Permit C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00259
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/11/2008
PARCEL: 2S 110BB -01700
SITE ADDRESS: 12365 SW CORYLUS CT ZONING: R -1
SUBDIVISION: AMES ORCHARD LOT: 008 JURISDICTION: TIG
PROJECT: DALY
Project Description: Installing backflow preventer.
CLASS OF WORK: 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
JOE DALY
12365 SW CORYLUS CT Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 6/11/2008 $36.25
[TAX] 12% State Surch 6/11/2008 $4.35
Phone : Total $40.60
Contractor:
LANDSCAPE ENTERPRISES INC
PO BOX 436
WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 682 -3343
FAX 503- 682 -3343
Reg #: PLM 5331
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 jam � . Permittee Signature: 2 W'it;-CoriWCY‘-/
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.
` FROM :LEI +' FAX NO. :5036823343 Jun. 89 2888 11:47RM P1
'.'lumbinz Permit Application RECEIVED
�
Building Fixtures JUN 0 9 2008 1ft)lt of i lc is ., t '1.1
- v City of Tigard RC cciVr d - � ' . n
13125 SW }fall Blvd., Tigard, OR 97223 CITY OFTIGAR � Rate /13 •: Permit No.: /4:413 + ,
I : Phone: 503.639,4171 Fat 503,598- , {::4 ILDING DIVISIO ya n RCVie , p No 1 I nsection Line llate Ay , ermit No
1 = r; n R t) p 503.639.4175 Ina R ` By:
Internet: www.tigard- or.goV 115 6l Sae Page 2 for
Noti6cd/Meil od: Q Supplemental lntanaat
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For edit! In urination use checklist
Descript pry. ' T Ea. Tota
❑ Addition /alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249,20
❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath • 350.00
El Accessory building ❑Multi family T SFR (3) bat 399.00
❑ Master builder ❑ Other Each additional bath/kitchen 45,00
Fire sprinkler ( sq. fl-) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: iv; 3 46,E iJur . i Catch basin or area drain TM 16.60
City /State/ZIP: 0 ■ 1 7 ,,u Drywell, leach line, or mach drain 16.60
Suite/bldg. /apt. no.: Project name: 'l/ Fooling drain (no. linear ft: ._ ) Page 2
Cross street/directions to job site:
fT Manufactured home utilities 110.00
'°-" Manholes 16.60
_ - Rain drain connector 16.60
Sanitary sewer (no. linear ft.: Page 2
Storm sower (no. linear ft.: ) Pagc 2
Subdivieiou: I Lot no.: Water service (no. tinter ft.: ) Page 2
Fixture or item
Tax map /parcel no.: -
- -- ~�-- Absorption valve 16,60
�� /' DESCRIPTION OF WORK Bgckftp,, p2vemhr ! Page 2
/Ara !' L 0 Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
2 PROPERTY OWNER 0 TENANT
Drinking fountain 16.60
Ejectors/sump I6.60
Name: 7S e___I i� Expansion tank - 16.60
Address: t a C /y 0 vii I�l l (1 Fixture/sewer cap 16.60
City /Statc/7IP: , L ,� 0 UC '7 )) J Floor drain/tloor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPIJC:ANT ❑ CONTACT PI'tRSON Hose bib 16.60
ice maker 16.60
Business name: i ' .cra + / •tf Oill ,,� Interceptortgrcesc trap 16.60
Contact name: v l `� Medical gas (value $ ) Page 2
Address: ry L , .>c,, (i ' / Primer 16.60
City /State /ZIP: Go, Go, ISQ irl V 1 k 1� . () 1 G� ! ] 0 -7 V Roof drain (commercial) 16.60
Phone: ( ) a _ 3 5r�. Fax:: ( ) Sink/basinllavatory 16.60
E-mail: pan 16.60
-..- - -- - Urinal • 16,60
CONTRACTOR Water closet 16.60
Business name: LaY1 �� . CAS-- W Water heater 16.60 ~
Address: Cs, c `� -A'1 # 4„, Other:
C :ity /StatcJZlP: ,dr� �. '1"70 7 Subtotal
` - Minimum permit fee: $72.50 ..--.r Phone: ( � ` ) " '/ .7 Fax: ( ) r - }� Residential backtlow minimum permit tbc: $36.25 .C
_._. ,.,,__:_.
CCR 1.ic.: j,3 3 i Plumbing Lie. no.: Plan review (25% of permit fee)
• , / ..-_„ 'NM, ,_ °` State surcharge (12% of permit fee) '
Authorized signature: _ r - ,_
�. !•ta TOTAL PERMIT FEE
Print name: b 6 Date: i q `oe T •this permit application expires if a permit is not obtained within l '
i ` 180 days after it has been accepted am complete.
*Foe methndnkwv set by Tri- Cramty Rttiidina Fndorctry Service Firrtrd
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008 005
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: €i'i'i /20Ot3
Phone: (503) 639 -4171 nvello ,,
Inspection Requests (24 Hrs.): (503) 639 -4175 :I
INSPECTION WORKSHEET FOR DATE: 6/18/2008 TIME: 7 :02AM PAGE: 45
SITE ADDRESS: 1236; SW CORYLUS CT CLASS OF WORK:
SUBDIVISION: AMES ORCHARD LOT #: 008 TYPE OF USE:
PROJECT NAME: DALY
DESCRIPTION: Installing backflow preventer.
OWNER: DALY, JOE PHONE #:
CONTRACTOR: LANDSCAPE ENTERPRISES INC PHONE #: 503-6813343
Inspection Request Scheduled For: Date: 6/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
30 Misc. inspection 071557 -01 503-682-3343 Y
Corrections/Comments/Instructions:
D e c e
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hA A. it a 4 \ Co - .- t, C---cA
n PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL XCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( C) 6 L►u..it x Date: 01 .dQ� Phone #: (503) 718-
CITY OF TIGARD- -- . _ .• .
BUILDING DIVISION
A, PERMIT #: PLM20013-00269
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 6/11/2008
Phone: (503) 639-4171 ,_,ltIlit.
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6123/2008 TIME: 7:01AM PAGE: 46
SITE ADDRESS: 12366 SW CORYLUS CT CLASS OF WORK:
SUBDIVISION: AMES ORCHARD LOT #: 0013 TYPE OF USE:
PROJECT NAME: DALY
DESCRIPTION: Installing backflow preventer.
OWNER: DALY, - JOE PHONE #:
CONTRACTOR: LANDSCAPE ENTERPRISES INC ' , . PHONE #: 603-682-3343
Inspection Request Scheduled For: Date: 6/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
396 Misc. inspection 071717-01 503-6112-3343 N
13 ..x..k4 g f-'1,,,,,,,i,
Corrections/Comments/Instructions:
CA., cl■---
1 PASS 7 PARTIAL APPROVAL CANCEL 7 NO ACCESS
El FAIL 7 CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
ic .
Inspector: Crolli‘A.5 \-\ , c , •.----t... Date: 6, 17s. Phone #: (503) 718-