Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00107
H 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/17/2005
PARCEL: 2S111 DA -09600
SITE ADDRESS: 09020 SW CORTLAND LN ZONING: R -7
SUBDIVISION: APPLEWOOD PARK NO. 3 LOT: 089 JURISDICTION: TIG
Project Description: Installation of residential backflow prevention 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
JEFF AMOTO
9020 SW CORTLAND LN Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 3/17/2005 $36.25
[TAX] 8% State Surcharl 3/17/2005 $2.90
Phone : 503 805 - 6368 Total $39.15
Contractor:
CASCADE LANDSCAPE & IRRIGATION INC
PO BOX 754 REQUIRED ITEMS AND REPORTS
SHERWOOD, OR 97140
Phone : 503- 625 -4112
Reg #: LIC 7832
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
952-0001-01 1 rough OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 50 - 246 - 66' • o 1 800 - 332 - 2344. •
Issued • Permittee Signat !
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.
MAR -16 -2005 22:37 FROM: CASCADE LANDSAPE 036250739 T0:5035981960 P.3
08/1•3/2 e i) 04 18:21 fAX 50 R VE I JO01
I II , . OF TIGARD 1
Building Fixtures .
pil1II1k1, )ll� Permit A►pp1�CA JIB 1 2005 1 . i Fort (It f. I C E I SE (7\ f .1
City a € �7igaYrd 'ITY OF TIG A n. ` i / � Ptem itNwr / , -661/6 7
13115 SW FM Blvd., Tigard, OR 0
Phone: 503.635.41 Fay 503•598. PlanRyNew 1` OderpezmitNo.:
1.
24 Roes lnapectioetind: 303- 639.4 DI ) i may' :
� ` � Mellott/By: y ygy &I See Sege 2 tar
Internet wwort:l- tigard.orus Netifietratettot 4, I , Supplemental Irdiermation
❑ New construction 1.3 Demolition _� For s • -. • madam w e chscktlsa `
Addititrolal0o¢etioa ement i Ot ber E' 'Pawl Qty Total
El Boise C 4✓ - 2-family dwellings (includes 1.0011. tot each utility connection)
l ^ :r • ` -- s . h .. - - - , • ,- ..,. 1 ., ' r n "_} a�tu' if S 1'S ) bath 249?0
o 1 and 2-turnly dwelling ❑ Coeometclalfindnsttial
Et ) bath 350.00
p
O Accessory banding El Multi fa>m1y )bath 399.00
`:� additional betbildtchen up. 45.00
Master builder tbal 41
p , � a � _ 1 _ }
i' • ( sq. ft-) �E� " -
In - . , 1 #. O • Sw o r� l . n Ln • basin or arcs dodo . . .. 16.60 '
City/State/Mt / /, .. ,• se. - _ ' r .. :. 16.60 .
Sultedhldgfspt. nom '4 Project name: kk 0. c.. drain (no. linear ft.: Page 2
. turod horns utilities 111 110.03
Gloss srrcet/ditectfo to job site: 16 :60
'iC- PorK land rerr • - Cl. . , cotmector _ 16.60
2,c" We oft ter%C.C.. k 0r1 S . '',py sewer (no. Hoare.: ____) Page
1..0 se. o r% Le .P4 - to nn Pi, k e. kit e"cr,s" Sto t sewer (no. lunar ft :._ ___) Page 2
Subdivision: Lot no: W s: • service (no. linear ft.: ) yap ,
# - or item
Tax map/pstctl 1110. Q, -'
�x r
.danvalve 16.60
F
u'a .:._ ... _ r _ r i,,..„. ` ° ''. €. , ? .,-, ' ! # �o preventer w,a Pa 2
=, 'J • . _ ( va ter Via" 16-60
« 14.60 q es washer
Q� _
ba 1660
-- - , -- � -= , ': r - 16.60
Name 'f C- Af /1 t 4 1660 •
A�esa: y I eRI 4 C ' a • _ 16.60 ..
City /sWe/Z1P: #. t/r vIQ • ` 2 Z 4 l drain /f[aorsfnto'twb MIN 16.60
Phone CO • : • ! ., FAX: ( !1 p 252 6 .. 1 • 16.60
T- i �. . : , _ bib . _ . 16.60
16.60
Busine ee naac / • I ,I_ id :I/ • " .it. 114.4 / •t1 L • t:L.. for /grease trap r 16.60
Coutact aamo: •n1G RATIV D l .extA Pa. No •- gas (values 5 ) cage a
Address: :. 16.60 .
City/StaterZIP: XWOoc' e) i ; : 87140 . M _ 14.60 .
Phone: ( (#2, r 12• I Fax:: 0 5010 to 2c 41. S :. "'; 16.60
Q b eb ower pan . 16.60
B.ma11. Goy . (a refs Celt • 4C ( '. r Z.ovi . > 4'- . _ , 16.60
. .`.. - , d..��._r.,.:.:" , -, �r i.4>v;�3r k . . fit i % :;- closet 16.60
Business .ae 4 -a l t?''(q�� /, 1 beater 16.60 ..
Address. 0.13CX - 1•15 - c9 • , '. . btotal
t ty/statdz1P: hGrrvao 4! - 4 ) 7/40 stS72.51
ttinwrnt sa s7a.sa p.
Phone: (eV) ciar -4 / 12 Fax: (1p�,) G 25 4//9- . b li
; Rasiacntial hacldlow minimum permit i; c: $3625
r•:: Lie.: : A d , Plumbing tic- no.: t Stan a IMAM (25% of t fee
.
.. • _ / . - V " raTA1. rERMrr EFE t . / 5
Ile-
Print name: .1, 0 � s
0 . er _VC Data gig V o pmt appScatioa saptrea Ka permit 1a not obtained within
130 day's after it has been accepted es complete.
se .,.,.o.oanlnw ex Mu Teil'mmw L1uldine Industry Service Board.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005.00107
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/17/2005
Phone: (503) 639 -4171 stiln\
Inspection Requests (24 Hrs.): (503) 639 -4175 .--
INSPECTION WORKSHEET FOR DATE: 4/11/2005 TIME: 7 :10AM PAGE: 73
SITE ADDRESS: 09020 SW CORTLAND LN CLASS OF WORK:
SUBDIVISION: APPLEWOOD PARK NO. 3 LOT #: 089 TYPE OF USE:
PROJECT NAME: AMOTO
DESCRIPTION: Installation of residential baclflow prevention device.
OWNER: C
AMOT, JEFF PHONE #: 503-805-6368
,
CONTRACTOR: CASCADE LANDSCAPE & IRRIGATION INC PHONE #: 503 - 625.4112
Inspection Request Scheduled For: Date: 4/11/2005 Pour Time:
q 4/11/00.►
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 00415001 • 503 - 625 -4112 Y
1 .3 " 7 - Z rD
1 Corrections /Comments /Instructions: -,
1 --TS eil' - 3/.2 fr
(Alrje C Ci Ir ('',- -lar °
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I / a
•
. .
; PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
[ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
r
Inspector: Date: V 1 Phone #: (503) 718-