Permit ,.
,..
A CITY OF TIGARD PLUMBING PERMIT
i* DEVELOPMENT SERVICES PERMIT #: PLM2005-00432
'�' °�' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/6/2005
PARCEL: 2S112CD - 11800
SITE ADDRESS: 07635 SW ALDER ST ZONING: R -
SUBDIVISION: HAMBACH GROVE LOT: 016 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: ze1 � , Permittee Signature: ,.S,bo_ cNT v
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 08 05 08:07a Martin Sander 503-847-9151 p.1
uAnf At�pniicatYO>m
SW Racer rcl C , ! l'crtnil N..: • / a 7 ✓ , /
DateA3 ,
25 O� Tigard mod, OR 9 E Plan Review OlttcrPermit Na.:
n SW Hall Blvd., Ti lx (� l 1 Date/ 3y- " See Pere 2 for
ne: 503.63ction Fm 503598.1960 639.415 i' 0 2005 i • 4 J Date Rc+dy/Dy: El See Supplemental inForrn�dva
Hour Inspection Line: 503.639. L �" Nofificd/Method:
met: �ytyvr ci.tigatd.or.a5 FEE* SCHEDULE
OF W�1 (�QRD Farsperlatinfarrrmiic #Cj � Total
Ea. (alt 1 ' ,a t 6 11 clop per_ ".t ion
few construction _ .. ^'
.vtw ❑ New 1- 2-family dwellings (includes 10 each utility eotttaccrion
lddition /altertttiotJrcplaaxttent 9y0
Z4
CATEGORY OF CONSTRUCTION 240.00
and 2-family dwelling ❑ Cottimert itslr SFR (2) bath ndustrial SFR (3) bath 350.00
Multi-family 1cc�ory building ❑ Multi- fam Ench additional bath/kitchen
❑ Other: Fire sprinkler (__ s9- 0-) ®
Waster builder ct
JOB Site oti2ifl
SITE INFORMATION AND LOCATION 16.60
Catch basin or area drain 16.60
site address-. i ( A �L Drywall. leach line, or trench drain
�i Z-�- •
//State/ZIP: j � A fooling drain (no. Linear ft.:.,.�� 110.90
Project name: ("1--1 ' a I_ ' i Manufactured home utilities
t/JJbldgJapt. no.: 16.60
ass strcct/dircdions to job site
Manholes 16 60 _ .
Rain drai n eonneclar
Sanitary sewer (no. linear ft.: ,__)
Page
Storm sewer ( no, fl.:
lin ear ._�
Page 2
Il i - L ot n o_.
bdivision: axy%to Fixture or 11cm
x map/parcel 16.60
1 no.: Absorption valve _
DESCRIPTION OF WORK Backtlow prt va nter Page 2 a -W0,,764-7, -W0,,764-7, -W0,,764-7, 11111 16.60
Backwater valve Mill 16.60
washer 11111111 l 6 -60
�� i Clothes wassh
t O Dishwasher
Drinking fountain 16.60
�
❑ TENANT 16.60
>� PROPERTY OWNER Ejectors/ sump
ame:
16.b0
' f • Expansion tank
1- e.• e��C 1� , Fixttmc(sewexcap 16.60
ddress: • \b";:-. c , 16.60 - • Z- �J T Floor drain/floor sink/hub
ity /SlntclLfP: G'pY GL 7-Z-3 Garbage disposal 1-6.60
_ gC 4 .� 16.60
hdn Fjvj) (4 2a a • Fax: ($c?� g Hose bib
1:3 CONTACT PERSON 16.60
ig APPLICANT ice maker
eusincssname: t-(ca_ ,L kai y. a ... A LA", or -S t- interceptor /greasctrap
16.60
:onlIICt name: v
Medical gas (value: S ) Page 2
i • _. 16.60
Primer
■dd�55: ^ i�' 3C> Roof drain (commercial) 16.60
-ity /Sude/ZlP: . I Nn 0 . 1 .6 . 9 3� Roof Sink/basin/lavatory (cmme 16.60
Fax :: (c5 (%' 7 ? 16.60
'hone: (�Q�) (� Y - 5 5 i,....-.7 -7 l Tublshow� /shotivcr pan
16.60
: -mail: Urinal
CONTRACTOR Water closet 16.60
16.60
► J:0 Water heater �
Susinrss name: t � / . • An '� Other.
address : ' Q . K� O ?C
r mate 13 7 Minimum permit fee: 57250 •
ay/State/ZIP: U� �In C .c..._. ' 5 / Residential back low minimum permit fcc: $36.5
hone: (54) 6 u1- 7 - Sr5 6 -1 Fax:6 ) (
CB Lie.: ..) LI Plumbing Lic. no.: _ .
- TOTAL PERMIT FEE
rint n m signature: -1 : Thi permit pp
Date: rmit a licstion expires if a permit is ant obtained tal
tint name: l L- ' 180 days after it has been accepted as complete
*I'cc methodology set by - Fri-County Building Industry Service Basnl
•
CITY OF TIGARD 11 1611L ' A
BUILDING DIVISION PERMIT #: PLM2005 00432 1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9f6f2005
Phone: (503) 639 -4171 /// i ,Hi NN r I f�
Inspection Requests (24 Hrs.): (503) 639 - 4175'! �..
INSPECTION WORKSHEET FOR DATE: 9!28/7005 TIME: 7:08AM PAGE: 92
SITE ADDRESS: CLASS OF WORK:
07635 SW ALDER ST
SUBDIVISION: HAMBACH GROVE LOT #: 016 LOT OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: Backflow preventer for irrigation.
OWNER: PHONE #:
CONTRACTOR: LEGEND HOMES PHONE #: 503-620-8080
MARTIN SANDERS GROUNDS MAINTEN 503 -647 -5567
Inspection Request Scheduled For: Date: 8/27005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 016768 -04 503-647 -5567 N
Corrections /Comments /Instructions:
/ c -- It / S ( k)
jr ))-, 11
t�
•
•
r ° ' SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � /
Date: � CJ _ Phone #: (503) 718-