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Permit
CITY TIGARD PLUMBING PERMIT )fr DEVELOPMENT SERVICES PERMIT #: PLM2005 -00435 �`£�'�' '--� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/6/2005 PARCEL: 2 S 112 C D -11600 SITE ADDRESS: 07701 SW ALDER ST ZONING: R -12 SUBDIVISION: HAMBACH GROVE LOT: 014 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: p Permittee Signature: st \p 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 OG 05 08:08a Martin Sander 503-G47-9151 p.4 Piumbine Permit ApPlicatibhil FOR 0141(1.: t Nt O\l.l City of Tigard 9-1\'''' v 13 ccci,y cl ) s / Prnnit No 1 v 13 125 SW Hall Blvd., Tigard, OR 97123 °� Plan Review Phone: 503.639.4171 Fax: 503.598.19601 O .t •.•� i . Date/fly: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 % SO LqL. •4 14 Date Ready/By: t°`i'i ayee 2 for • Internet: www.ci.tigard.or-us .•tr, �c{0 Notified/Meihoi: r Supple � Sc Sec mental information TYP kig g New construction U WOflX�I,Sl°" FEE* SCHEDULE 1L U1 r i - ❑ Demolition Total For special infarnsarion use checklist 8 Description I Qty. � F- ❑ Addition/alteration/replacement ❑ Other Ncw 1-2-family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 24920 ❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 SFR (3) bath 399.00 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( , sq. IL) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities • Job site address: - 7i G i � l/ ti i Pc t ( � 'k V 3 Catch basin or area drain 16.60 City /State/ZIP: • T le a U + R q•'1 2_2_ Li thywell, leach lint, or trench drain 16.60 Suite/bldg apt_ no.: I Project name: t••} -Qen VV./ Footing drain (no. linear R.: �) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: , ) Pagc 2 Storm sewer (no_ linear ft_: ) Page 2 subdivision ! ' Lot no.: 1) , Water service (no. linear ft.: ) Page 2 lickro b6 (AA L Vp SS i.-N3 Fixture or item Fax map/parcel no.: _ Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 21 -S11h Backwater valve 16.60 C „ , Clothes washer 16.60 Dishwasher 16.60 ® PROPERTY OWNER ©T Drinking fountain 'TENANT l Ejectors/sump 16.60 16.60 ' lame: Le.g'df C.-Ai • Expansion tank 16.60 kddress: (y-1 SS S -u ( i TK \ . Sale 1 e 7 Fixture/sewer cap 16.60 :sty/State/ZIP: rDY#. t „A Q I .0 - 7 Z-Z3 Floor drain/floor sink/hub 16.60 ? y 'hone: tS (o 2„.0 Fax: (S' S9 - g arbage disposal 16.60 co GQ Hose bib 16.60 APPLICANT ❑ CONTACT PERSON Ice maker 16.60 tusiness name: Iv1 Ct. r t tvt SA "IA e ---rte CT yv c1 I9-I±_ interceptor / trap 16.60 :ontact name: T"l e ,�, .{-1� a c1�t"� Medical gas (value: $ ) Page 2 lddress: e 0 l� r�u 3,,,-- 16.60 Primer q \ Q Roof drain (commercial) L 16.60 :sty /StatrJZiP: G��(� pal ��yl 0 1 / 3 Sink/basin/lavatory 16.60 'hone: (523) 1D ` S S - Fax :: ( 6;'/7 - yis, Tub/shower /shower pan 16.60 mail: Urinal 16.60 CONTRACTOR water closet 16.60 lusiness name: MA-r h lt7 Sr A4dyLf '5 62 ,E ,.md`s Water heater 16.60 ,ddress: P. o 6 o )e - j Other. Subtotal ay/State/ZIP: O r: -V C G` .Yi S (JI1 '7 I...-' Minimum permit fee: $72.50 Res idential baekfiow minimum permit fee: $36.25 hone: (50.& (p K - jS 6 Fax: ��) (p ` f Gf [ S Plan review (25% of permit fcc) 'CB Lie.: S') Li Z Plumbing Lie- no.: e State surcharge (8% of permit fee) .uthorized signature: 4 -es TOTAL PERMIT FEE , 25 rant name: I4 a if / �C H ` + Date �. , / � This permit application expires Ira permit is not obtained within 180 days after it has been accepted as complete_ *Fee mcthodoloev set by Tri County Buildine Industry Service Board CITY-OF TIGARD ... . . _,.., BUILDING DIVISION PERMIT #: Inspection Requests (24 Hrs.): (503) 639-4175 PLM2005 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/6/2005 Phone: (503) 639-4171 41111, . 2001 ,„111- . II- INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 9/23/2005 7:07AM 62 SITE ADDRESS: CLASS OF WORK: 07701 SW ALDER ST 1 SUBDIVISION: LOT #: TYPE OF USE: HAMBACH GROVE 014 PROJECT NAME: HAMBACH GROVE DESCRIPTION: Backflow preventer for irrigation. 01 OWNER: _" PHONE #: LEGEND HOMES, 503 CONTRACTOR: PHONE #: MARTIN SANDERS GROUNDS MAINTEN 503-647-5567 Inspection Request Scheduled For: Date: Pour Time: 9123/2005 1 Code # Inspection Description Confirm # Contact # Message 399N Plumbing final 016451-04 503-647-5567 N Corrections/Comments/Instructions: C ... Le - ASS PARTIAL APPROVAL 0 CANCEL I I NO ACCESS • FAIL CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED ---,..„ Date: ___;--d Phone #: (503) 718- . , .