Permit t .', , , , CITY OF -
•
s r �,,, PLUMBING PERMIT
°' PERMIT #: PLM2007 -00197 • COMMUNITY DEVELOPMENT
,...,„,4 DATE ISSUED: 5/17/2007
Atd R13 �", 13125 SW Hall Blvd., Tigard, OR 97223 503
�. x. PARCEL: 2S109AA; 04800
SITE ADDRESS: 14225 SW 128TH PL ZONING: R -7
• SUBDIVISION: ELK HORN RIDGE ESTATES LOT: 014 JURISDICTION: TIG
PROJECT: WILEY
Project Description: Install residential backflow prevention device 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
MARK WILEY
14225 SW CARLIN BLVD Description Date Amount
TIGARD, OR 97224 [TAX] 8% State Surcha 5/17/2007 $2.90
[PLUMB] Permit Fee 5/17/2007 $36.25
Phone : Total $39.15
Contractor:
TRIPLE "T" LANDSCAPE AND t 3
MAINTENANCE )13
PO BOX 70 REQUIRED ITEMS AND REPORTS
LAFAYETTE, OR 97127 . ' • 8
,..,,,.
II
Contact # : PRI 864 -4084 � , r�
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Reg #: LIC 6380 (�, f /�y
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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.
Issu By: 3 d Permittee Sign e , � - moo �C.`,.,
• 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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: pct 0/97 REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection Description PASS Date By ✓ Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing _ 120 Electrical rough -in
805 MFG- Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or healing unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall _
250 Roof nailing - ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG - Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final _ 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab
910 Sprinkler rough -in PLM - Plumbing Permit
915 Fire alarm rough -in 305 Plumbing underslab
310 Crawl drain
920 Suppression trip test
315 Post /beam plumbing
995 Misc. inspection:
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
_ 205 Footing y 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
- 499 Final inspection 599 Final inspection
I: \Building \Forms \InspCard- AOP- Blank.doc 02/02/07
CITY OF TIGARD P1,1-I ?, ? - Da Ig'7
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 - a , me , lp�ypi i
In Requests (24 Hrs.): (503) 639 -4175 .. __..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: I "i l P CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: PHONE #:
OWNER: .T CONTRACTOR: 1 ' f l %. �` PHONE #: I. 4 1
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Commen s /Instructions: • d
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00197
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/17/2007
Phone: (503) 639 -4171 40 p+ll l l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/23/2007 TIME: 7:00AM PAGE: 71
SITE ADDRESS: 14225 SW 128TH PL CLASS OF WORK:
SUBDIVISION: ELK HORN RIDGE ESTATES LOT #: 014 TYPE OF USE:
PROJECT NAME: WILE.Y
DESCRIPTION: Install residential bacld'lo+nr prevention device for irrigation.
OWNER: WILEY, MARK PHONE #:
CONTRACTOR: TRIPLET' LANDSCAPE CONSTRUCTION PHONE #: 503.581 -7507
Inspection Request Scheduled For: Date: 5/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 048870 -01 503 - 518.9837 N
Corrections /Comments /Instructions:
% _. off i •
n PASS VI_P/RTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL n CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: i ) 1�' Date: -5 b - ,)1!/ I Phone #: (503) 718 - `l Y/
CITY OF TIGARD L4-,(
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 uaBgMu411141
Inspection Requests (24 Hrs.): (503) 639- 4175'��
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: L Aac\Arer.s . S CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
w • S 4e S ' PHONE #:
ONTRACTO TOR: d L- 1 PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections/Comments/Instructions: C PLI-47,00(p p� C 1 c 0 b iJ r'CJ" O& Q -A. IN . - 0 0 i 1 "1 S /
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❑ CANCEL �I NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
'G CITY OF �I��® PLUMBING PERMIT
Y V
'' ' ` COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00197
v DATE ISSUED: 5/17/2007
PTIGAR D, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 109AA - 04800
SITE ADDRESS: 14225 SW 128TH PL ZONING: R -
SUBDIVISION: ELK HORN RIDGE ESTATES LOT: 014 JURISDICTION: TIG
PROJECT: WILEY
Project Description: Install residential backflow prevention device 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
MARK WILEY
14225 SW CARLIN BLVD Description Date Amount
TIGARD, OR 97224 [TAX] 8% State Surcha 5/17/2007 $2.90
[PLUMB] Permit Fee 5/17/2007 $36.25
Phone : Total $39.15
Contractor:
e0ki 2uc T/D&v 1
TRIPLE "T" LANDSCAPE AND
MAl T E N N G E 2 0 4 6w a / t a y ,J 4 '
X7e �i ��. ero,. '/ a . 2 REQUIRED ITEMS AND REPORTS
ETTr , 0R 9 1 - ✓ 77e02
! I L /
Contact # : PRI 864 -4084
Reg #: LIC 6380
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.
/ /i / Permittee Sign- • j
■11.".-- MIENIP
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.
1 ..
g. Application - d� `j`� )lit 1(i r !I',l ZI�Y()\I 1'r ,' :
WI4 3��r, ti 1',
Plumbing Permit � t
`r 5' Received
�* Ci o f Ti
Permit No.: 4 , y � �/ 9
Date/By: / 7 a 7 N/ pw l obi
7
p r a 131 25 SW Hall Blvd., Tigard, OR 97223 Plan Review
t` 9 Phone: 503.639.4171 Fax: 503.598.1960
Date /By: Other Permit No.:
TIC ,D Y 4 Inspection Line: 503.639.4175 Date Read B y See Pa e 2 for
AK
.. ci,r.a:...vm Internet: www.tigard - or.gov Notified/Method: Suppkmentat Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. 1 Ea. 1 Total
E ' Addition/alteration/replacement ❑ Other: New 1- 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
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: /4/,77,5 c.J) /28 -1)4 'Lace Catch basin or area drain 16.60
City/State /ZIP: 77 /ary: DZ. 9722y. Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: J Project name: Footing drain (no. linear 11.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Au/L //r• i ev e T
Manholes 16.60
GI"l°t7) - (r,-. Ld 1"
Dr, i hT o/) n n s
] �i I Rain drain connector 16.60
1,T l 0 d 12 7-/9 / , efi £ of 5'7iz _ __ f Sanitary sewer (no. linear ft.: ) Page 2
7 i_ , I B f Storm sewer (no. linear ft.: ) Page 2
Subdivision: k i7iei / fidj(e �' r 7 e s I Lot no.: Water service (no. linear ft.: ) Page 2
S / d' 7 J G9 -A D�1 g0 Fixture or item
Tax map/parcel no.: Absorption valve 16.60
_. / DESCRIPTION OF WORK Backflow preventer / Page 2 27, SS
n
lC.. id / Al '/4 h2 °(�,'f o&) /�( 9i - fe : Backwater valve 16.60
0 ' .icy /P1 i I ' ii Ne � a C y Clothes washer 16.60
/ y J / Dishwasher 16.60
PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
/ Ejectors/sump 16.60
Name: Gl /Z ��! C
1 Expansion tank 16.60
Address: / y2_2,5 5 /,V 128TH Place Fixture/sewer cap 16.60
City/ State/ZIP: 2 j j am 0,, 9722 Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
. ❑ APPLICANT CONTACT PERSON Hose bib 16.60
/ ,, //J/ Ice maker 16.60
Business name: Tie /!'LC 7 Lar1 o$a e eOr) s r. o/7 Interceptor /grease trap 16.60
Contact name: F 27 /)-ep� [ es Medical gas (value: $ ) Page 2
Address: 2a 3 (p 5W rL 11 0 is t o p Primer 16.60
City/State/ZIP: 13 P `ji-) 0E g Vor/) Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: (42�) 5Q/ _ 7597 I Fax: : ( 5 0 3 ) 5 q/ -759'7 Tub/shower /shower pan 16.60
E -mail: eo ieS Pi 0 /f7 5/) -, ea/r Urinal 16.60
r f � CONTRACTOR / �,� - Water closet 16.60
Business name: 7 / n lC 7 La „ d sea e CY 1,r� 'l io Water heater 16.60
Address: ZO.34, S 5 0 e� `I N &Ord Other:
ty eaverTod✓ Dc '77 do Subtotal 27,
Ci / State/ZIP:
Minimum permit fee: $72.50
Phone: (.6/A) 5 q 1 ._ 4, Fax: (5 q 1- 75 q7 Residential backflow minimum permit fee: $36.25 34, ZS
CCB Lic.: / (D t ' I - , ath , 380 Plumbing Lic. no.: 4/ 6 Plan review (25% of permit fee)
State surcharge (8% perm
8% of permit fee)
Authorized signature: ' J5 , o ,
r �L∎ / TOTAL PERMIT FEE f
Print name: / - L 0 S/D I V/ e tc Date: 5 j / ,'"7 This permit application expires if a permit is not obtained within
/ 180 days after it has been accepted as complete.