Permit i
CITY IGARD PLUMBING PERMIT
°IA DEVELOPMENT SERVICES PERMIT #: PLM2005 -00603
2-
- �1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/27/2005
PARCEL: 2S 104CD -02600
SITE ADDRESS: 13636 SW HILLSHIRE DR ZONING: R -7
SUBDIVISION: HILLSHIRE ESTATES LOT: 026 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: 0 .
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
ZI MM ERMAN Description Date Amount
13636 SW HILLSHIRE DRIVE
TIGARD, OR 97223 [PLUMB] Permit Fee 10/27/200: $36.25
[TAX] 8% State Surcharp 10/27/200` $2.90
Phone : Total $39.15
Contractor:
JOHN DARBY LANDSCAPE INC
13867 SW BENCHVIEW TERRACE REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Phone : 503 -579 -5298
Reg #: LIC 7110
PLM 12319LCL
•
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 -66 9 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.
•
1 RON :JOHN DARBY LANDSCR FAX NO. : 5035246613
. Oct. 25 2005 06: 34PM P3 •
,
Building Fixtures . vp :0
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Plumbing Permit A . . ..,,. ., .•:.:.,„;•,,,,,s.",‘.,:Y.:,,,',.'..,, e IA,:re;44 _4.,
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City of Tigard
K\ 74,..ivad . i
DataBy: a ! A so ... Perruit tslo.t aPPS--' ke
13125 SW Hall Blvd., Tigard, OR 97223 „., 0 P:i ' ' , , , Plan lieview
phone: 5o3.639.4171 Fax: .503.5911,1960 . 0 houtt,hoiAl., roate/13 : .'. • Other Permit No.: , • _'
74 Hour Inspection Une: 503.639.4175 cc4 ‘'.) 0;(;)T'' _di,. d4 il ' D p . ...• LH: 67 Ste PLLUi 2 For,
Internet; www,ci,tigarctor, us G 0: 0A .
Notified/Method; S a Supplcimaisltlifurrtitiod ;•
•
g ' 7 " 471 ..P ..14 ,,f I __,
,..- •,..::- 4,.. - , .,, , , - ft. , • 4.. '' ' ..4.....,44041: ' `I • - .,.21.1.t.i - : ta, ^.. IA v.-.. q , . - ,, , , -
For special ink>rioation use cheeldist,
0 New construction • . 0 Demolition
Description 1 Qty. I Eu I Total
D Additi on/alteration/rep lacement . ['Other : , New 1.2-lamily dwellings (includes 100 ft. for each unhty connection)
Z
'.:''.T' Now kt SFR, ( 1) ,ath I I 249.20 I
1 ,_ ; n:th;:zi,S4A.2.;i:stILT.- ,';.115...tact.L.t:e,.2ET.T , ...
FET 2.11thily clI;velling . torrirrieroiliVtudilstrials SFR (2) bath
• 350.0(7
._ . . . S PP. (3) bath • 399.0(7— :
0 Accessory budding'
0 Multi-family • .. ,
• • • Each additional bath/kitchen 45.00 I .
0 Master builder Other:
_ • . „ • „ ,, • „ : ';•••,.,,, -
., „,
Fire sprinkler ( , sq. ft.)
. Pa,r. 2 1 •
':, • • .
:::ji,-.1 4,.. .. -,), , ', akti;:,N14:::M5i.,!' Al Site utilities . . .•
Job site addiessi : •:, g.. ,-3 ,M,MThlp .. Catch basin or area drain I 1640 I ,
■.' 1
c i w is tuc iztp, ;. 1111.11.. • . $ 4 6 . ., ar: i qt a V il l i o Drywell, leach line, or trench drain 16.60
‘31 •
S ruo.: II • Project name! _ : • . ft.:
Footing drain.(no. linear ) Paez 2
— . Manufactured home utilities . 110.00 1
Goss street/directions to job site: • • .. 6.6 7- 1 - ----
•
......_______ . .. Manholes
,
- Rain drain connector 16.6tTr :
I . Sanitary sewer (no, linear ft.: ) Page • I ' 1
..—____----T---.-_.
Storm sower (no. linear fl.: ) Page 2 I i
Subdivision: Lot no.:
Water service (no. linear It: ) Page 2 I .
- - , Fixture or item - !
Tax map/parcel no.: j .
'". ' " • • •••• •;r1 , . Abgorpton valve . .. , 16.60 I
. . i'7. 7 , 471476 1 KRIRSarig,„RPROW)PPN11,04 ' " —
L:',:tri.•:-,;;',.:::g. , . • ,,, BaCkflOve P rcventer Ng.) 2 •
-- 3Y e eg I OW R3ArTrit ,.• i 4 _:".. i , ' I: Backwater valve ' . 16.60 '
Clothes washer. ; • : - • • 16,60 I
- . • . • • ..
..
' • :.„•,, :: .Dishviast
, .
b 16.601
-7-4-7;:',:i.:',,;:?.7,ell:•,4-7:"*WW4-EVd.'",1.,MiatInggilitprilvtge,7,3R,Appolimi _linking fountain — —
.1 • l ,^21-1',1_:-. •t■ .. ‘, 1,A: T.:./1 • Ej ec t ors / sump • 16.60 1
. .. .... . . .. ... . . . . ..... .
. —.---
Name: (..1, ,,..—........„..L.A.--- axpansion tank --: :
Address: Fixture/sewer cap , 16.60 I
City/State/VI': •• ." Floor drain/floor sink/hub I 16.60 I • :
,
Phone: ( • ) Fax; ( ) . . . Garbage disposal 16 60 I I
1
• :=3;;F:7, 1 1.‘T-T.II:c.-7,1 4 ,',WiliWgrojAKTI'l'..4.1.7",,,p,,P.W . RiFtE147V., iF .. . Hose bib . . 16.60 1 ___I
5: '2.4■21 i „ • I 6 60 I 1
interceptor/grease trap . — 16 60 I
Contact name: ---.0 Itt r\ 1)/9„ge,(/
. „ Medical gas (value: $ ) .
Address: Primer 16.60 1
- . .
City/Statc/ZIP:„. . • . . , , . . . , ' Roof drain (commercial) ' 16 60 1
. . ., . .
• 16.60 ;
Phone: (. ,•• )• • • Fax : ( • •;. ) . • Sink/basin/lavatory
' --
Tub/shower/shower pan ' 16.60 t
•
E-mail: . ■‘' . •
Urinal . ' 16.60 I 7
r7,:l.Z59:7,T1.1.:1 ,. -:, FP:. .. ,„ MILT,,,,y_Z qi, l...3.1q;,,IfinPl..M.F.f..Z.F...170,57, ••
. ..x.s.tili ':,...".'-,- . .1t. i :trel?WtkaLtE.:;2512.41ret.:Ittikw.a Water closet 16.60 I 1
• Business name: ---- fa mmtragnrar . .. Water heater . . . 1640 I . 1
Address: IMMIIIME n . • Other: .1 I
1. I
City/State/ZIP: IBMIMMINNE11.1.11111111Mill Minimum permit Subtotal
fee: S72 50 I 1
Phone; ; is) --.;- TIMM." Fax; 4 ) S . --- , 0 I _ Residential backflow minimum permit fee: S36 25 1 i
t ----_.,
CCB Lie.: if . . , -7 j I 6 Plumbing Lie. no.; . • . Plan review (25% of permu fee) i I
. .. .
, 1. State sUrcharge (8% of permit fee)
. I • .. e.r
Authorized signature: c .... _ 5 ; -- ------... . .. ,.• ,...:. • : -, : .;,
TOTAL PE1N1 i'r FOE
Print name: d This permit application expires If A permit is not obtained ■N ithin
—
a
180 it has been accepted as complete. • .
.*Fce methodology set by Tri-County Building Industry Service amid.
0,Buildina\Pcmits\PLMF-PerrnitAvadoe 12/03 440-461GT(noimicomfwea) .
'' '..
�~~'- - .- - -'_-----
BUILDING �DIVISION , . � PERMIT #: PLkH2006-00603
\ 13125 SW Hall Blvd., Tigar , OR 97223 DATE ISSUED: 10127y2005
Phone: (503) 639-4171 \
Inspection Requea�(��Hmj:�}3)S3S4�175 Joitil��
11/3O/�DO� 7:09AM INSPECTION VVORKSHEETFOR DATE: TIME: PAGE: 67
SITE ADDRESS: 13030SWH|LLSM|REDR CLASS OF WORK:
HILLSHIRE 026 SUBDIVISION: ' LOT TYPE OF USE:
PROJECT NAME: ZIMIVIERMAN
DESCRIPTION: BeokDmwprmvwn1wx for irrigation.
OWNER: Z|W1kAERK4AN, PHONE #:
CONTRACTOR: DARBY LANDSCAPE INC, JOHN PHONE #: 503
Inspection Request Scheduled For: Date: 11/3012005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RFVbanlef|mmprmveler 022612'01 503-679-8298 N
Corrections/Comments/Instructions:
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^. / �'�, ^, �
el •
~ASS I I PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
/ FAIL ri CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
17 )(V)--- � / /J �� |nopec�oInspector: Date: / �^ Phone #: (503) 718-