Permit .� CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00087
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/4/2008
PARCEL: 2S 112CC -19800
SITE ADDRESS: 15744 SW 81ST AVE ZONING: R -12
SUBDIVISION: GAGE FOREST LOT: 005 JURISDICTION: TIG
PROJECT: GAGE FOREST
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
TIMBERLAND HOMES INC
12670 SW 68TH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 3/4/2008 $36.25
[TAX] 12% State Surch 3/4/2008 $4.35
Phone : 503- 620 -8860 Total $40.60
Contractor:
HERITAGE LANDSCAPE GARDENING
11709 SE WOOD AVENUE
MILWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 - 317 -7152
FAX 503- 794 -8619
Reg #: PLM 6963
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: i mittee 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.
Mar 04 08 12:43p Stephan 5037948619 p.1 ..
-- Plumbing Permit Applientionk EC E I V E • • . .
• Building Fixtures F OR o1•Fit t 5t•: O\i,1
City of Tigard MAR - 4 2008 n Rastved
.:. :. • � • Pennit.Ata�: / 1 a ' 7 7
N..._. 13125 SW Hall Blvd., Tigard, OR 97223 .
111 Phone: 503.639.4171 Fax: 503596 0 Man OtherPeunit Na:
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.," , ,,,,, won Line: 503.639.4175 G l T OF TIGARD Bale Rerely/BY: : , El See Page for
2
Internet vww.ugard -o:gov BUILDING DI A/1010 N°� Supplemental tn �n
Fo spedatfn
oxli:
TYPE .OP'W
is use
New construction ❑ Demolition - DPI - I Qty. � Ea Total
New 1 -2- family dwellings (includes 100 IL for each utility connection)
❑ Addition/alteration/replacement ❑ Other SFR (1) bath 24920
' • ` . ` : , :. CATEGORY OF CONSTRUCTION ' SFR ( bath 350.0
pri- and 2- family dwelling ❑ Comnnercialfindustrial SFR (3) bath 399.00
❑ Accessory building ❑ Multi-family
additional bath/kitchen 45.00
Fire sprinkler (_- sq. . ft.) Page 2
❑ Master builder ❑ Other: Site utilities
JOB SITE INFORMATION AND.. LOCATION basin or area drain 16.60
. Catch
Job site address: t S •7 . y S k S i 1.1- ! 'e. Drywef, leach line, or trench drain - 16.60
' City/State/ZIP: -r, t va 1 . �l a drain (no• linear ft: __) Page 2 ,
SuiteJbidgfapt. no.: I Project name:
Manufactured home utilities ] 10.00 •
Manholes 16.60
Cross street/directions to job site: Rain drain convector 16.60
. , Sanitary sewer (no. linear !t: _) . - Page 2
• Storm sewer (no. linear ft.: ) Page 2
•
Water service (no. linear IL: 1 Page 2
• Subdivision: i u f �-I- I Lot no.: �j Fixture or item
Absorption valve • 16.60
Tax map/parcel no.: Backflow preventer - i Pa 2 3� :
DESCRIPTION OF WORK-
Backwater valve 16.60 .
/ ^A$-*/ /// h.g / .G tf ,/Z ye ✓ Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
EJedors/sump 16.60
PROPERTY OWNER . ❑ TENANT Expansion tank 16.60
• Name: MRE.r t -A : Her► Ea /.10- Fixtur !sewer cap 16.60
6 y
Address: i "2 O S C-) & S ""+ 7 �. Floor drain/floor sinlc/bub 16.60
City/State/ZIP: j; .0 oz. 91 z^ 2 3 Garbage disposal 16.60
Phone: (S 0 . 1) a 2-0 - e 4 "i. o Fax: (. e Sq g - q e g 1 Hasa bib 16.60
Ice maker -
60
Cl APPLICANT - ❑CONTACT PERSON : Interceptor/grease 16 nap 16,60
Business name: , F.Li 1 nT t' T e C
f ►`� f _ 4 ., A ns �1r- T %).S i . Medical gas (value: s ) . Page 2
Contact name: Slz a,i 3 iC.n�,3' , ' • Primer _ 16.60
Address f E ° i 01 s F._ t rni1 Attic Roof drain (commercial) 16.60
C i t y / S t a t e f Z I P : ill , 1, .k A "ic. E 01?-.• 4 ) 72-_Z_ Sink/basin/lavatory 16.60 Tub/shower/shower pan 16.60
Phone: (-5o3) 71 i- 8 61 9 I Fax:: ( )
Urinal 16.60
E-mail:
Water closet 16.60
CONTRACTOR water heater 16.60
Business name: S14 yte - RS INF O'JF" Other.
Address: Subtotal
Minimum permit fee: 572.50
City/State/ZIP: '--//? i lop Residential backflow minimum permit fee: $3625 .3b • � �
Phone: ( ) ! E Fax: ( ) Plan review (25% of permit fee)
CCB Lic.: (, Plumbing Lit. no.: State surcharge (12% of permit fee) 1'{ , 3C
Authorized signature: TOTAL PERMIT FEE ' 1.0,W
This peraait application expires ifs permit is not obtained'"' within
Print name: • '" ' .;, f ,r c.,-;:,;,,, Jam v ' . e . . I Date: 31 410 ( 180 days after it has been accepted as complete.
"Fee methodology set by Tri- County Building Industry Service Board.
FEE * .: I
r:lBtatdingWensitiVISIF•AamitAjp lec 12!27/06 440.4616T(1W02/CtlaltWm)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM` 2008 -s X97
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3i4f. G ;S
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 - _
INSPECTION WORKSHEET FOR DATE: 46012 1 TIME: 7:t) AM PAGE: 7
•
SITE ADDRESS: 15744 r.i T Ayr . CLASS OF WORK:
SUBDIVISION: ()AGE r OP ST LOT #: fir TYPE OF USE:
PROJECT NAME: GAGE f.OP'I'S*1
DESCRIPTION: Insiging b ciflOin PStfiC;ntef
OWNER: TIMES `LAW: PHONE #: 5 62U CE 60
CONTRACTOR: t IERITAGF, LANDSCAPE: : GARDENING' PHONE #: :. 3.3 i 71 f,7
Inspection Request Scheduled For: Date: .1130/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
PlumL;rl Pn :1 05909c -f) i E03. 137 -9811 : I'
Corrections /Comments /Instructions:
�P I c.t.-17e
Ca ( a ww 1,
•
g PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 1 Date: y l 3 to (o n Phone #: (503) 718-