9 . 3 +tS t :,7 . r f vr l / G3 t .,? 1'S 11 ,4,1 y . . ...- • itt.,vu 4 -. s i kt i.:5� l,` . w �` p `:. (-8 � a ;z.ti Wc,..i61 . i1 4.t :'d Lla '' W ate r closet 16.60
Business name: / L �ri C `► �' I 1 L ��/ _ _ I Wat cr. h eater .. _ 1 66 0
.1
i Other: f
Address: - 1 11R.fi I �.L > > ��I_ • • Subco:al
City/State/ZIP: i s i 4 , . ' • - -
Minimum permit ice: S72.SC
• • • • �
. +` • 1j 4 -
CCB Lie.: Residential baekflow minimum perrrlit fee: $36.25 I • YSum: _
� j l Q / � G.� i Plumbing Lin. no.: Plan review (25% of permit fee) •
y --- -- ,
... Su surcha,'ge (8% of perinit foe)
Au[hotizedsigtature: . . . . . . • TOTAL PERMIT ;EET f 15
name: e: �f� I/l Vl , � �f Date: ,+014 This st r
permit applicativ expires If a pe: o is i of 7bc�i ic;,;'
`1`«• ' ` 180 days after It has beer, accepted as cu:npict,
*Fee methodology set by Tri -Count' Building industry Se:': to '3(.arc
i :\ itdistTer n PLMF.ParmitAp ?.dx 12103 440- 4616T(to/e2/COM/WEB)
Y
CITY OF TIGARD ' ,•
BUILDING DIVISION PERMIT #: PLM200f -00157
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/25/2005
Phone: (503) 639 -4171 : 'ii' ii �.
t '
Inspection Requests (24 Hrs.): (503) 639 -4175
1
INSPECTION WORKSHEET FOR DATE: 5/19/2005 TIME: 7 :12AM PAGE: 99
SITE ADDRESS: 14547 SW 130TH AVE CLASS OF WORK:
SUBDIVISION: WOODFORD ESTATES LOT #: 026 TYPE OF USE:
PROJECT NAME: HIRSCHMANN
DESCRIPTION: Backflow device.
OWNER: ONE #:
HIRCSHMANN GUNTHER JR + Ivi RISO - PH
A ,
CONTRACTOR: DARBY LANDSCAPE INC, JOHN PHONE #: 503.579 -5298
Inspection Request Scheduled For: Date: 5/19/2005 • . Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RPfbackflow preventer 007209-01 503- 579 -5298 N
Corrections /Comments /Instructions: ,=_
C a rc.( ■—.A.-.A 94."-)
•
•
z - PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( Date: 61 MI/V Phone #: (503) 718-