Permit C ITY OF TIGARD PLUMBING PERMIT
r ,1 4, DEVELOPMENT SERVICES PERMIT #: PLM2005 -00302
411 DATE ISSUED: 7/11/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112CD -10900
SITE ADDRESS: 07773 SW ALDER ST ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 007 JURISDICTION: TIG
Project Description: Installation of 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
LEGEND HOMES
12755 SW 69TH AVENUE Description Date Amount
PORTLAND, OR 97223 [PLUMB] Permit Fee 7/11/2005 $36.25
[TAX] 8% State Surcha 7/11/2005 $2.90
Phone : 503- 620 -8080 Total $39.15
Contractor:
MARTIN SANDERS GROUNDS MAINTEN
PO BOX 307
NORTH PLAINS, OR 97113 REQUIRED ITEMS AND REPORTS
Phone : 503- 647 -5567
Reg #: LIC 5742
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: c
Call 503 - 639 - 4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jul 11 05 09:48a Martin Sander 503 - 647 -9151 p.2
Piumbille Pel - Mit &tpnlicat ion j E D c Xt i t (.41 1 F O'. 1
city '�"�'- Y 7 � - 1'a :� arit 1�aorJS mc� 3a.�
13123 SW Blvd. Tigard, OR 97123 Plan
Phnom 503.639.4171 Fax: 503_590-1960A 9 1 2005 *wafer Oda=Pc 1160.
2a � kncpatiaa Zinc: 503.639.41T5)Ui.• l
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of ti6aror n. r .l,r:/ r G T I (. A n ° =mod Swy�n�vol iwrw+wieow
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�r v and �)xvtalitian F or r/ealal dwfirs.ariin ar as drnea$t
Nevv tamti9c6on Descriyllon 1 4ty. 1 CA- I Tatra
❑ AddieaafatOCratiaJrtp)atemeal 0 Other Pew 1- 2- fatmly de olla ga ( ehadcs 100 ft for each utility connection)
1 - 1:f aZ. • ; - r t 249_20
`..r: -r _z ,'' , . •, .? -' " %.- k� ,1- ,:7 ._..:_..- .�-_r_i_s:�, - ` g'R
*1- and 2:•9ror1y dwelling 0 carenticiaruldustriid SFR (2) bath • 350.00
0 Y bra ❑ -tmn7Y six (3) bath 399_00
Facia additional beth/ltitcben 4s.00
o Master beadle pod= Fief: sprinkler att. ft_) PaGe 2
i) »� SA : sc Site aiAitias
Jab site address i r S - e t Cinch bast es arns drab. 16.60
City/State/ZIP: 'f at.tc4 r .. q. i LZ mywan. *Kb line, or trench drain 16.60
1 Footing drain (no. linear R: ) _ Page 2
Suite/WO/pt. no.: . Ise nal= 4410% ‘Pa r k . Cr g ,
1Vtarusfw:naed tome utilities 110.00
Cross strect/directians to jab sit= . o l, a . 16.60
Rain drain cor.acrar 16.60
Sanitary sewer (no. linen 11.: ) Page 2
Storm sewer (no. linear ft: __,) i Page 2
K a (. 1 - L r I Lul m -:`� - wa nervier Via. . ante R ) Page 2
Subdivisi aa (T r �� ` � Hawn or lcow
Ties tnarp/pareel no.: k ttft�C Absorption valve 16.60
h `.l a .• r. [' ' I". . _ .. - Bodthowpreventy I Page t ( s) fi
$acicasdr value 16.60
L a� a s eaa_ t 1Y` t Q� Q othens ei Ct masher 16.60
J Ctistronotter 16.60
y , r. -r• 11"1646338 fcunlam 16
•1 } *' �: �._.`_�i�._ - •.e..:::r•�! a ? �.' = ' -? < saws r =3:.: � ' ? '� � Ejectors/sump 16_60
Hun Le Ge, Gt leVEP S Evansioa rank 16-60
Ate: 2_'1 SS &,.f !a4 Tti Ave... S4I l oC Fuatane/serrerratp 16.60
v Floor drain/(loar si nk/bub 16.60
("rty/SratelZlP: PpY.� 411-.1 d e v t¢- I �� disposal (6.60
p1'unc �j tow- O Fast ( SCE) s' g g9 G bags a
�__ 16.60
rocs M�`c f AST r
• r� >� �.A s.:a.. � 16.60
Btnsinessoa= IA a. f "�1f\ C , R v Gvt2v/?ds., boe,ccpted • 16.60
Contact name: " r + t o r ltO.A-t 0.._ Medical pa (value: S ) Page 2
Address: . O . 6 qrg. 3 o 7 > 16.60
Roof drain (commercial) 16.
CCity/State/22P: N G �f'4 -. J (awV► S e L?14Z. C 7 1 sialoroasnni.tary t 6.60
uc
Pbe ( ) boy 7 • $S(O 7 1 Face : (,�) 40 � I .1 - 1 p ist Tab/sho«ler/showerpan 16.60
$-Trail: Urinal 16-60
:-. . ,
, i-0 *. i41 -� < -r:J. ! ' 3 ii� . i . - w 16
::za C7�' 9- ; r a - K_ J �: »s3ir`! � ' :) aterelOSM
Businrssllamc Res /•�Yl S a1 dt.a. -esr C7tvvvnet5 01, a 1 6.60
Address: e. n . $v7c 3 cri , OOder: _
/StaV�: aa � .'r el �t _ S.bt.tal
Ci
a !v ��! � ` A-�r�S n ` (r '3 3 Minim m Per te S i2-50 �{
Phan=( 50) G -t7 - 5SS�7 Fate( S, Y 7. 9 is / Residentialbaekllowrmmuarmpermitf 536.25 3 £
CCB Lk.: $ 1 4.f 7 bung Zir- na.: - Plan review (23% ofpermit fee) (1
Smte surea nze 01% of permit fee) .2_
AIr1111DTIZed 51,10,C171= l I.� ay / TOTAL PERM iT FEE .rrt5
I Pdm UMW: M. Q4.• (/.1 6 a /l a 1 ! "' {Q - d5, The pernet appiiestion capir� if a per.ae :s rant elm:bled wi h:n
ISO days after it tees teen accepted as complete.
*Fee methodology Set by Tn-County Building 1ndastry ServiceRossi.
Cif.I& :a sc ..nrww rtarawwauLaws 12#U) w.V - 4616T(tOttalCOMM1571) _�e
3 / 5
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 00302
I 13125 SW Hall Blvd., Tigard, OR 97223 f ; DATE ISSUED: 7/11/2005
Phone: (503) 639 -4171 /�i�p ti f'
Inspection Requests (24 Hrs.): (503) 639 -4175 ° .. � '�
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 83
SITE ADDRESS: 07773 SW ALDER ST CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 007 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: Installation of backflow device.
OWNER: LEGEND HOMES, PHONE #: 503- 620.8000
CONTRACTOR: MARTIN SANDERS GROUNDS MAINTEN PHONE #: 503.647 -5567
Inspection Request Scheduled For: Date: 7/14/2005 Pour Time: .
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 011352-05 503647 -5567 N
Corrections /Comments/ Instructions:
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PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
iv. ;:
::-. _CALL FOR INSPECTION II] ADDITIONAL FEES ASSESSED
Inspector: \76;\ Date: /6'f( Phone #: (503) 718-