Permit `' a CITY . OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00162
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/18/2008
PARCEL: 1 S125CD -09100
SITE ADDRESS: 07502 SW RED CEDAR WAY ZONING: R-4.5
SUBDIVISION: JACKSON WOODS LOT: 006 JURISDICTION: TIG
PROJECT: RAINBOLT
Project Description: Installing backflow preventer.
CLASS OF WORK: ALT 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
KEN & CARO RAINBOLT
7502 SW RED CEDAR WAY Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 4/18/2008 $36.25
[TAX] 12% State Surch 4/18/2008 $4.35
Phone : 503- 683 -4745 Total $40.60
Contractor:
GROWCO LANDSCAPING
164 HARDING BLVD
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS -
Contact # : PRI 503- 655 -5454
FAX 503- 723 -9679
Reg #: LIC 6895
PLM ALL PHASES 8
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 / ittee Signature ca
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.
Apr Ti 08 03:49p Bookkeeper 503.723.9679 p.2
P;lflrlitiiig Permit Appl' c:. �i• tel:
EIVED
Site Utilities APR 1 6 2008 FOR OFFIC . l!Sl: ONLY
City of Tigard Rec eived / � , "_ t�
'� •
Phone: 503.639.4171 I3125 SW Hall Blvd., Tigar�yn TIGA �"
e2 Other Permit No.:
Inspection Line. 503639!
Plan Review
��� 1 N y.
T I G A R D .' IVI S I� Y Date Ready/By: )wis RI See
Internet: www.tigard- or.gov Pege2 for
�totificd/Method: I Sapplemeotel tofarmation
TYPE OF WORK FEE` SCHEDULE
® New construction ❑ Demolition For special Information use checklist
❑ Addition/alteration/replacement ❑ Other: Description I Qty, Ea. Total
New 1- 2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
El I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen
Other:
❑ Master builder ❑ O
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 7502 SW Red Cedar Way Catch basin or area drain 16.60
City /StaterZIF: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60
Suite/bldgJapt. no.: I Project name: �
PA / J (t Footing drain (no. linear ft.: _ Page 2
Cross street/directions to job site: SW Landau St. /"' Manufactured home utilities 1 10.00
Manholes 16.60
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.: Thomas Guiede 655 G1 Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer 1 1 Page 2
Install Back Flow Device Backwater valve 16.60
:nit w 1.0
Dishwasher 16.60
® PROPERTY OWNER I ❑TENANT Drinking fountain 166.660
Name: Ken and Carol Rainbolt
Ejectors /sump 16.60
Expansion tank 16.60
Address: 7502 SW Red Cedar Way Fixture /sewer cap 16.60
City. /State/ZIP: Tigard, OR 97223 Floor drain/floor sink/hub 16.60
Phone: (503)683.4745 Fax: ( ) Garbage disposal 16.60
® APPLICANT ❑ CONTACT' PERSON Hose bib 16.60
Business name: Growco Landscaping, Inc.
Ice maker 16.60
Interceptor /grease trap 16.60
Contact name: Alta ray Medical gas (value: $ ) Page 2
Address: 164 Harding Blvd. Primer 16.60
City /State21P: Orego City, OR 97045 Roof drain (commercial) 16.60
Phone: (503) 6555454 I Fax:: (503) 723.9679 Sink/basin/lavatory 16.60
E -mail: groweolandscaping a@msn.com
Tub /shower /shower pan 16.60
Urinal 16.60
CONTRACTOR Water cl0set 16.60
Business name: Same as above Water heater 16.60
Address: Other: •
City /State/ZIP: Subtotal
Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 36.25
CCB Lie._ 6895 Plumbing Lic. no.: 10497 Plan review (25% of permit fee)
Authorized signature: att /_ State surcharge (12° /n of permit fee) 435
TOTAL PERMIT FEE 40.60
Print name: Alta Ray / Date: 4/16/08 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: IauildIng 'YermaclPLMu.PermilApp.doc 12.'27/06 440.46167(10e2/COMAVEa)
CITY OF TIGARD - -
BUILDING DIVISION • PERMIT #: PLM200B- 00162
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 4t1Er2008
Phone: (503) 639 -4171 u ti, 'l��
Inspection Requests (24 Hrs.): (503) 639 -4175 `__..
INSPECTION WORKSHEET FOR DATE: 4/25/2008 TIME: 7:01AM PAGE: 18
SITE ADDRESS: 07502 SW RED CEDAR WAY CLASS OF WORK:
SUBDIVISION: JACKSON WOODS LOT #: 006 TYPE OF USE:
PROJECT NAME: RAINBOLT
DESCRIPTION: Installing backflow preventer.
OWNER: RAINBOLT, KEN & CAROL, PHONE #: 503 - 5834745
CONTRACTOR: GROWCO LANDSCAPING PHONE #: £03655 - 5464
Inspection Request Scheduled For: Date: 4/25/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3!W Misc. inspection 06890g.01 503.655-5454 N
Corrections/Comments/Instructions:
i eefpd
91..)
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \f"4^^' Date: l 1 241/Oct Phone #: (503) 718