Permit CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00178
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/2/2007
PARCEL: 2S105DD - 07600
SITE ADDRESS: 13815 SW SANDRIDGE DR ZONING: R - 7
SUBDIVISION: COSTIUC PART /MLP2001 -00005 LOT: 003 JURISDICTION: TIG
PROJECT: GROSS
Project Description: Backflow preventer.
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
MITCHELL GROSS Description Date Amount
13815 SW SANDRIDGE DR..
TIGARD, OR 97223 [PLUMB] Permit Fee 5/2/2007 $36.25
[TAX] 8% State Surcha 5/2/2007 $2.90
Phone : 503-5243303 Total $39.15
Contractor:
CASCADE LANDSCAPE & IRRIGATION INC •
PO BOX 754
SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS
•
Contact # : PRI 503- 625 -4112
FAX 503- 625 -0739
Reg #: LIC 7832
. SUP ALL PHASE &
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: � ;if/ / Permittee Signature: / ?13J ,a / r en
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.
107 14:04 5036250739 CASCADE LANDSCAPE PAGE 01/02
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Plumbing Permit Application r(,i: ()l 1-1t 1. 1.4 11,E ,
City of Tigard f' 01 1001 Received Permit No.: 11 ,,� v .
13125 SW Hall Dlvd., Tigard, OR 97223 Date/3y N _ l - , ��
Pisa Review
• .. E. Phone: 503.639.4171 0���c}1 503 i { � ` ma • Other Penult No.:
, , . Inspection Line: 503.639.4195 �ruW Date Ready/13Y: > ®SaP . 2 for
M . ,r Internet; www.tigar -3r tf flan . a L. •._ . ., , `. "* _ •
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..?;`fin' • r�hi: �) �tA.i. :. .... cS:tti.s�: ..F? Y''� : ✓+ - `K 3 . �� +C�*r�e �. ... � P} t !.: 'i�s� ". t l; .. p} .c. 6�:" „`! - Valk
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❑ New construction ❑ Derl,olition For special information use checklist
Des motion . Qty. I Ea. I Total
❑ Addition/alteration/replacement E l Otlter: back f l o w w , . , . New 1- 2- family dwellings (includes 100 R for each utility connection)
:.. •- , so v • •rivc4At'; r 1, + :'r + ' �y!Yi s a f -,Zee - - N t a ; - ; : ,-,qcs`
?•...:;y ?� a,.. .:1-
.,c. !
_... ' a!'. ... E . `® :,. . , .,,:> ;. r ~c SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath . 350.00
El Accessory building [] Multi - family SFR (3) bath 399.00 • ❑ builder additional bath/kitchen ; .. 45.00
MaSter ® Other: residential
Fin sprinkler (_ sq. R) Page 2
`, .?FB !ix.. ' 4":v x'�4 '�` i` -N;,a ` i' ` ' ;N ' ; w �"�k' g s � "t 'lk Siteatilities •
Job site address: 13$ I S btiv ga nd IC_t d q4. pr ' Catch basin or at ca drain 16.60
City/State/ZIP: { t I � u roI q�� J Drywall, leach line, or trench drain 16.60
r �
Footing drain (no. linear ft.: __) Page 2
Suite/bldg,/apt, no.: [ Project name: Dsa1 13 /
W- m 5
Manufactured home utilities 110.00
Cross street/directions to job site: .
Manholes 16.60
Rain drain connector • • 16.60
-
Sanitary sewer (no. linear ft.: _)_ • Page 2
Storm sewer (no linear ft.: . ) • Page 2
Subdivision: ,Lot no.: Water service (no, linear ft.: 1_ Page 2
Fixture or item
Tax map/parcel no.: qi. 25 (Q 5 D ■ b , 4,.m
. ':g.,:.:x�ti^•h.. � ':-:;.'s;41,`• ;. ^ t �: �,,,� � l-.yr� Absorptionvalvc 16.60
.�', • �•:, t , ,; tr;.?h `a
?•:fitir.il-. . r..'--.
r. ` ° zi ,., �f % c � A• ' e: � • : 4; ) - Backflow preventer / Page 2 N 25
BACK - FLOW Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
c tea. yotc•, .� Drinking fountain 16.60
f 'f i� ice " ^ a i wZA« w E'J l)rs/sump • 16.60
Name: r n L' . (/.f
l (�J �C y� Expansion tank 16.60
Address: I.3 g 15 • Sand 4 I� 1 r d Bird • Fixture/sewor cap : 1660
City/ State/ZIP: �( a rd op-. I . 7a j ' Floor drain/floor sink/hub 16.60
Phone: (503) 53 1,� p Fax: ( ) Garbage disposal 16.60
r; J r. �. •.., .Y•.. �: 3 -.' w •. • .. . s, Hose bib 16.60
-.. w . �, :'?:;LV4 c.• S4+:1;. is %L .. ,, ., X 11 Ice maker 16.60
Business name: CASCADE LANDSCAPE AND IRRIGATION INC
Interceptor/grease trap 16.60
Contact name: RERNIE/LILY Medical gas (value: $ _ ) Page 2
Address: PO BOX 754 Primer 16,60
City/State/ZIP: SHERWOOD, OR 97140 Roof drain (commercial) 16.60
Phone: (503) 625 -4112 I Fax: : (503) 625 -0739 Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: CASCADELANDSCAPE®VERIZON.NET Urinal 16.60
c ' Y ^ t -s r+ ':T' y "� ^
'. ' " tea . ``e f • ' 1 :' c,+ ...k..^ :sc i ..b ` : ` ..' , ... _ . v .. . . 'i . . . , • Water clos 16.60
Business name: CASCADE LANDSCAPE AND IRRIGATION INC Water heater 16.60
Address: PO BOX 754
Subtotal
City / State/ZIP: SHERWOOD, OR 97140 Minimum permit fee: $72.50 3(a9
Phone: (503) 625 -4112 Fax: (503) 625-0739 Residential back low permit fee: $36,25
CCB Lic.: 7832 p � � �, �j� Plumbing Lic. no.:
Plan review (25% of permit fee)
Authorized signature:
�� rP tijt/r% r/, 1t >� State surcharge TOTAL PERMIT FEE Z ' .
- �1.i5
Print name: BERNARDO BRAVO 1 Date: 1 I ( 0j 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 • ice Board.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00178
13125 SW Hall Blvd., Tigard, OR 97223 i DATE ISSUED: 5/2/2007
Phone: (503) 639 -4171 relit
Inspection Requests (24 Hrs.): (503) 639 -
INSPECTION WORKSHEET FOR DATE: 6/18/2007 TIME: 7:02AM PAGE: 57
SITE ADDRESS: 13815 SW SANDRIDGE DR CLASS OF WORK:
SUBDIVISION: COSTIUC PART/MLP2001 -00005 LOT #: 003 TYPE OF USE:
PROJECT NAME: GROSS
DESCRIPTION: Back low preventer. '
OWNER: GROSS, MITCHELL PHONE #: 603-524-3303
CONTRACTOR: CASCADE LANDSCAPE & IRRIGATION INC PHONE #: 503 - 625.4112
Inspection Request Scheduled For: Date: 6/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 048569.01 503-625 -4112 N
Corrections /Comments / Instructions:
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- /Are l ,fin ' __!...- -.- 1 4111 A‘e:-// r
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I ' ° S PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / 7 j ( Date: 4y6 Phone #: (503) 718
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