Permit CI TY OF T I GA R D PLUMBING PERMIT
,.i DEVELOPMENT SERVICES PERMIT #: PLM2005 -00342
�I DATE ISSUED: 7/28/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112CD - 11100
SITE ADDRESS: 07751 SW ALDER ST ZONING: R -
SUBDIVISION: HAMBACH GROVE LOT: 009 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 AVE # 100 Description Date Amount
PORTLAND, OR 97223 [PLUMB] Permit Fee 7/28/2005 $36.25
[TAX] 8% State Surcha 7/28/2005 $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: e ��r Permittee Signature: -L c>
cr
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 27 05 02:13p Martin Sander 503-647-9151 p.5
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Plunabhie Permit Artiesitim rut: of 1- ti' F. i ■r -om N
Ti OR . - 4, $110M11:11 Park Ner.r."
1312S SW= gard, 97223 „ • i r Z6
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Pleon 503.639A171 Ea= 503_5984960 0),`
‘ 6 ' 4116 . . Mrs Romeo
tkocrtiy OdscrPtimeislo6: .
24- now trispection Li am 50.1.639.4175 .1 - 1
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toterec& wwatoithseoleens ..-ry (.)-- 1 ' ..-InN NociSederfsnod; i (A 5 Soep1e.emos tororooli...
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. P. New coristruesia n _ , V 1 13 Thereshliew For special informs r
riew retekeeNist.
Description I C1S. Then
C3 AdditionleitcresionizeplsounenS 0 Other: New 1-2-fasetay dwellings (includes 100 it foe tacit utility connection)
R (1) bath 249
iti 1:,; jr, - - ' - ii-t=r 4 . - e<412 1 . : ' - .. - ':. • ' Tr SF
' ::-...- :..." ''''':.; -. a•-'-' .: -.'-'- - ' • ''' -` -- 1 4:7. - =7. 4",:i 5 _,_.
El I- apaz-amilychweitios 0 Cogunsarcialrusdostrial SFR (2) bens . 350.00 -
' SFR CI) bath 399.00
CI Accessory bailing Ei Triniti4anay
Each addkieeeel bethikitcben 45.00
0 Mester bender 0 Other:
Fine sprinkler (______Isq. ft) PaSc 2
-71. . eL 7W E 't.' , IFO G E -= ' 2 • =- 4 7 ,,:e -:-1, z,
• gal .111 s int Os ' t.i i : - . C ' ' ' t - • " ' . ' - ‘
vmsr.a.z.mItt . ....... .....-- • - . . - .1 ec?"-t Site onnti' es
Job site snares= ,T.9.7 - S 7 s 1 ., 1 ,7 ye ) - i iri-- (51 4.:
. Catch basin or area &win 16.60
Cty/S00c/Zak I Aa n ,R / 11Lf 1Dryarell. kach line, oe trench drain 16.60
L.2 rooting drain (no. linear 11..: '1 PaCc 2
Su/id/Mg/apt no c-- I Proicalmr= Ff aes'I'l b a c f 1
Mentsfessareel borne utilities 110.00
Cross strooldlucceions mints sit= , 1
Ationbolcs 16.60 :
Rain dna connectoe 16.61) -
Saslow sewer (00. *neer 11.4 ____) Nit 2
Storm: se.er (nth linear ft: ) Page 2
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Subdivisisser 11 (1),.. L Ar72,56" /c7j I Lot no_: 9" Weser service (no. linear ft.: ) Page 2
Flews or Items
Tax tropipareel no.:
Absorption valve 16.60
L- aAri c Ls (cc 7 vv 4 Arr) 13,AL.- val.. 16.60
Clothes 1 16.60
Distromobct 16.60
7 '_•.•,•' , ,• s .:•:.• - - • :.- . - .7„.,7. ,..; z. p.,.5 - .. - ). 77 ,_ Drinking founinn 1660
- - * ' . ' . - ' 1 - • "; -'
Nanic I .r...al AEL_ IFL. • T •Jr •=g-A4- e.... Exp.i. rank
Address: g 629 rH .
sycia, Eudercisewer cep 16-60
aryiState/22P: ' - e liir : 414 Aa (ed, OR cr72z1 Boor drain/Hoar einkibub 16.60
Phan= (5) ) 62,0 - 1 ;_j c • Fax ) .51 - T 1 (7 Online disposal
1 6.60
!- 7.7 R - -1 1, 7. r a f7 .71*; . • : , 1 +"... :;'.... s . „ ' is, Hose bib
- tee tralcor 16.60
Bt zzu i ? a t 4/ r) L 0.4 4 crivn-es iltia-.nt. , bsterceptorfgnesse nap 16.60
Conn= nem= Cr--?"11 In Medical is (value S env 2
-
Address: f', 0 , eoc ab 7 Priors 16-60 , .
CitY ii)0 r efe)7 f Ole< el 7 / 5 Roof drain (corranercin/) . /6.60
Sinlobesinflevesory 16.60
no= C.< ) & if 7 - _5:56. 7 I Fxc 1 ( $ =' tv `t_ - W-C/
Tubishowerishower pm 16.60
Egesil:
Mien ' 1 6.60
1 7.,;..,. ,,72 • Ft-t It r• v=1. •.•••L.•,'. . .. *1%,!.. ....„ , ----,--.•-• - • er_.4 . , _ ---..._ -7,: .-..-.,r,-,1 ■
:: ?-$.: . 77 _ ti5-.7-1.. :°Fi . k7",-_ . _ -. •/...`-t L --`4 g:!: cl :1 Water closet 16 ,
Business nem= rna 5 d e _cc. Wan= heeler 16.60
- .
Address: 't D . L‘3 ox 3 ---7 Other:
Subtotal
CitaiStent/ZIP: eV A) (i11,1 Pa/Y/S 19/ 9 2 /-?3 Minimum proynit fec S72.30
Phemc ( .-S (2 IO
1 - 7 Fa= C 5b3 ) b 1 17 - V/S/ Resident's/ backflow nainisrenn permit fee: s36.2.5
Plan review (7_5 ofperrnit fee) '
CCEI lie_: -7. rbscobks Lic- no.: ,59 6 j
Slate surd:age OM of permit (Ca)
Authorized signaler=
TOTAL PER/An 3( . 25
Print =en= 40 p/r c5.614-/ rIt3 - -
2 1 This person appnortion empires We rermat it tort onex111.6:1 witbio
ISO Maya otter it tat born accepted as co:opine.
"Fco unethodolagy set by Tri-Cocrnty Building Indy-ivy Service Bout. •
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CITY OF TIGARL 0
BUILDING DIVISION PERMIT #: PLM2005 -00342
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/2005
Phone: (603) 639 -4171 :amiu it
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 002005 TIME: 7 :02AM PAGE: 79
SITE ADDRESS: 07751 SW ALDER ST CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 00g TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: Installation of backfiow device.
OWNER: LEGEND HOMES, PHONE #:
CONTRACTOR: hagaldIMWEERS GROUNDS MAINTEN PHONE #: 503.64 686
Inspection Request Scheduled For: Date: 8/5/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RP /backflow preventer 012760 -01 503- 547 -5567 N
Corrections /Comments /Instructions:
•
9LPASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: . / Phone #: (503) 718-