Permit CITY TIGARD • PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00539
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/13/2005
PARCEL: 2S109AC-02100
SITE ADDRESS: 14850 SW 132ND TERR ZONING: R -7
SUBDIVISION: ALBERTA RIDER ELEM. SCHOOL LOT: JURISDICTION: URB
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: E1 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
TIGARD - TUALATIN SCHOOL DISTRICT
6960 SW SANDBURG RD Description Date Amount
TIGARD, OR 97223 [UPLUMB] Permit Fee 10/13/200 $72.50
[UTAX] 8% State Surc 10/13/200f. $5.80
Phone : 503 -431 -4003 Total $78.30
Contractor:
TEUFEL NURSERY INC
12345 NW BARNES RD
PORTLAND, OR 97269 REQUIRED ITEMS AND REPORTS
•
•
Phone : 646 -1111
Reg #: L1C 5133
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 -0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: � , -3 Permittee Signature: _a.e, ciNs
•
Call 503- 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
10/12/2005 16:23 5035301330 • TEUFELLANDSCAPE PAGE 01/03
Plumbing Permit Application FOR 01 rice U5.E ONLY
City of Tigard Received
13125 SW Hall Blvd.. Tigard, OR 97 4 '" • Datc/B �� �' r Permit No.. \ ___,,
Phnnc: 503,639,4171 Fax: 503.598. ± Pl a n Rcvicw
°`•,' si$) "` Other Permit No.:
24- Hour Inspection Line: 503.639.4175 a i
Internet; www.ci.tigard.or.tts = . I I Date Ready/By: . r. gee Page 2 far
�� {{'' X
TYP OI V 6R L
Notified/Method: ar i • appiementat tnrnrm lion
FE t [U
L J rye construction `TN Pc � For special it fo rination use checklist.
❑ Addition /alteration/replacement :.�
+ �
CA
I Dcscriptinn Qty, Ea. 1� Total
, ` T T b.SIO New 1. 2-family dwellings (includes 100 ft. for each utility connection)
• • F (ON StRUCTION t1 . T
. .. SFR(1)bath 249.20
•
❑ 1- and 2- family dwelling [] Commercial /industrial SFR (2) bath _ 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399,00
� Each additional bath/kitchen 45.00
[
❑ Master builder " Other: 3� q D
Fire sprinkler ( . s9, R•) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities ..
Job site addres �
e) ',J ,2? � , \ /5 A !` Catch basin or area drain - 16,60
City / State/ZIP: `""C `""C a • f i' � Drywell, leach line, or trench drain 16,60 .
Suite/bldg./apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2
C
Manufactured home utilities 1 10.00
Cross strcct/dircctions to job site:
— Manholes 16.60
_-2.*■_Ct CE-V- - A - ., Rain drain connector 16.60
' Sanitary sewer (no. linear ft...: ) Pagc 2
Storm sewer (no. linear R.: ) Page 2
Subdivision: Lot n0 -: Water service (no. linear ft,: , ) Pagc 2
•
Tax map /parcel no.:
Fixture or item
Absorption valve _ 16.60
•
•
n»SL'RI'1'T[O OF WO RK BaekfThw prcvcntcr Pagc 2
• Backwater valve 16.60
.itiM t Clothes washer 16.60
Dishwasher 16,60
Drinking fountain 16.6(1
. :. 'E( P OW :.. • L 0 TENANT
Name: \ ( _ Ejectors /skimp 16.60
1 C`i k Expansion tank 16.60
Address:
_ Fixture/sewer cap 16,60
City /State /ZIP: Floor drain /floor sinWhub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
■
A l T Hose bib 16.60
❑ CONTACT P ERSON
Ice maker 16.60
Business name: c \ �p
1 E A� Interceptor /gm -Ise trap 16.60
_Contact name: P Medical gas (value: S ) Page 2
Address: .. v 45 `I� 1$�Ci,6(1e 0 �
4 Primer
City / State/ZIP: ` •v 1 � a i__ Z�C v (/ — - Roofdrain(commercial) 16.60
Phone: (� Fax:: Sink/hasinllavatntY 16,60
a
E -mail: Tub /shower /shower pan 16.6(1
2, a nr ,. 5751 4$/ a urinal 16.60
CONTRACTOR Water closet 16,60
•
Business name: ri o C.t: ts_0 D" Water heoter 16.60
Address: ZL _ 0 Awe. , • t Y f Other:
City /State /ZIP: - ` _ Ablrttl• t (D'L CkM2 -� �► � Su
Minimum permit ofpc $ 2
Phone: (35 at 'c OS�Z Fax: ( (-6 Wit�L Residential backflow minimum rmit tee:
( ` Plumbing Lic. no.: Plan review (2
, Q t�J — 2 3(11,
CCD Lic.: ' (25% of fee)
L �`� State surcharge (8% of permit fcc)
Authorised signature:
TOTAL PERMITFFF. n.3o
Print name: e e A 1 W1 ' Date:1('}) { This permit application expirex if a permit is not obtained within
''(� 180 days alter it has been accepted As complete.
`Fee methodology set by Tri- County Building industry Service Board.
I V luilding1Pcrmiis \PI.M- PermitAPO.d°c (10/05 14o.4010T( ICWO2 /t (1M /WEn)
CITY OF TIGARD -
• PLM2005- 0053?
BUILDING DIVISION PERMIT #: 10/1312005
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Jit l11111- Inspection Requests (24 Hrs.): (503) 639 -4175
10/24/2005 7:02AM 77
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
14850 SW 132ND TERR
SITE ADDRESS: ALBERTA RIDER ELEM. SCHOOL CLASS OF WORK:
SUBDIVISION: ALBERTA RIDER ELEMENTARY LOT #: TYPE OF USE:
PROJECT NAME: Backflow preventer for irrigation.
DESCRIPTION:
TIGARD- TUALATIN SCHOOL DISTRICT, 503431 -4003
OWNER: TEUFEL NURSERY INC PHONE #: 646-1111
CONTRACTOR: PHONE #:
10/24/2005
Inspection Request Scheduled For: Date: Pour Time:
Co # I f in prev n e9 VN1%t i 89 ,t96411 3569 Mesysage
Corrections /Comments /Instructions:
ar to ac.uJLe_. S�l 1'� 'l.d� to Li
raw
t 1' t lam✓ �--vl
PASS ❑ PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: ell) ► \ b Date: /to J2 y /Or Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005.00539
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/13/2005
Phone: (503) 639 -4171 fl 1p , fd�i
Inspection Requests (24 Hrs.): (503) 639 -4175 � -.
INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 93
SITE ADDRESS: 14850 SW 132ND TERR CLASS OF WORK:
SUBDIVISION: ALBERTA RIDER ELEM. SCHOOL LOT #: TYPE OF USE:
PROJECT NAME: ALBERTA RIDER ELEMENTARY
DESCRIPTION: Backflow preventer for irrigation.
OWNER: TIGARD - TUALATIN SCHOOL DISTRICT, PHONE #: 503 -431 -4003
CONTRACTOR: TEUFEL NURSERY INC . PHONE #: 646 -1111
Inspection Request Scheduled For: Date: 10/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 018964 -01 503 - 209.8669 Y
Corrections /Comments /Instructions: •
$ Git< O ✓ t e ���. —dt� J `� 2,J t t. S ,a 4 t , 1v\ v-; 1-64J " `,ek,
1 1 ' ✓ a -} o;i o v 1 c . A - e j - -
- - - OX.
o4"6‘i C'kc vk Cf -v-c• L.-1( 'r e ✓ � I tee -.1-0 (AS ✓ r ° (A 1 6�
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: cr. Date: IZt 0 C') Phone #: (503) 718-
a.
Inspections Required for: PLM2005 -00539
✓ Code Inspection Description PASS Date By ✓ Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground/slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service /reconnect
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 _ Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
•
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
•
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line •
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection • 635 Smoke detector shutdown
•
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post/beam plumbing
995 Misc. inspection: 320 Plumbing rough -in
998 Alarm final 325 RP/backflow preventer
999 Sprinkler final 330 Water service
. 335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation _ _ 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing X 399 Plumbing final
210 Foundation walls
215 _ Footing drain
420 Sprinkler supply lines _ SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection - 599 Final inspection
I :\Building\IVR \InspCard- AOP.doc 02/02/2005
f
C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005-00539
a , JI�I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/13/2005
PARCEL: 2S 109AC - 02100
SITE ADDRESS: 14850 SW 132ND TERR ZONING: R -7
SUBDIVISION: ALBERTA RIDER ELEM. SCHOOL LOT: JURISDICTION: URB
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: El 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
TIGARD - TUALATIN SCHOOL DISTRICT Description Date Amount
6960 SW SANDBURG RD
TIGARD, OR 97223 [UPLUMB] Permit Fee 10/13/200` $72.50
[UTAX] 8% State Sure 10/13/200; $5.80
Phone : 503- 431 -4003 Total $78.30
Contractor:
•
TEUFEL NURSERY INC
12345 NW BARNES RD
PORTLAND, OR 97269 REQUIRED ITEMS AND REPORTS
Phone : 646 -1111
Reg #: LIC 5133
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.
By: ' Permittee Signature: Issued B . � f�� � g _.a�ia (")
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.