Permit 4.
CIT OF T I GA R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005-00303
���I DATE ISSUED: 7/11/2005
L W 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112CD -11000
SITE ADDRESS: 07765 SW ALDER ST ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 008 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.
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Issued By: el Permittee Signature: _y..2 -2 CZ) T .Q
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 0:48a Martin Sander 503-647-9151 P.3
---- -- -----
Plumbing Permit AmplirsitiCAZEIV ' „Kt
City of Tigard Received
rhOcrPY: i '--) t' - 0 '' Pe) - ' Pcnn41Z4° l`C
13125 SW Hall Blvd., Tigard, OR 97223 JUL ii ?A Plan Review
Phone: 503.639.4171 Fax: 503-598.1960 Reeler Ocher Permit No,
24- Row tnepccrian Lin= 503.639A175
C DucReady0iy: , , is Sat Page2 for
Intemet wurat.ei.tigard.or.es Nadfaidlidatiod: -1"/ (I I simpieresed toformation
4410- - ‘.t . * ?. t . * -''' ; - IC W[1. :-' •;. : ''. 2-7: '2
1,...I.TY . (1 I 7
EINew anistruction . 0 Demolition For special letforsaffeers oar checklist
Des p1108 I Qty. i Ex- I - rots!
0 Addltiarriallenttionheplimement 0 Olber: New 1- 2-hornly theellIngs (includes 100 it for earl utility connection/
1eV- .. R. , SFR (I) balk 26920
-
21.1- and 2-0=11y dwelling 0 CommeteisVindestrial SFR (2) bath . 350.00
R
0 Accessory building 0 Multi-family SF (3) bath 399.00
Each additional barb/kitchen _ 45.00
0 Master builder 0 Other '
Fare sprinkks ( , to. it.) Page 2 _
" PON IMPti. - `.P . 0*.: ': ■ ' '-' .:-", ":'.: 5"
Job site address: •1 65 ,sw A1 A p...e ta,4E-/e--)t Catch basin or aixa drain 16.60
Csty/StatrJZIP: -laau--„A 0 1 cti 2-1=-.1 , DrywelL leach line, sir trench dusin 16.60
Footing drier' 1 (na. linter R.: 1 Page 2
Suitefbldg./apt. no.: Project name: -k 45 , c
lvtanufeetured borne utilities 110.00
Cross =cm/directions to job sit=
Manholes 16.60
- Rain drain connector 16.60
Sanitary SCUT,' (no. linear ft: ) Page 2
. Storm MCWCT (no. linear ft.:. ) . Page 2
1 L4t11°-:
( , Water service (no. linear R.: ) • Page 2
_16 CserpSS
IFLctura or item
Tax map/parcel no.:
Absorption valve 16.60 . .
k .,,,,,,,,.., , 1 Page 2 / (2,447)
Backwater valve 16.60
Lo-4- l ctS C-AiCIP I . .'
ir- iel, ..- "ND 11 16.60
Clothes umber
. '
Dishwasher 16.60
:" '.17%.4117:10igiiiiilegilifiCrif Igsp,:-. 41 ,A... ,.;,..,,,oa.. , -, 1 ,10.13. : „..5.-..! . :AE
Ejecicast Drinking suntp fountain 16-60
!• Jr;!., :-:-.^... _ - ...: . .. •:- • . - -- : ...... 'Si .--''':' % :".' t .4+ -.° '''' . '''' '''''' . **2' ' 4 16.60
r L-faly___1=b1D____M.E.5 , Expansion temle 16.60
Address. VI:7 SS SN C-, . Tfrt Aye. ( Ste (cc" Fixturehewer cep 16.60
CitY/SlateiZEP: FG trki el et CA ola, q - I Z-7- 3 , Floor drain/floor sinkaasb 16.60
I
Phone: (55) 4.0 7.4!7• g9 ga f I Fax: ( &t1t; SIX ''' X1/47000 Crattlitte dis 16.60
' ',n--:. - ' - • ' lheii,aiii. ;._Mp& ..„ - • • ' , , h ::&* 1.. ',..., ,:z..
maker Rote bib 16.60 ■
'els:, i czt.t.-.:1 . ,, - . • - - .. ItOttts,.t.r - A ...',.. ... - - - . r.z......
' !cc 16.60 '
Badness nalw: ariiy, ,c a nag_CS ("rot) nctS *62..:14 • Interceptor/grease Dap 16.60
-■
Contact name: .,61 ar ky/N oz.{ W.A.:4;n .._ Medical Gas (value: S ) Page 2
Addrets: p a , 6. a an • Primer 16.60
CilYiStitterLIP: Q 47.A1,. e(e..-0.1.5 , c 12 Cg n Readmit (oommucial) - 16.60
Sink/basin/lavatory )6.60
Pbcate: ( 50 ( 1 . 5 S "7 I Faic: : (603) sl glcc,
Tubtaltovverfsbower pan 16.60 ,
E-mail: ,
Urinal 16.60 _
.-:•-- ! 7 , ...i. . 4,-..,,
:1 • :.'t ; t 2 ;:reff..- ? qr; Warr dosct 16.60
Business name Water heater 16.60
Address: ( I IA 4.1 o ' ' Other
'City/State/ZIP: . Subtend
Minimum permit feet S72.50- ..,
Phone ( ) ' .vFax: ( ) Residential backflow minimum nearer fee<83 6.25 ; 1'
..
Plan review (25% of penult fee) ,
CCEI Lie.: Plumbing Lir_ no.:
Authorized signeaum . State surcharge (8% apermit fee) ,2 41 6
TOTAL PERMIT FEE
l
I Print narme: At 4,4,--Al" Sec" e per„....--.5" Ont 4, ..-- Thls permit application expires if a parade is gum abeshied within
180 days after it tura bast accepted SS ecrtnislate.
*Fee methodology set by Tri-County Building Industry Service Board.
"tlivilcimailiamniodfEALAfamaAon.doe Ivo ono-ndidTritatiVCOmranam 34,7115
CITY OF TIGARD
BUILDING DIVISION / PERMIT #: PLM2005 -00303 '
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1-U2005
Phone: (503) 639 -4171 : �mn�nl�'�YP�VGI��I1rl1\
Inspection Requests (24 Hrs.): (503) 639 -4175 W '__..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 81
SITE ADDRESS: 07765 SW ALDER ST CLASS OF WORK: '
SUBDIVISION: HAMBACH GROVE LOT #: 008 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: Installation of bacldlow device.
OWNER: LEGEND HOMES, PHONE #: 503. 620.8080
CONTRACTOR: MARTIN SANDERS GROUNDS MAINTEN PHONE #: 503547 -5557
Inspection Request Scheduled For: Date: 7/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 011352-07 503-647-5567 N
Cor ctions /Comments /Instructions:
S \2/2_ s a -
uji c \ . .
L d f)
•
L CIL '
I4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
,;i4 ' ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/p' ,
Inspector: Date:7 1 (� i ® ' N Ph one #: (503) 718 -
P � ) •
CITY OF TIGARD
BUILDING DIVISION • " / PERMIT #: PLM200 &00303
13125 SW Hall Blvd., Tigard, OR 97223 r / � DATE ISSUED: 7/11/2005
Phone: (503) 639 -4171 �° di Ott �l�f� i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 82
SITE ADDRESS: 07765 SW ALDER ST CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 008 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: Installation of backflow device.
OWNER: LEGEND HOMES, PHONE #: 503 - 62043080
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
325 RP /backflow preventer 011352 -06 503-647-5567 N
Corrections /Comments /Instructions:
T i2Aie,vo 0_7\ , ___g t-- L -s 6i._
_,
fki PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
o
''`' ' AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V Date �/ �/ Phone #: (503) 718 -
p )