Permit C ITY OF T I GA D. PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00436
°'---� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/6/2005
PARCEL: 2S112CD-11500
SITE ADDRESS: 07707 SW ALDER ST ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 013 JURISDICTION: TIG
Project Description: Backflow preventer for irrigation.
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 9/6/2005 $36.25
[TAX] 8% State Surcha 9/6/2005 $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: ms L PS
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.
Sep 06 05 08:08a Martin Sander 503- 647 -9151 p. 5
m .
Plumbing Permit Application
NED `
1-111 0I••1.1(.1. I sl. 0\t.l
City of Tigard Received
13125 SW Halt Blvd., Tigard, OR 97223 L ' Date/By: AM i Permit No.c 1 �� i\ y /
Phone: 503.639.4171 Fax: 503.598.1960 O 6 �oo� Plan Review ' U O
s °'iT1'� !
j J 1 Date/By: Other Permit No.: P
24- Hour Inspection Line: 503439.4175 3; '
Internet: www.ci.tigazd.or.us Date Ready/Ely: luris: 121 See Page 2 for
CITY OF TIGAra; - { Notified/Method:
TYPE / SmpP�em>sllefotmit:om
• FEE* SCHEDULE
New construction ❑Demolition For special information use checklist
❑ Addition / alteration /replaceme ❑ Other Description Qty. l a. Total
New 1 -2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath
24920
❑ I- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building SFR
0 Multi- family ( bath 399.00
Each additional bath/kitchen q5 00
❑ Master builder ❑ Other.,
JOB SITE INFORMATION AND LOCATION Fire sprinkler ( sq. ft.) Page 2
Job site address: Q � --7 i Site utilities
"' [ , P\ ` S t f c--A Catch basin or area drain 16.60
City/State/ZIP: f p r �
�.-/ Z Z -7 Drywoll, leach line, or trench drain 16.60 -
Suite/bldgJapt. no.: I Project name: t E0.rr, Footing drain (no, linear ft.: ) Page 2
h r ,fin
Cross street/directions to job site: Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: �� c1,1 ��Si�qq Lot no.: t Water service (no. linear ft.: ) Pane 2
Tax map/parcel no.: J Fixture or item
DESCRIPTION OF WORK • Absorption valve 16.60
•
Backtlow preventer Page 2 f1f'4efd117
!'
Back valve 16.60
La.i�1 e� r Jrn:s o n Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNER 1 ❑ TENANT Drinking fountain 16.60
Name: Lege�c�l D ! Ejectors/sttmp 16.60
Address: � (--Ni ` I l v q Expansion tank 16.60
_ P
{ 2-1 SS S tiJ f--> ! - Pi i� . <A )()(') Fixture/sewer cap - 16.60
City /State/ZIP: p. y.k. `�,--) 0 " 4z-3 Floor drain/floor sinkdtub
Phone: 5c >3) C 2....0 - g- Fax: ( S�) S�g - 'g9 co Garbage disposal 16.60
81 APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Business name: J Ice maker 16.60
nAt ems 6YDcmd s t- Interceptor /grease trap name: Evi Qv - � p 16.60
S4 c1ao -r Medical gas (value: S ) Page 2
Address: i- t. , >>l c5-) Primer
16.60
:ay/State/ZIP: 1 ,,.r ±te-k i 1 l_ ,}-1 o ts 9 - 1 3_ Roof drain (commercial) 16.60
�) ' - 7/3-, Sink/basin/lavatory 16.60
'hone: (5P3) Lt-7_ 5 5 6_,, 7 I Fax :: ( 6; � 6 of 7
: -mail: Tub /shower /shower pan 16.60
Urinal 16.60
CONTRACTOR
f Water closet 16.60
ttrsiness name:
ii-44../" 7 Water heater
�� �� �� � ['L�C/y]c 16.60
address:
0 . 6 o � �• -7 Other:
:ity /5faie�LlP c)\(-4-1.-‘ (p ( �- :VI 5: 1.-3 Subtotal
hone: (5D Y SS Fax: 6 Minimum permit fee: $72.50
3 ) G 4- 7 '7 - 9/ S / Residential baekilow minimum permit fee: $36.25
L Z Plumbing Lic. no.:
review (25% of permit fee)
'CB Lie.:
uthorized signature: / / _ State surcharge (8% of permit fee)
`�' - GAS TOTAL PERMIT FEE 3 .2_5
riot name: r
!,v./ G / 7-i/ ,5 is j � ,. Date: ,a' 1'1411 G 1 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Pee methodoloev set by Tri- County Build Ina Industry Service Board.
,- ,
CITY OF TIGARD .
BUILDING DIVISION - PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: PLM2005 00436
I Phone: (503) 639 -4171 //�u lm�i t � A � 0
Inspection Requests (24 Hrs.): (503) 639 -4175 : �I
INSPECTION WORKSHEET FOR DATE: 9123/2005 TIME: 7;Q7AM PAGE: 67
SITE ADDRESS: CLASS OF WORK:
07707 SW ALDER ST •
. SUBDIVISION: HAMBACH GROVE LOT #: 013 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: Backflow preventer for irrigation.
OWNER: PHONE #:
LEGEND HOMES, 503-620-8080
CONTRACTOR:
MARTIN SANDERS GROUNDS MAINTEN PHONE #: 503.647 -5567
Inspection Request Scheduled For: Date: 23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
32'\ RPlbackflow preventer 016451 -01 503-647-5567 N
Corrections/Comments/Instructions:
PASS I f PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 ` Date:/ " 3 y( 5-------- Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PL_h+1DOb OC36
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/61,2005
Phone: (503) 639 -4171 �m�INi�;pgyl�l
Inspection Requests (24 Hrs.): (503) 639 -4175 �_' `__..
INSPECTION WORKSHEET FOR DATE: 9/23/2005 TIME: 7:07AM PAGE: 65
SITE ADDRESS: 07707 SW ALDER ST CLASS OF WORK:
SUBDIVISION: HAMBAChI GROVE LOT # : 013 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION:
BacMow preventer for irrigation.
OWNER: LEGEND HOMES, PHONE # : 503 - 620 -8080
CONTRACTOR: MARTIN SANDERS GROUNDS MAINTEN PHONE # : 503-647-5567
Inspection Request Scheduled For: Date: 9/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 016461 -02 503-647 -5567 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: lv Oe `Jk Date: 2 31 Qb Phone #: (503) 718-