Permit C ITY OF TIGARD PLUMBING PERMIT
.1 ''° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00414
TIGARD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/24/2008
PARCEL: 1 S125DB -03200
SITE ADDRESS: 09342 SW 74TH AVE ZONING: R - 4.5
SUBDIVISION: BOULEVARD HEIGHTS LOT: 015 JURISDICTION: TIG
PROJECT: DENNY
Project Description: Installation of residential 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
TOM & MAUR DENNY
9340 SW 74TH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 10/24/200E $36.25
[TAX] 12% State Surch 10/24/200E $4.35
Phone : 503 -544 -4733 Total $40.60
Contractor:
REDWOOD LANE NURSERY
8222 BROADACRES RD
WOODBURN, OR 97071 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 678 -3242
FAX 503- 678 -3252
Reg #: LIC 7009
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 N• • • - - -nter. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
thes- ules or direct q : sti• • „ OUNC by calling 503.246.6699 or 1.800.332.2344.
Is - ued By: , 4 j ,, ' 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 Application
Building Fixtures ��: 4 ag._ y oll t t ,o r l,1, ;,, T01 � f ,�
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t '' CI Of T I and Received /� � �j Permit No.: ,
rr ii:A08, a g DateBy: It! p\ OO G// ' /f w ih• " a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
''.;.. 7 .'; Phone: 503.639.4171 Fax: 503.598.1960 Date/By Other Permit No.:
''' Inspection Line: 503.639.4175
rl X li 1 (, Di Date ReadyBy: / � 0 See Page 2 for
.,.r,,4,,0 , ,,,A , Internet: www.tigard or.gov Notified/Method: (i Supplemental Information
TYPE OF WORK FEE* SCHEDULE
•
® New construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 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
❑ 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: 9342 SW 74 Ave. Catch basin or area drain 16.60
City/State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Cedarcrest
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: 1 Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer x Page 2 40.60
Irrigation Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
• ® PROPERTY OWNER I Drinking fountain 16.60
❑ TENANT
• Ejectors /sump 16.60
Name: Maureen Denny Expansion tank 16.60
Address: 9342 SW 74 Ave Fixture /sewer cap 16.60
City /State/ZIP: Tigard, OR 97223 Floor drain/floor sink/hub 16.60
Phone: (503)544 -4733 Fax: (503- )598 -9081 Garbage disposal 16.60
® APPLICANT ❑ CONTACT PERSON Hose bib 16.60
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: ( ) I Fax :: ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Redwood Lane Water heater 16.60
Address: 8222 Broadacres Road Other:
City /State/ZIP: Woodburn, OR 97071 Subtotal
Minimum permit fee: $72.50 „=_= =T�
Phone: (503) 678 -3242 Fax: (503) 678 -3252 Residential backflow minimum permit fee: $36.25 ' ' i.
CCB Lic.: 7009 Plumbing Lic. no.: Plan review (25% of permit fee) 0,
Authorized signatures State surcharge (12% of permit fee)
TOTAL PERMIT FEE yQ. (pD
Print name: Maureen Denny Date: 10/24/08 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.
1: \ Building \Permits\PLMF- PermitApp.doc 12 /27/06 440- 4616T(10 /02/COM/WEB)
CITY OF TIGARD �Y;
BUILDING DIVISION PERMIT #: =Lh.P(lc ?E 00414
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: �,.
Phone: (503) 639 -4171 ��� ltf /� r1!'%tt
Inspection Requests (24 Hrs.): (503) 639 -4175 ,'.._ "-
INSPECTION WORKSHEET FOR DATE: 10121 /200 TIME :01AM PAGE: 26
SITE ADDRESS: 09 :42 SW 74TH AVE CLASS OF WORK:
SUBDIVISION: BOULEVARD HEIGHTS LOT #: t)i5 TYPE OF USE:
PROJECT NAME: DENNY
DESCRIPTION: Installation of residential b: ckflow presenter for irrigation.
OWNER: DENNY, TOM & MAUREEN PHONE #: 603.544_,/ /33
CONTRACTOR: REDWOOD LANE NURSERY PHONE #: 50(j7247
Inspection Request Scheduled For: Date: .10/20/2018 Pour Time:
Code # Inspection Description Confirm # Contact # Message
309 Plumbing final 077241 -01 503. 6144733. N
Corrections /Comments /Instructions:
_D ..,tc, .__
Coate, r L., A 9 "v
•
j PASS n PARTIAL APPROVAL n CANCEL I I NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CMNA L/ LA ' \ ' _ Date: 1 O IA 10 t) Phone #: (503) 718-
CITY OF '� ^
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��K��U��� DIVISION PERMIT BUILDING ~�"°"~°"~~"" #: PY'kA2008-00114
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1Of24/2008
Phone: (503) 639-4171
Inspection Requests (24Hroj:(5O3)G30'4175 As
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: � 1U/J7/20D8 � 7:ODAN1 � i5
SITE ADDRESS: 09 CLASS DFVVDRK�
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SUBDIVISION: LOT #: TYPE � BOULEVARD HEIGHTS � 015 �
PROJECT NAME: � DENNY
DESCRIPTION: /oV(aUoiioo of residential bankf|mm prwwentmrtur irrigation.
OWNER: DENNY, TOM &IVIAUREEN PHONE #: 503_544-4133
CONTRACTOR: REDWOOD LANE NURSEY PHONE #: r;O�_O7B'-3242
Inspection Request Scheduled For: []ate 10127/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 077201'01 5035M~4733 N
Corrections/Comments/Instructions:
[� ' ��la�� ��4L./�
T e _ ��- � (°.4�b ~^ A '�°n»J' �
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ri PASS �� PARTIAL APPROVAL El CANCEL NO ACCESS
| | FAIL ri CALL FOR INSPECTION 11 ADDITIONAL FEES ASSESSED
Inspector: (3 i V 1 / 4 .i'\°-.-~ Date: 'Cl \2;) | o 7 Phone #: (503) 718-