Permit 1
CITY 1I(ARD PLUMBING PERMIT
A
l l DEVELOPMENT SERVICES PERMIT #: PLM2005 -00345
+- � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 4171 DATE ISSUED: 8/1/2005
PARCEL: 2S111 DB -15300
SITE ADDRESS: 09332 SW HOME ST ZONING: R -4.5
SUBDIVISION: KESSLER ESTATES LOT: 010 JURISDICTION: TIG
Project Description: Irrigation bakcflow.
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
LANDON MORSE Description Date Amount
9332 SW HOME ST.
TIGARD, OR 97224 [PLUMB] Permit Fee 8/1/2005 $36.25
[TAX] 8% State Surcharq 8/1/2005 $2.90
Phone : 503 968 - 0156 Total $39.15
Contractor:
ALL NATURAL LANDSCAPE LLC
PO BOX 2815 REQUIRED ITEMS AND REPORTS
CLACKAMAS, OR 97015
Phone : 503 740 - 0852
Reg #: PLM 7883
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 -6 99 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: y,:2.l Ctg
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.
ir t..
Robert Lussier 5035580788 p.2
Plumbing Permit Applied c���VE ' Eon OFFICE USE ONLY
Tigard City of Ti g d - Received
`J 301. 1 8 005 Date /By: p / f /D� i'� 4 M
13125 SW Hall Blvd., Tigard, OR 97223 2 (3 N / / °+1 ` l ...0584.15 2 wi
05
Phone: 503.639.4171 Fax: 503.598.1960 Plan Revie
Permit No.:
Tail
{ Date /By: Other Permit No.:
24 Hour Inspection Line: 503.639.4I75 CITY OF �� I I
, Date Ready /By: .. ris: Ed See Page 2 for
w
Internet: ww.ci.tigard.or.us WORK rat 9yt DING t] l t Not T Supplemental Information
�,/ TYPE OF WORK FEE* SCHEDULE
Lr Ncw construction ❑ Demolition For special information use checklist
i Description I Qty. I Ea. I Total
❑ Addition /alteration /replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection;
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
- and 2- family dwelling _ ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: q 3 1 D 5 , \_,,7 . E -r
Catch basin or area drain 16.60
City/State /ZIP: _1 -� U� l ,,,.� �-_ 1 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street /d to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. Jinear ft,: _ ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: Lot no.: _
' Fixture or item
Tax map /parcel no.: Absorption valve 16.60 -
DESCRIPTION OF WORK
Backflow preventer Page 2
e r \'E I1_ c-1,l 3 � --\ l - Backwater valve / 16.60
Clothes washer 16.60
Dishwasher 16.60
.EKROPERTY OWNER 1 ❑ TENANT Drinking fountain 16.60
Name: Ejectors/sump 16.60
�-D.a 1 Un ryy-Ot S c� Expansion tank 16.60
Address: 3 3 a S , c = l�� - Fixture/sewer cap 16.60
City/State/ZIP:' V\ ty-o ` GL • ce ,k Floor drain/floor sink /hub 16.60
Phone: (.,q3) . ). (0 -T31 S k Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
_APPLICANT ❑ CONTACT PERSON
' Ice maker 16.60
Business name: A \, `\-- A l pe. �.
l°ttt -� Interceptor /grease trap 16.60
Contact name: e2 4e_tZ� Medical gas (value: $ ) Page 2
'
Address: -e . c , e,./7c .MS- Primer 16.60
City /State /ZIP. Gt Y t. i6\-A n t::=3 , 9 - - 6 lc- Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: (a 4 U _ - 33 Fax:: ( S - O to �
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: " e }..-;, 5 6L1Jb■. Water heater 16:60
Address: Other:
City /State /ZIP: Subtotal
Minimum permit fee: $72.50
Phone: ( ) r Fax: (aS ) 5, 8 ,_ �'}c, ,s Residential backflow minimum permit fee: $36.25 -3‘,,a5 CCB Lie.: o `6. Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized iigrta4 + � State surcharge (8% of permit fee) 2
i TOTAL PERMIT FEE ' i� 5
Print name: 12 c L,C�� S`�C2 Date: a$1o� This permit application expires if a permit is not obtaincwi within
l 180 days after it has been accepted as complete.
•
*Fee methodology set by Tri- County Building Industry Service Board.
C!T OF TIGARD , ��-
BI�IL lVG DIVISION +� PERMIT #: 2OC3 — 0 D3 (15
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Ipi
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 9 , / CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - 3 0 ki Pour Time:
Code # Ins ect'on Descri do Confirm # Contact # Message
3 `, 9
A- b `7 0 77
Corrections /Comments/ Instructions:
e
•
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FA L n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0/ C_ ' `� Date: /3/z Phone #: (503) 718-
•
CIT ,,OF TIGARD „ r"-') , 4
Bi ILD NG DIVISION ,.� , - PERMIT #: PLMO()!rf03,
13. —5 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: aft/2006
Phone: (503) 639 -4171 liPlA 'Ii
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2J9/2006 TIME: 7 :01AM PAGE: ' , c ,
SITE ADDRESS: 09332 SW HOME ST CLASS OF WORK:
SUBDIVISION: KESSLER ESTATES LOT #: 010 TYPE OF USE:
PROJECT NAME: MORSE
DESCRIPTION: Irrigation bai;
OWNER: MORSE, LANDON PHONE #: 503,969.0166
CONTRACTOR: ALL NATURAL LANDSCAPE LLC PHONE #: • 503 - 710.0862
Inspection Request Scheduled For: Date: 202006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 026439 -01 503-740-7733 N
Corrections /Comments /Instructions:
1 .T z v i7 % i f S L.) C,' /T F c i R■ i---tol1/4/ p rz / TI L A/
4 s Elute -`/ PZ.7o, -Z
z) t�l '0 vi6 r 2c& UJ,ca-- b c,- f'' T'�' al Gi F= I,c, -- , /
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S.) r r o.k// ' K e & u o 2 C % b C . /. C /1 C PCB ! Aisl _c/ 7 o3,/
The plumbing installation defects noted
on this report shall he emrectedand
an Inspection request made within 30
calendar days per OAR 818- 785 -0280
:q • (j ?\, d/f/0 b
PASS / - i RTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ' LF INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � � Date: Phone #: (503) 718 - L /
VI