Permit CI TY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #. PLM2006 - 00337
� I DATE ISSUED. 7/10/2006 • 13125 SW Hall Blvd , Tigard, OR 97223 503 - 639 -4171 PARCEL• 2S103BD - 11100
SITE ADDRESS. 11737 SW ERROL ST ZONING' R -4 5
SUBDIVISION. CAPPOEN ESTATES LOT. 002 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
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 • 503 -590 -0805 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:, A n4,✓t AS Permittee Signature T Q ept CO ��-
Call 503-639-4175 by 7 a.m for an inspection that business day. T
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 RECEIVED
Plumbing Permit Application FORpOFEIC ONLY ; .
JUL 1 0 2006
City of Tigard Received
P NO / / -�Q 537
' II 13125 SW Flail Blvd , Tigard, OR 9720ITY OF TIGARD
Date/By mZ / /O /O�j jig Permit .i v
' I 0 Phone 503 639 4171 Fax 5 03 598QA6(DING DIVISION Dat Other Permit No ''''s — co 9D9
TIGAR D. Inspection Line 503 639 4175 Dam Ready/By tuns
Internet wwwtigard -or gov y y Supplemental See Paget for
NotifiedThlethod Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty I Ea I Total
❑ Addition/alteration/replacement ❑ Other New 1 -2 -family dwellings (includes 100 ft for each utility connection)
- CATEGORY OF CONSTRUCTION 4 - - SFR (1) bath 24929
❑ I- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350 00
❑ Accessory buildmg ❑ 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
i Job site address -
+ .577 Catch basin or area drain 16 60
City /State /ZIP 776.44-0 / O fL Drywell, leach line, or trench drain 16 60
Smte/bldg me 2..... I Project name adefo f //a- Footing drain (no linear ft ) Page 2
Cross street/directions to job site /T, Manufactured home utilities 110 00
The 16 60
6 . ' Aria Rain drain connector 16 60
EN ja G. -Cr 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
- , DESCRIPTION OF WORK" Backflow preventer Page 2
L i Le Backwater valve 16 60
Clothes washer 16 60
Dishwasher 16 60
PROPERTY =OWNER;'., ' ':'-' - Fj" Drinking fountain 16 60
/" _ _ - I -_, ', - 7 ' -.,❑ = TENANT' t ,.
Ejectod/sump 16 60
Name to/h2- D CAN/ ST. ro .
Expansion tank 16 60
Address +. o - • S 7 Fixture /sewer cap 16 60
City/State/ZIP ' z4 , SU r/ 0t - O Floor drain/floor sink /hub 16 60
Phone 629 5'70 _ Op o % Fax ( ) Garbage disposal 16 60
_ , ,,, ) APPLICANT ' ' - ' CONTACT PERSON Hose bib 16 60
Business name Ice maker 16 60
Interceptor /grease trap 16 60
Contact name
1 /1
n i j. Medical gas (value $ ) Page 2
Address Primer 16 60
City/State /ZIP Roof drain (commercial) 16 60
Phone (5j3, 7IO -ea / Z I Fax ( ) Sink /basin lavatory 16 60
E -mail
Tub /shower /shower pan 16 60
Urinal 16 60
' CONTRACTOR Water closet 16 60
Business name Water heater
–size kr jai– / 16 60
Address Other
City/State /ZIP Subtotal
Minimum permit fee $72 50
Phone ( ) Fax ( ) Residential backflow minimum permit fee $36 25
CCB Lie Plumbing Lie no Plan review (25% of permit fee)
Authorized signatur _'� State surcharge (8 % of permit fee)
"+ rte_ �_ TOTAL PERMIT FEE
___
Date So, 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
1 \ Building Permits \PLMF- PenmtApp doc 04 /06/06 4404616T(10/02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT # PLM2006 -00337
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 7/10/2006
Phone (503) 639 -4171 - A
Inspection Requests (24 Hrs ). (503) 639 -4175 M
INSPECTION WORKSHEET FOR DATE 7/11/2006 TIME 7:00AM PAGE 1
SITE ADDRESS 11737 SW ERROL ST CLASS OF WORK*
SUBDIVISION. CAPPOEN ESTATES LOT # 002 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION. BackNow preventer for irrigation.
OWNER. FOUR D CONSTRUCTION, PHONE #: 503 - 590.0005
CONTRACTOR CROWN LANDSCAPE INC PHONE # 682-1100
Inspection Request Scheduled For: Date: 7/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 032921 -02 503 - 720-0012 Y
Corrections /Comments/ Instructions.
r---:—l---e----/ /
PASS El PARTIAL APPROVAL El CANCEL El NO ACCESS
` I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 11 e Date: Th Phone #: (503) 718-