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Permit • CI TY OF TIGARD PLUMBING PERMIT Av. , T,, , .I DEVELOPMENT SERVICES PERMIT #: PLM2005 -00339 DATE ISSUED: 7 /28/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2 S 112 C D - 13400 SITE ADDRESS: 07770 SW CYPRESS LN ZONING: R - SUBDIVISION: HAMBACH GROVE LOT: 032 JURISDICTION: TIG Project Description: Installation of backflow 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 LEGEND HOMES 12755 SW 69TH Description Date Amount SUITE 100 [PLUMB] Permit Fee 7/28/2005 $36.25 PORTLAND, OR 97223 [TAX] 8% State Surcha • 7/28/2005 $2.90 Phone : 503- 620 -8080 • Total $39.15 Contractor: MARTIN SANDERS GROUNDS MAINTEN • PO BOX 307 NORTH PLAINS, OR 97113 REQUIRED ITEMS AND REPORTS Phone : 503- 647 -5567 • Reg #: LIC 5742 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: 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. Jul 27• 05 02:12p Martin Sander 503 - 647 -9151 p.2 Plwnbing Pe* .N.Oplication City of Tigard IIk 2 1 70' R.4-d �� (J rui: cis ti F 1 F ONO 13125 SW Hal Blvd , "Tigard, OR 97.273 e - + Permit No.- /a +I < ?Loot 503.6394171 Far sa3s9a ks6o 'I(::.NAu Flan Renew 24- Hew' trt pc ion Lira 503.6391f-Y,175 ' Q e IO •1 1 t>osal�Br Oda: re. tvoz tat/CM= wwe...e:- tigard.orste �1 1� t I��it - �l��a DIVISIO „ 1 Dam RddAly: _ / ( i a sa•la k. 4 t 1 `� - . r: 4� 1 5. 6 11 A � ..i `ma c ��: =z t S-J = - . �. �; gcE ' l Sray ewosf ldanw� P. New construction ❑ Demolition For "cad befo wade. d oaf mck © laoemeynt 0 Other: Description t Qty. ! Ea. ( Total '3:::::::_r- " ? - _ s�zw�r Flew 1- Z6nn1y dwellings (includes 100 P_ for earls utility connection) '`mower k ''Z_, J� : , r. .*7 c 3'^r .» ;- t..: re .7‘...1.......4... . ' , . - ' ri ' . -` 4 ` = •1 t : ,.. - _ �.. _ ..., ,' -:. _ . � SFTt(1 }4atD 249.20 0 1 - and afimily dwelling 0 Comsmexcialruultest ia1 T SFR (2) bath 350.00 El Accessory building E:1 Medti.fian7y SFR (3} bads 399.00 © Master bealdv Each additiiotrai beth' it chat 45.00 t ; 1 = ,_ �acoe a , �Rl; tt Fire sptittkler (_•__ _ eq. R..) Pa. gc 2 Job site addtt , L , a ! - cb 3' 7 ( � / 70 $ J 0. Ft.:. Catch basin army. drain 16.60 Gly/Stntc/ZIP: 1 �, 0 I '� ivy f e r C S , Drywell. leer line, or trench tram 16.60 Suiitdbldg.hpt, no.: 1 pio I- Fax,...) b a G , t Footing drain (no linear ft: ) Page 2 Cross svaet/d$eztiom to job sit M>olttfacttaed borne utilities 110.00 Manholes 16.60 Rain drain connecter 1640 1 1 { Sanitary sewer (no- linear n.: ) Page 2 i Storm sewer (no. linear R_:, ) page 2 aom f /1 f -„� i , Tot m_: W. It: ) Page 2 11'' � 1 ` E : t �� Subdivi r1� � � Z :rat:mice (no. linear Tex � no.: Fixture or item W ,. .� . .. 11 =t� ,` iF• : _ .•. 1 Bad®ow atI c 3 i1 i 1• l t 1 16.60 Pace 2 A42,4; stream/ter ,.� Page2 .. A , •. # - A 6 .. Ufa eack.war valve 16.60 Clothes "usher 16.60 Oishwasher . t6-60 16.60 ( 117^ - r : . , 11si..�--• „� r, -- Drinking fountain yr. •..•.. ._..l.,r.. i 1 . ;..- -. 2F.� T,r '(`1. :-, .. .,t " l- -._I - • i- ? v. le _Name t o_ `41-& 15-5- l i'• 1 S L. / 12-4 9 v 'vl�tn Eisctats�lttr� 16.60 Address: ..- $ IN � c7 % H II i/f Sit' l c! Pi*tm ..p 16.60 C,ely/StarrJZLP: (�i.1�/(Vr�Vir 41 4.16 ^1. i n _ Foordrain/tloorcindbub 16.60 Phone: (5o3) (, - Fort • . ) 5f' € 5 l)<:2 image �Posal 16. • • 'ant L:aT't S` C , � ' jam fi .r y _ • • Rose bib 16.60 p �/, � fie' 16 -60 Btaaress trsas>C a r^ f ill`? c �K,nt7 /S 4rrx < i 7G -)T7 . Interceptor/grease tag 1660 Contact names Al)-,) . rc✓ 1M'1 Medical gaa (value: S ) pays 2 Address: e, 0 e 60X . 3b 7 . Piarier 16.60 City/S8i 1ZMP: f1 ) -4-1 �y ) c; • - c • 2 / 5 Roofdrsist (commercial) . 1 6.60 Prom (....)3 ) l /F i ` l 7 - S sc 7 1 Fax:: ( $ ='3) LO` - 77 " WS/ Sinldbssin/tevatory 16 ba E -mail: TuMShower/sbowcrpro 16,60 : 1' •a rea - _ t . s _ AT; _ Urinal 16.60 � :gin - � Z ; ---- ' . i , ¢W 'iikita Water closet 16.60 en inma ; en 0 , 4 ,4, 11 C. ,1^ ,. ,d , �c Water heater 16.60 � Address: L. ' ox � 3 0 1 Other: CilylSta :e 1, A) (SY-41/1 p /(Li - }' ; 12 R 9 " Se biota/ Phett (3o 3) 1 / 62 ` 1 7 • ,S 7 Fa (/) k t V7 - s/ Residential bscldlow minimum Pmt fee: 5 CCI3 Lk.: S--)Y 7, Plumbing Lic no.: 459' 6 / rte, rcvicw (259s of permit fee) Authorized sign IIt[C State surcharge (614 of permit fee) Prim =Me: l TOTAL PERMIT FEE , '3L . 2 5 W ✓fl in f5 Le N D ' 2 7 D� This permit application cep ucs if rt permit is nat abaleed within ISO tlays after it tun been accepted its complete. ��� � 1 .c *Fee methodology set by - 1 - 6-County Building Industry Service Based. o- attaTC�I CITY OF TIGARD - BUILDING DIVISION PERMIT #: PLIvf2005 003 9 lIG 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/2005 Phone: (503) 639 -4171 Kom N����i�jll l l Inspection Requests (24 Hrs.): (503) 639 -4175 '__.. INSPECTION WORKSHEET FOR DATE: 7/29/2005 TIME: 7:07AM PAGE: 48 SITE ADDRESS: 07770 SW CYPRESS LN CLASS OF WORK: SUBDIVISION: HAMBACH GROVE LOT #: 032 TYPE OF USE: PROJECT NAME: HAMBACH GROVE DESCRIPTION: Installation of baclflovd device. OWNER: LEGEND HOMES, PHONE #: 503-620.0O00 CONTRACTOR: MARTIN SANDERS GROUNDS MAINTEN PHONE #: 503. 647 -5567 Inspection Request Scheduled For: Date: 7/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 012447 -04 503- 647 -5567 Y Corrections /Comments /Instructions: 4 1:ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 Date: / Phone #: (503) 718-