Permit 4s
CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00244
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/3/2005
PARCEL: 2S112CD-13500
SITE ADDRESS: 07794 SW ALDER ST ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 033 JURISDICTION: TIG
Project Description: Installation of backflow device.
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
LEGEND HOMES
12755 SW 69TH AVENUE Description Date Amount
PORTLAND, OR 97223 [PLUMB] Permit Fee 6/3/2005 $36.25
[TAX] 8% State Surcha 6/3/2005 $2.90
Phone : 503- 620 -8080 Total $39.15
Contractor:
MARTIN SANDERS GROUNDS MAINTEN
PO BOX 307
NORTH PLAINS, OR 97113 REQUIRED ITEMS AND REPORTS
Phone : 503- 647 -5567
Reg #: LIC 5742
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: - .1(4_,g4 ���� Permittee Signature: -e- (� \0
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.
Jun 03 05 01:44p Martin Sander 503-647-9151 p . 1
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plumbinpennitiOnh r tion FOR iiFt: it: F. 1 •••F il N
City of Tigard
EataiRY: 6 7.1)---761" perrnitseq\145--,42yy
13125 SW Th11 Blvd- ligard„ OR 97223 , nos Review
Phonr 503.639.4171 Fax: 503_59S.l9600 () - . • ', Issuiny: Oder PgraitWo.:
24. Baur Inspection Litre 503.639.4175 •
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tmet www.cil oto igard_onsas ..-■, lik: V - ,..,r rci4....' NadEle04e isod: - 1 - kr innounno iarormSs
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ii New eeztertnection . , 501,1-3 Le DarealitiOn For--frossele v a ono ckeddis' t.
, Descri i l_ptIon QtY. Ea Thud
0 Additiathdtorationhtplaceancal 0 Oda= Pew 1-- 2-faxisly dwellings (includes 100 A. for earls utility connection)
.j .... . . z , : ■-,..: ,-.. 144 . J, s a) bah 249_20
1,1. :-....Z ::: . • • tr.Ortriu." • ...-...... ....0 : E'
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■• 1 - and 2-lktmly dwelling 0 Cosuntercialfindustlial SFR (2) barn . 350.00
SFR (3) bath 399.00
0 Accessory building 0 Multi-faxne1y
Each additional bath/kitchen _. 45.00
0 Master builder 0 Other
Fite speinkler ( . so_ ft) • Plat 7
- Site engines
lob site adders= 2 Ls,/ A 1d' 7- Catch bask or ams shirk
a 16-60
ni/Staterar: 77ja r-c, 0 c- . 7 .-..,' 2- ci Dirndl. knob line, or trench drain 16.60
Suitdbldg.hrpt. no.: 1 Projectnam= I.-/A 6. ,,, H ci1 ,.. Footing drain (oo. ITIMIT ft.: ___„) Page 2
hiarm6mtuted home utilides 110.00
Cross strocilditecriato to job silk
NianbOks 16.60
ship drain connector 16.60
Sankey sewer (no. linear ft.: ______) Page 2
Storm sewer (no, linear ft.: ) Page 2
Subdivision: /.-M.iA,./ia.A-C' „..., e _ 2 „ .. .„-,,„,.._ J Lot no., 3 Poeta service (no. linear R.: .._.) Page 2
Fixture or Itene
Tax map/parcel no.: Absorption vain 16.60
7 :.... - -
I !.. : Z_Iintti iiisaatriksiv7dPirirblkinkfitrVer".:"."' -• il-,;•'"- .
'. -- - Bacillow prevent= (e> o / Pate 2
/ 1 1 - A/D56 - t - P" . / ,2 12( 64- 7 Z>i‘.) Racktemer vahm f 16.60
Clothes washer 16.60
-
Dishwasher 1 16.60
:t /!/,',1- - :r , :'''-'•-' - ' 1 W , l''''..;" , '"' r "• - • . ;'''''''''' 4 ' ; '''' Ejectors/sump ' 16.60
owls 16.60
Address:
/ a 7.5_S 5 1 ‘,<7 77--/ _/11/ , - nature/sewer cap 16.60
Ow/State/ZIP: --
0 c( .--- -2_2_7> Floor drain/00er sialcIbub 16.60
Phone; C9_,S) Gzwii
- < c> KO R (c93) ss:y R - g•c-i 00 Cuoissigx dislmsal 16.60
- • • Rose bib 16.60
:kft-ir:*-VgregitifttelliKA al --€3.4111';■1:- Ice makm I 6.60 .
Business tam= &- f Seis rAQ_cs ( _s -.k.,et-N\ t. Intemitptortgrease trap 1640
Coaract nut= i ..-.4. Medics] gas (value: S ) Pate 2
Address: 47. 0 is .-_-,?< 3 -0-1 Primer 1640
Cit)/StPleIZIP: k c=x--t--1 e , Lac.. INc■ C 0e_ 9 - 7 13e
Roof drain (commerrial) '- 1640
, ,.._ ., Sink/basin/lavatory 16.60
I Fax ( ')US ) L, L i 7 -`•/.5't Tub/showarlshower pan 16.60
E-mail: 1
Urine] 16.60
...• .......1•44-•-" 1_ _.,- ,=`!"',.?: ' ' '.." • • ''' s t . f4.."': '• : • ''"Y"T ."....Crt,11
.--- : - >: , c - : F • W * '',".. - -:: 325 =.1; M:ii i ; WatC7 C1OSct 16
ansine55 namc l '7 y , cet. 6 (13c/71 4- Hi: w.--).-- 16.60
.
_
Address: p . e _... 0 ,„<-- 3 i..-:, -2 Otter: I
Sebietal 3 , -2:
at 1.„D e....,-,---1-1--, e,,.,_ 'Ark "" i e-. IQ- 97 / - Minirrtuni permit fie: S72.50
%et= ( Si23) C L i ( 7 - S.S e2 7 Fix: ( Si ) (e, --i7 - c/f_..S7 Residential backflow minimum =roil Re: S3615
CO3 Lic.: .5 - 7 4 /2_ , Plumbing Lk_ no.: man review (25% of peiu± fee)
State surrinerge (Et% of permit fee) "
Authorized signaturr e/ - ? -- -- ------- - TOTAL PERMIT FEE 3, , /5
Print MUM: "t'llZ ,c ki4e14-c I DIrl 6 / - e7.5 I This permit application capita it per to
pert is wet abashed within
ISO days atter it has lama accepted as complete.
*Fee methodology set by - Uri-County Building industry Service Ros.rd
oroosimurnlontrar.vonaApa.ase run •so-,sleMitutet/COMN/SID)
CITY OF TIGARD , • /�
BUILDING DIVISION / / PERMIT #: PLM2005 -00244
1 13125 SW Hall Blvd., Tigard, OR 97223 � DATE ISSUED: 6/3/2005
Phone: (503) 639 -4171 / �x�nu,�i'p4 ill'
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR • DATE: 7/7/2005 TIME: 7:10AM PAGE: 24
SITE ADDRESS: 07794 SW ALDER ST CLASS OF WORK:
SUBDIVISION: HAMBACH GROVE LOT #: 033 TYPE OF USE:
PROJECT NAME: HAMBACH GROVE
DESCRIPTION: Installation of backflow device.
OWNER: LEGEND HOMES, PHONE #: 503 - 620 -8000
CONTRACTOR: MARTIN SANDERS GROUNDS MAINTEN PHONE #: 503- 647 -5567
Inspection Request Scheduled For: Date: 7/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RP /backflow preventer 010934-01 K,03- 209-5346 N
Corrections /Comments/ Instructions:
•
3 2
rr PASS [ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL i CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: '2 C)-t--- Date: "7 / 7/ Phone #: (503) 718-