Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00351
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/5/2005
PARCEL: 2S112CA -08500
SITE ADDRESS: 07568 SW ASHFORD ST ZONING: R -7
SUBDIVISION: RENAISSANCE WOODS LOT: 011 JURISDICTION: TIG
Project Description: Installation of residential backflow prevetion 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
. MARK & PAU VANDEHEY Description Date Amount
7568 SW ASHFORD ST
TIGARD, OR 97224 [PLUMB] Permit Fee 8/5/2005 , $36.25
[TAX] 8% State Surcharq 8/5/2005 $2.90
Phone : 503 684 - 5206 Total $39.15
Contractor:
MATT SANDER LANDSCAPING INC
21350 NW FARM PARK DR REQUIRED ITEMS AND REPORTS
HILLSBORO, OR 97124
Phone : 503- 647 -0800
Reg #: LIC 5703
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 -000 i 110 th . ugh OAR 952 - 0001 -0100. You may obtain copies of these ruler direct questions to OUNC by
calling :03-24.-669* o • • r 332 -2344
Issue. :y: � , / Permittee Signatur t
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.
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CITY OF TIGARD
• BUILDING DIVISION ' PERMIT #: PLM2005-00351
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/5/2005
Phone: (503) 639-4171
.
Inspection Requests (24 Hrs.): (503) 639-4175 —3,11- AL.
INSPECTION WORKSHEET FOR DATE: 8/18/2006 TIME: 7 PAGE: 103
SITE ADDRESS: 07568 SW ASHFORD ST CLASS OF WORK:
SUBDIVISION: RENAISSANCE WOODS LOT #: 01 1 TYPE OF USE:
PROJECT NAME: VANDEHEY
DESCRIPTION: Installation of residential bacHlow prevetion device.
OWNER: VANDEHEY, MARK & PAULA PHONE #: 503-684-5206
CONTRACTOR: MATT SANDER LANDSCAPING INC PHONE #: 503-647-0800
Inspection Request Scheduled For: Date: 8/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RP/backflow preventer 013760-01 503-647-0800 N
'corrections/Comments/Instructions: •
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PASS --- i2„ PARTIAL APPROVAL Li CANCEL 0 NO ACCESS
FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
\ Inspecto Date: Phone #: (503) 718-
_ \ -