Permit CITY TIGARD PLUMBING PERMIT
I I DEVELOPMENT SERVICES PERMIT #: PLM2005 -00634
�I DATE ISSUED: 11/14/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S133CD-16200
SITE ADDRESS: 11550 SW TALLWOOD DR ZONING: R -
SUBDIVISION: PEBBLECREEK NO. 3 LOT: 052 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: 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
FORES BEAUDRY
115500 SW TALLWOOD Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 11/14/200E $36.25
[TAX] 8% State Surcha 11/14/200E $2.90
Phone : Total $39.15
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS
Phone : 503- 682 -6076
Reg #: LIC 8079
PLM ALL PHASE & BA
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: 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.
,* .
Plumbing Permit p tion Reeei�ed s OFFICE U ON LY
City of Tigard DateBy: // / / o)-'�� Pemut \ \\%,2av7 - 006 s'
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 1
Phone: 503.639.4171 Fax: 503.598.19¢0V 10 2005 4Ltgr "•.1, t y Other Permit No.:
DateB
24 Hour Inspection Line: 503.639.4175 :'
p �Ready/By: Juriq.
Internet: www.ci.hgard.or . us TIGAR �'' 1! s See Page 2 for
Date S
CITY Notified/Method:
pplementalInformation
� <. ,�";�� - F E>J •SG " " -:" �
e rr
4gl New construction ❑ Demolition For special information use checklist.
Description I Qty. Ea. Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
` .° `:_ < -_ ,tea ; „ ,. . , :,∎r A,< -
'7- 4L(�ORY:OF``CQNSTRUCTION '-
� r ,�; . � .n �,, �,������� .� ,�� .. �. ,- , <� ��� „- __ ,=�; � SFR (1) bath 249.20
C 1- 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:
f,.r .p. ;.. <, =..:ter,= -e a;.: ,;
- :;r <YL Fire sprinkler ( sq. ft.) Page 2
:. . JOB"'SI EllVO -
. <: / ; k . _ .- .: -, ATION AND LOCA <TIt -f 4 Site utilities
Job site address: t giQ - Km \ vsyQp 8, Catch basin or area drain 16.60
City /State /ZIP: - ‘ ,„.....10 0 R , cc-kaa3 Drywell, leach line, or trench drain 16.60
Suite/bldg./apt. no.: (Project name: Footing drain (no. linear ft.: ) Page 2
F��S �ect.,...., Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
s k._ Sejr1S*(CS, 'I k .. 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.: ) Page 2
Fixture or item
Tax map /parcel no.:
^ y,;r 41-'''..f0:',.: 16.60 R 3 .m D OF " 'St'I i ,
..uj e . aJA Cfk. - ,,. , r
" "'" ' `' -� Absorption valve
Backflow preventer i Page 2 3(
Backflow for sprinkler system. Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
= 'fi ` PIi yPER., y :iNTIt ; £.`3,' P , - .�s„ ,. �F�:r.W� -- 1 . +-: r , Drinking fountain 16.60
`� °` ,
O T. b�VNER ' �,, � <� -, 0 �ENANT < -.' %`.�y?;r
' , �! j� ... . . ,oF y ,. .�� , .
Ejectors /sump 1 6.60
Name:
Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City /State /ZIP: T i�A -I`D r b Floor drain /floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
r kr "-: - .,.. „F, ., ,,. mss° ... ; <:,.. -z,.. A Hose bib 16.60
,£„r fit. ,>~ ;y,, -, ® i1t'PLICAl • _- :° .,,,,',:„•,•:,;> ` r ' F 2 :14.CONTACT } I?LRSON; 4-,;
-.? .ac Na, a ,. '' - ., ,''•00, ,LAftwd,, ,r,4 . ,,,,,, . ,;. Iee maker
16.60
Business name: ProGrass, Inc.
Interceptor /grease trap 16.60
Contact name: Tons Eberlei Medical gas (value: $ ) Page 2
Address: 29895 SW Kinsman Rd. Primer 16.60
City /State /ZIP: Wilsonville, OR 97070 Roof drain (commercial) 16.60
Sink/basin /lavatory 16.60
Phone: (503) 682.6076 ext 217 Fax: : (503) 682.2872
Tub /shower /shower pan 16.60
E -mail: TomE @ProGrass.com Urinal 16.60
u.. ,;�:s :2 r
: ,,i• ?;zCON'1'12ACTOIit ,,, ,TA, „" �: :
,x"-,! � -� <,ft >„��.��'i•z;_ ,, _ ,..,.<, <.�- �,- A, >r = s��;.; �,6,.<:�r��s�r�,� �.. - . �`�� water c
Wl oset 16.60
Business name: ProGrass, Inc. Water heater 16.60
Address: 29895 SW Kinsman Rd. Other:
City /State /ZIP: Wilsonville, OR 97070 Subtotal
Minimum permit fee: $72.50 .
Phone: (503) 682.6076 ext. 217 Fax: (503) 682.2872 Residential backflow minimum permit fee: $36.25 3 L' .
CCB Lic.: 8079 '---- 2 d6 Plan review (25% of permit fee)
Lic. no.: 25 f i
( p )
State surcharge (8% of permit fee) `,Z ,1�
Authorized sign . TOTAL PERMIT FEE 39 , 15
Print name: Tom Eberlei Date: \` - -5_o5 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 \Building \Permits \PLM- PermvApp.doc 12/03 440- 4616T( I 0 /02 /COM /WEB)
CITY OF ��nn w v�'m nn�m�mnn��
BUILDING DIVISION ~� ' � PERMIT #: PLM2005-006341
13125GVV Hall B|vd.. Tigard, ORQ7223 ' DATE ISSUED: 11/14/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11/I1/2005 TIME: 7: 13AM PAGE: 98
SITE ADDRESS: 11550 SVVTALLWQODDF9 CLASS OF WORK:
SUBDIVISION: PEBBLECREEKM0. 3 LOT #: 053 TYPE OF USE:
PROJECT NAME: BEAUDRY
DESCRIPTION: ilerticfrow preventmrYor irrigation. l
OWNER: BEAUQRT.F()RES PHONE#:
CONTRACTOR: PR0GRA0S LAND8CAPE SERVICES PHONE #: 5O3-882-6076
. Inspection Request Scheduled For: Date: 11/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RFYb@Ckƒ}owp|e/ente[ 021926'01 603-082-6076 N
Corrections/Comments/Instructions:
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I_\- Z-SS I_ PARTIAL APPROVAL n CANCEL 0 NO ACCESS
I I. ��CALLF[�\NSPE�T\ON | ADDITIONAL FEES ASSESSED
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Inspector: O rY\ '' .42
Dote: Phone #: (603) 718-