Permit ..
r :.,,,,
. • CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00551
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/13/2007
PARCEL: 2S110DC -90091
SITE ADDRESS: 15655 SW 114TH CT 9 ZONING: R -25
SUBDIVISION: FOUNTAINS AT SUMMERFIELD CONDO LOT: 009 JURISDICTION: TIG
PROJECT: FOUNTAINS AT SUMMERFIELD
Project Description: Backflow preventer for irrigation. Located on corner Summerfield Dr. and 114th, outside of the
brick wall.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SFA 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:
TUBISHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
MARSHALL, MARY RUTH +
GEORGE L JR Description Date Amount
2560 AGATE ST [TAX] 8% State Surcha 12/13/2007 $5.80
EUGENE, OR 97403
[PLUMB] Permit Fee 12/13/2007 $72.50
Phone : • Total $78.30
Contractor:
WILLAMETTE LANDSCAPE SERVICES, INC.
18480 SW PACIFIC DR
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 625 -9600
FAX 503- 625 -9714
Reg #: LIC 6949
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: 9 v 7 - -, , ,,,,a-A cah-----
zed,,,gr.„„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.
P - 12. 2007 10:5OAM WILLAMETTE LANDSCAPE SERVICES No. 0928 P. 6
Plumbing Permit Application R ECE l"ORR cirri(, USE ONLY •
izeeeivteB : fl ed
City of Tigard e ( X1/3 / �1
i � b P e r m i t No? aeV / 7 ` 0551
I v 13125 SW Hall Blvd., Tigard, OR 97223 DEC 1 2 2 1Da, Plaa Review
ll Phone: 503.639.4171 Pax: 503.598.1960 � t
Other Permit No.:
,}�
Inspection Line: 503.639.4175 CITY i p� r'��;r
Da
T t C. r� R r� bate Ready/Hy: ttirig See Page 2 or
Internet www.tigard•or.gov BUILOIRODIUIr*rged/Metbod: y [ � /, y� S y uppplementalIntermetson
TYPE OF WORK . . PEE*' SC E. ' ..
For special information use checklist.
New construction
❑ ❑ Demolition
• Desert tion I lEa I Total
j Addition /alteration /replacement El Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
. CATEGORY O F . CONSTRUCITION' . . SFR (1) bath 249.20
El 1- and 2- family dwelling ❑ Conu nercial/hndustrial SFR (2) bath 350.00
❑ Accessory building l5 ulti - family SFR (3) bath 399.00
El Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft.) Page 2
.019' SITE INFORMATION AND :LOCATION' ' : .. Site utilities
Job site address: 15 5 lea it q Imo, c+ Catch basin or area drain 16.60
City /State/ZEP: Tea t lit a a N Drywell, leach line, or trench drain 16.60
r
r Pr od ct name: Footing drain (no. linear ft.: _) Page 2
Suite /bldg. /apt. no.:
�5 �`iti � - Manufactured home utilities 110.00
Cross street/directions to job site:S , i th, 4.. tI ii •- Manholes 16.60
44...e -. cote- - Pi-. 51,4.,u.4 e 4 Qt' d< I 1 ' 4 "' c"^ Rain drain connector 16.60
1 Q wt S. AL al- 1-Mt.. ka rir,tt t.3c ^.u) Sanitary sewer (no : linear ft.: ) Page 2
Storm sewer (no. linear ft,; ) j Page 2
Subdivision: Lot no.: Water service (no. linear ft.: _ ) I Page 2
Tax map /parcel no.: Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK 00 Backflow preventer l P 2
- 1740.zu f ft .rt,1( L VA 1 ' T efe ka�✓• delArt(. Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
. • Drinking fountain 16.60
.. : :E':PROPERTY OWNER ■TENANT
- Ejectors /sump 16.60
Name: (D, b -- f owv, ( a v}t Cte'V A.c _ 4-) Expansion tank 16.60
Address: L 5 6, os 6 w j,(.4#-. 0. • Pixture/sewer Cap 16.60
Cit /State/Z1P: �' �� _ FIoor drain/floor sink/hub 16.60
Phone; (5v5) 15 a <-1 ' j , Fax: ( ) Garbage disposal 16,60
Hose bib 16.60
Q A1y1?LYCANT 11 CONTACT 1PIERSOIN
. • 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
Sink/basin/lavatory 16,60
Phone: (' ) Fax:: ( )
Tub /shower /shower pen 16.60
E-mail: Urinal 16.60
. ∎' : , ; CONTRACTOR' •
■.... Water closet 16.60
Business name: m11a.,..�4 hl( kety t set„ t'e[.,-, 2- - Water Treater 16.60 _
Address: \{'o si,� 'fi �lv- Omer:
_ Subtotal
/
y am+ t ������ 1 � ' 1„a Minimum permit fee: $72.50
'Phone: (5c3) kx2.5 ,-.. ct & (g p Pax: (5o3) bL c 1 y Residential beckflow minimum permit fee: $36.25 la SO
CCB Lic.: 1 c,[3 'A Foci ii 1 Plumbing Lie. no.: Plan review (25% of permit fee)
r State surcharge (8% of permit fee) 5 '3O
Authorized signature: L f tivizo TOTAL PERMIT FEE `]1 .'3 n
Print name: �Q3(_ emu. i Date:l at ( 1 0 7 This permit application expires if a permit Is not obtained within
• 180 days after it.has been ac cijIed as Complete,
*Fee methodology set by Tri•Counry Building Industry Service Board.
CITY' 'OF TIGARD
BUILDING DIVISION
PERMIT #: PLIVI2007-00551
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12J1312007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 IL
INSPECTION WORKSHEET FOR DATE: 3/24/2008 TIME: 7:00AM PAGE: 33
SITE ADDRESS: 16655 SW 114TH CT 9 CLASS OF WORK:
SUBDIVISION: FOUNTAINS AT SUMMERFIELD COND LOT #: 009 TYPE OF USE:
PROJECT NAME: FOUNTAINS AT SUMMERFIELD
DESCRIPTION: Bacidlow preventer for irrigation. Located on comer Summerfield Dr. and 114th, outside of the brick
wall.
OWNER: MARSHALL, MARY RUTH +, PHONE #:
CONTRACTOR: WILLAMETTE LANDSCAPE SERVICES, INC. PHONE #: 503-625-9600
Inspection Request Scheduled For: Date: 3/24/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 067180-03 503-572-8427 Y
Corrections /Comments/ Instructions:
D e C-91 v
C &Pc-
PASS n PARTIAL APPROVAL 0 CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: 3 12-Ltkp) Phone #: (503) 718-
_ .