Permit C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT# PLM2006 -00335
13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED. 7/10/2006
PARCEL. 2S 103 B D -11400
SITE ADDRESS: 11698 SW ERROL ST ZONING' R -4 5
SUBDIVISION: CAPPOEN ESTATES LOT. 005 JURISDICTION TIC
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 Description Date Amount
PO BOX 1577
BEAVERTON, OR 97006 [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: - ; Permittee Signature: Tex, P,„
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.
V
` Building Fixtures RECEIVED
` OFFICE -, "
Plumbing Permit Application
City of Tigard
JUL yy O 200 C Received // FOR OFEICE.,USE ONLI. •
IN e J 1 6 /!! 0 / • ermIt No ) _ /e /)! JJr 9
13125 SW Hall Blvd, Tigard, OR 97 Date /B ) r+v0 a
Plan Review it N. /pL�3
'' Y - - Phone 503 639 4171 Fax 503 OF TIGARD e _ 14 ab
Lispeohon Line 503 639 4175
ING DIVISION DazeBy
31 GA RD Internet www hgard -Or gov Date Ready/By Ie",a -// ® See Page 2 for
NohfiedlMethod 4 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 0 Other New 1 - 2 -family dwellings (includes 100 ft for each utility connection)
- CATEGORY OF CONSTRUCTION - SFR (I) bath 249 20
❑ 1- and 2 -family dwelling ❑ Commercial /mdustrial SFR (2) bath 350 00
❑ Accessory building ❑ Multi -family SFR (3) bath 399 00
Each additional bath/krtchen 45 00
❑ Master builder ❑ Other
Fire sprinkler ( sq ft) Page 2
,JOB SITE INFORMATION AND LOCATION Site utilities
Job site address
/ • + ST• Catch basin or area drain 16 60
City /State /ZIP, 7761/2 -D n /L Drywell, leach line, or trench drain 16 -60
Sude/b1Ug,(Tp1 7' r I Project name ry- //�� Footing drain (no linear ft ) Page 2
Cross street /directions to job site
U � /`� Manufactured home utilities 11000
Manholes 16 60
%� -- 6 M _..' taw Rain drain connector 16 60
„, a („ =MIMI 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
n DESCRIPTION OF WORK BackBOw preventer Page 2
3ntKfL /0 /r.I-- 1/1.44e- Backwater valve 1660
Clothes washer 16 60
Dishwasher 16 60
-PROPERTY ;OWNER, �., , ENANT ' Drinking fountain 16 60
:,I, T - ' -T
r.:` Ejectors/sump 16 60
Name r-864,2_ p Co( 57 re, Expansion tank 16 60
Address -• 0 r e
.$' 7 Fixture /sewer cap 16 60
City /State /ZIP /3 4 - O ri / at 21707-5- Floor drain/floor sink /hub 16 60
Phone (52:3 `. '7 _ oat . s e— Fax ( ) Garbage disposal 16 60
APPLICANT - - " ' P CONTACT PERSON Hose bib 16 60
Business name Ice maker 16 60
Interceptor /grease trap 16 60
Contact name 4. ,t 1 Medical gas (value $ ) Page 2
Address r Primer 16 60
City /State/ZIP Roof drain (commercial) 16 60
Phone ( 5- e , 7 To BOO / z I Fax ( ) Sink/basin/lavatory 1660
E -mail
Tub /shower /shower pan 16 60
Urinal 16 60
CONTRACTOR
Water closet 16 60
Business name off_
(� Water heater 16 60
Address (in �
f w : :::, rk 5 f q _ t J
Other
City/State /ZIP ' 1 � + Subtotal
Minimum permit fee $72 50
Phone ( ) I - F ax ( ) Residential backflow minimum permit fee $3625
CCB Lic in. e l . ,66 + Plumbing Lic no Plan review (25% of permit fee)
Authorized signatur ir State surcharge (8% of permit fee)
'? / t— �' ----k TOTAL PERMIT FEE
reeigMAII Date /p 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 Tri -County Building Industry Service Board
I IBuildunAnermits5PLMF- PermitApp dac 04/06/06 4404616T(10 /O2/COM/WEB)
I
PP OF TIGARD .
BUILDING DIVISION . PERMIT # PLM200S •00335
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED. 7/10/2006
Phone (503) 639 -4171 Aa i
Inspection Requests (24 Hrs) (503) 639 -4175 A IL.
INSPECTION WORKSHEET FOR DATE 1119/2006 TIME 7:02AM PAGE 52
SITE ADDRESS 11698 SW ERROL ST CLASS OF WORK
SUBDIVISION CAPPOEN ESTATES LOT # 005 TYPE OF USE
PROJECT NAME. CAPPOEN ESTATES
DESCRIPTION Sackflow preventer for irrigation.
OWNER FOUR D CONSTRUCTION CO, PHONE # 503 -690 -0805
CONTRACTOR CROWN LANDSCAPE INC PHONE # 682 -1100
Inspection Request Scheduled For Date' 11/9/2006 Pour Time:
Code # Inspection Descri Ion Confirm # Contact # Message po
399 Plumbing final 039525 -01 503-718.2433 Y ym
Corrections /Comments/ Instructions'
_// J-
S
_�— h2 d� °eel r
e l
ASS n PA •TIAL APPRO • ❑ CANCEL NO ACCESS
// FAIL ' A 1 / ON ❑ ADDITIONAL FEES ASSESSED
EI / �
Inspector Date: /� /� f° Phone #: (503) 71�