Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00334
aLljr ,,��I DATE ISSUED: 7/10/2006
13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 2S103BD -11500
SITE ADDRESS: 11716 SW ERROL ST ZONING: R -4 5
SUBDIVISION: CAPPOEN ESTATES LOT 006 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
FOUR D CONSTRUCTION CO
PO BOX 1577 Description Date Amount
BEAVERTON, OR 97075 [PLUMB] Permit Fee 7/10/2006 $36 25
[TAX] 8% State Surcha 7/10/2006 $2 90
Phone • Total $39.15
Contractor
CROWN LANDSCAPE INC
STEPHEN HARMS
PO BOX 883 REQUIRED ITEMS AND REPORTS
WILSONVILLE, OR 97070
Contact # : PRI 682 -1100
Reg #: LIC 6181
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: -Ty / t v l 4 / A -- - Permittee Signature. 4 ,P
1 d`9 1
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.
• Building Fixtures
Plumbing Permit ApplieatiRFCEIVED Foa oFF ICE: ISE,oNe
City of Tigard 1 1 2006 C Rece _
" 13125 SW Hall Blvd, Tigard, OR 972A YL 1 0 2006 Date /By a 0 6 f I/ Penult Nol,\\ \c 2 0(29633
® ,; Phone 503 639 4171 Fax 503 598.19y Plan Review a e t No " .— ever/
C:11 Y OF TIGARD Date/By TIGAKO D ate Ready/By
Inspection Line 5036394/75
_ - Internet wwwtigard -orgov BUILDING DIVISION Jane � ' 1 RI See Information
Nonfied/Method (/I Supplemental ental Information
TYPE OF WORK FEE* SCREDULE
❑ New construction ❑ Demolition For special information use checkless.
Description I Qty [ Ea l Total
❑ Addition/alteration/replacement ❑ Other New 1 -2- family dwellings (includes 100 ft for each utility connection)
- - CATEGORY OF CONSTRUCTION ' SFR (I) bath 24920
❑ 1- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350 00
❑ Accessory building ❑ Multi -family SFR (3) bath 399 00
Each additional bath/kitchen 45 00
❑ Master builder ❑ Other -
Fire sprinkler ( sq ft) Page 2
, ,JOB SITE INFORMATION AND - LOCATION Site utilities
Job site address
_4 t_ _57 Catch basin or area dram 16 60
City/State /ZIP -77‘ O / o a - Drywell, leach line, or trench drain 16 60
Sude/bldg /a. _ i Project name „- i � /� Footing drain (no linear ft ) Page 2
e re
Manufactured home utilities 110 00
Manholes 16 60
% .. -. /i• Ram drain connector 16 60
it a L $ Sanitary sewer (no linear ft _ ) Page 2
Storm sewer (no linear ft ) Page 2
Subdivision I Lot no Water service (no linear ft ) Page 2
Tax map /parcel no Fixture or item
Absorption valve 16 60
r - _ -' DESCRIPIION OF WORK . - Backflow preventer Paget
6'
GO �/ Backwater valve 1660
Clothes washer 16 60
Dishwasher 16 60
;, WPROPERTY _ t° ' I H , •+-`c- ❑ TENANT • ('( ^'2I, Drinking fountain 16 60
Name O8 p � s
Ejectors/sump tank 16 60
/ 7. �� Expansion tank 16 60
Address e•
S 7 Fixture /sewer cap 16 60
City/State /ZIP . F 4v ' t v /•/ / O Q rte” 707 Floor drain/floor sink/hub 16 60
Phone (529 57 _ o t $ F ( ) / Garbage disposal 16 60
CON PERSON Hose bib
• APPLICANT , - 16 60 •
Business name Ice maker 16 60
Interceptor /grease trap _ 60
�
Contact name •
2 i/ 1: Medical gas (value $ ) Page 2
,;� Primer 16 60
City /State/ZIP Roof drain (commercial) 16 60
Phone ( 523 nv - Oa i Z _ I F ( ) Sink/basin/lavatory _ 16 60
E -mail
L Tub /shower /shower pan 16 60
Urinal 16 60
• CONTRACTOR
Water closet 16 60
Business name 5 4 ./ ( Water heater 16 60
Address r � t I r,_. \ ` f t--1 Other
City /State /ZIP Subtotal
Minimum permit fee $72 50
Phone ( ) Fax ( ) Residential backflow minimum permit fee $36 25
1■► Q .N Plumbing Lie no Plan review (25% of permit fee)
1
Authorized signatur -_ I% State surcharge (8% of permit fee)
�— _'---� TOTAL PERMIT FEE
Print name Q jgic, D L _ 10,1111111111 Date /a9 a This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tn -County Building Industry Service Board
I \Buiiding\Permita PLMF- PennitApp doc 04/06/06 44t4616T(10 /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION A PERMIT # PLM200S -00334
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED. 7/10/2006
Phone (503) 639 -4171 yNill�
Inspection Requests (24 Hrs) (503) 639 -4175 IL
INSPECTION WORKSHEET FOR DATE. 1/25/2007 TIME 7:03AM PAGE 20
SITE ADDRESS 11716 SW ERROL ST CLASS OF WORK.
SUBDIVISION CAPPOEN ESTATES LOT # 006 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION Backflow preventer for irrigation.
OWNER PHONE #•
CONTRACTOR GROWN LANDSCAPE INC PHONE #. 682 -1100
Inspection Request Scheduled For Date: 1/250007 Pour Time
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 042517 -01 503-720-0012 Y
Corrections /Comments /Instructions
,I1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
T�t
Inspector. 111 c � Date: 1 / 7 /
SS / Phone #: (503) 718- _ �7 / ////���