Permit CITY OF TIGARD
PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: P -00315
DATE ISSUED: 7/14/20014120% 5
=--' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109 BA -08200
SITE ADDRESS: 13634 SW LEAH TERR ZONING: R -7
SUBDIVISION: DAFFODIL HILL LOT: 008 JURISDICTION: TIG
Project Description: Irrigation backflow.
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
GOODLETT MARSHALL BLDG & DEV. Description Date Amount
PO BOX 91551
[PLUMB] Permit Fee 7/14/2005 $36.25
[TAX] 8% State Surchari 7/14/2005 $2.90
Phone : 503 291 - 1881 Total $39.15
Contractor:
CATANDELLA IRRIGATION +
BACKFLOW REQUIRED ITEMS AND REPORTS
5334 SE DEL RIO CT
HILLSBORO, OR 97123
Phone : 356 - 8022
Reg #: PLM 7022
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 d,Q t • uestions to OUNC by
calling 503 - 246 -6•• or 1- 800 - 332 -23 .
Issued By: fie � Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection e at 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.
Building Fixtures
% '
plumbing Permit A plica it � \ • :, FOR OFFI USE ONLY x
City of Tigard I ��� :' DDate/By. I `(I o T.J J ' -o) '/ j4
13125 SW Hall Blvd., Tigard, OR 97223 :)!`l
`1 D Permit �o
Plan Review' 1
Phone: 503.639.4171 Fax: 503.598.1960 //yi�a•Glµ . Other Permit No.:
_ } • I' '
24 -Hour Inspection Line: 503.639.41 &'�°/ ®h TI�tVID :. I '> : DateBy. Y _. Date Ready/By: 7 aris 0 See Page 2 for
Internet: www.ci.tigard.or.us
AIM n9fi1(` ni1/1 lnil Notified/Method: Supplemental information
' TYPE OF WORK - . FEE* SCHEDULE '
New construction ❑ Demolition For s ecial information use checklist.
Description Qty. Ea. Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft for each utility connection)
• " " • CATEGORY OF CONSTRUCTION • .. SFR (1) bath 249.20
><1 and 2- family dwelling ❑ Commercial /industrial SFR (2) bath
.�` 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
LI 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: 1 2 / 3 G,..( e. , ,e..„ --' `" 3 r - Catch basin or area drain 16.60
City /State /ZIP: z Ac,t_. b 0 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: k k Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street /directions to job site: .
Manholes 16.60
1Y' ,I...c.1L.k.) .P� ..J Ac�r or L L -i. ,Rain drain connector 16.60
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 W Backflow preventer X 1 Page 2
----Z, I - -l..- y ArA + t)� 3 floc_ k "(c e. Backwater valve 16.60
! Clothes washer 16.60
Dishwasher 16.60
❑ ; <PROPERTY _,OWNER Drinking fountain 16.60
❑ T)_1VANT
Ejectors /sump 16.60
Name:
Expansion tank . 16.60
Address: Fixture /sewer cap 16.60
City /State /ZIP: Floor drain /floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
, ❑,'APPLICANT Hose bib 1 .60
.. ❑CONTAQT_ PERS _'_ ;_ :
Ice maker . 16.60
Business name:
Interceptor /grease trap 16.60
Contact name. Medical gas (value: $ ) • Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain•(commercial) 16.60
Phone: Sink /basin/lavatory 16.60
( ) Fax::( )
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Cc. e, " "It -f/ rte _ , l , 8 `i / ) Water heater 16.60
Address: J C / c Other:
� Subtotal
City /State /ZIP: j../ I /� b, r t5 0 ? 4 ' 13 Minimum permit fee: $72.50
Phone: ( ) 3 5 <6Z. 7, Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: 7 2,7.. Plumbing Lic. no.: /1/e./19.3 Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature: .
7 e /-____ ir TOTAL PERMIT FEE
Print name: > � Date: �� l�� e�� This permit application expires if a permit is not obtained within
�! 6 ! 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
is \Building\Perm MF- PermitApp.doc 06/05 440- 4616T(10 /02 /COM/WEB)
CITY OF TIGARD (1) S
A' 6 BUILDING DIVISION PERMIT #: PLM2005003i5
13125 SW Hall Blvd., Tigard, OR 97223 ,i' DATE ISSUED: 7/14/2005
Phone: (503) 639 -4171 4����r %p„�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/15/2005 TIME: 7:11AM PAGE: 4
SITE ADDRESS: 13634 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 008 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: Irrigation backflow.
OWNER: GOODLEIT MARSHALL BLDG & DEV., PHONE #: 503.291 -1881
CONTRACTOR: CATANDELLA IRRIGATION + PHONE #: 356 -8022
Inspection Request Scheduled For: Date: 7/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RP /backftow preventer 011531 -01 503 - 515.3804 N
Corrections /Comments/ Instructions:
k ‘El- &-J CS51
°Th g -1--e-S .--- 31(.____ -.3; L1 I •-1 i
C f If"
S- - ❑- PARTIAL - APPROVAL E- CANCEL _F NO
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - Date: -- )/1 \-1 (e—
Phone #: (503) 718-
1