Permit ,„ 'CITY OF TIGARD PLUMBING PERMIT
• ° -, COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00293
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/10/2008
PARCEL: 2S 112CC - 22900
SITE ADDRESS: SW NO ADDRESS ZONING: R - 12
SUBDIVISION: GAGE FOREST LOT: 00C JURISDICTION: TIG
PROJECT: GAGE FOREST
Project Description:. Hookup backflow for irrigation for water quality facility located in tract "C" on SW 81st Ave.
CLASS OF WORK: ALT 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:
/�, B/ FEES
• £ 7Piry _ Description Date Amount
agge
a3 / irosky c// LV [PLUMB] Permit Fee 7/10/2008 $36.25
[TAX] 12% State Surch 7/10/2008 $4.35
lAies 41. wV, Uve 17eIG ' $40.60
Phone : Total
Contractor:
RIGERT LANDSCAPING
21800 SW MURPHY LN.
ALOHA, OR 97007 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 649 -8024
Reg #: LIC ALL PHASE &
PLM 5629
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 ado ved by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may o(tain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. .1
Issued B, ��i/ s�i %i •ermittee Signat re / / /_.
— i� —
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 ` _ G -,..9 . c.)0
• Building Fixtures ® • FOR OFFICE USE ONLY
City of Tigard `C d 95 Received y
7 y 8'� l�}
Permit No.: 7 , a, -a ,
V 13125 SW Hall Blvd., Tigard, OR 972 `\ \ 7' • 'ew
C ;. •. Phone: 503.639.4171 Fax: 503.598.1960 ,V' o (, a .. eB `" a _ t Other Permit No.:
T I G AR p Inspection Line: 503.639.4175 ®A ' :`, R eadyBy: 4s: El See Page 2 for
Internet: www.tigard- or.gov `ay t`e`r 'ON Notified/Method: t Supplemental Information
V ` .
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolitt ° 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
CO •
1- and 2- family dwelling ❑ Commerciallindustrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ 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: SW Bond & 81 Ct. Catch basin or area drain 16.60
City/State /ZIP: Tigard OR Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: 6, Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Near Hall and Durh m
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Gage,Forest I Lot no.: Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: ( RS J! 1� a a .?•z --7;6 e C (' Fixture or item
i _ Absorption valve 16.60
(1 • DESCRIPTION OF WORK Backflow preventer 1 Page 2 27.55
Hookup t irrigation for WQF - j / - . /t,. Backwater valve 16.60
,. -i.t -. -- 5I A0 e- Clothes washer 16.60
Dishwasher 16.60
N I . - OWNER I ❑ TENANT Drinking fountain 16.60
,� Ejectors /sump 16.60
Name: i -,A,..i jj •,_;, a ite-- • Expansion tank 16.60
Address: Ot j/ M,L��
� � � Fixture /sewer cap 16.60
City/State/ZIP: i �' pi G f ).n', V ) e q 7(6 " Floor drain/floor sink/hub 16.60
Phone: 6 ) 6�G�, O(�� Fax: ( ) Garbage disposal 16.60
® APPLICANT ® CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: SECO Dev
Interceptor /grease trap 16.60
Contact name: Barry Medical gas (value: $ ) Page 2
Address: 23281 SW Bosky Dell Lane Primer 16.60
City/State/ZIP: West Linn OR 97068 Roof drain (commercial) 16.60
Phone: (503) 638.5068 I Fax: : (503) 638.6122 Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
. CONTRACTOR Water closet 16.60
Business name: Rigert Lnadscaping Water heater 16.60
Address: 21800 SW Murphy Lane Other:
City/State /ZIP: Aloha, OR 97007 Subtotal
) (503) 649 -8024 F. Minimum permit fee: $72.50 36.25
Phone:
( ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: 5629 O L j P,, ° ing Lic. no.: Plan review (25% of permit fee)
�/
�-- ti 1 ,, State surcharge (12% of permit fee) %t 35"
Authorized signa v.' TOTAL PERMIT FEE 1046
Print name: Barry Sandhorst Date: 07.09.08 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.
L\Building\Permits\PLMF- PermitApp doc 12 /27/06 440- 4616T(l0 /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PI.M2008-00293
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/10/2008
Phone: (503) 639-4171
i t
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/17/2008 TIME: 7:00AM PAGE: 47
SITE ADDRESS: SW NO ADDRESS CLASS OF WORK:
SUBDIVISION: GAGE FOREST LOT #: 00C TYPE OF USE:
PROJECT NAME: GAGE FOREST
DESCRIPTION: Hookup backflovv for irrigation for water quality facility located in tract "C" on SW 81st Ave.
OWNER: SANDHORST, BARRY PHONE #: 503-684•0652
CONTRACTOR: RIGERT LANDSCAPING PHONE #: 503-649-8024
Inspection Request Scheduled For: Date: 7/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 072788.01 503-638-5068
Corrections/Comments/Instructions:
v e•(. - r c• 4 - 'Le k tpo v11
cot re '1
IAPASS n PARTIAL APPROVAL 0 CANCEL El NO ACCESS
I I FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: 11 VvrA....)1 \ Date: - 7/t) ja) Phone #: (503) 718-