Permit 44.
CITY TIGARD PLUMBING PERMIT
i , l4`a DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PERMIT #: %500238
DATE ISSUED: 6/3/205
PARCEL: 2S 112CD -10600
SITE ADDRESS: 07817 SW ALDER ST ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 004 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 AVE # 100 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 $39.15
Contractor:
MARTIN SANDERS GROUNDS MAINTEN
PO BOX 307
NORTH PLAINS, OR 97113 REQUIRED ITEMS AND REPORTS
Phone : 503- 647 -5567
Reg #: LIC 5742
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature:
y� �' �- >7,C�i��
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jun 02 05 12:53p Martin Saber 503 -847 -9151 p.2
1 ... , , ,A.4 , .vv'I AO. AO IAA JVJJdO1000 � A '-Ili V! 11VZUU1 1(eiUU1
Plumbing Pervit Application?, 2 05 F u1: or,-.(F.- 1- s r cr 1.1
s
City of Tigard T 1GI\ Ezceivea _ 7 -rt �Q Pom>ir r>o �p
13123 SW Hal! Blvd., Tigard, OR 97273 Q\ 0 � DI� \s Plan �ed8 i / (/ � �" �, �U.� � q �J 1J
Phone: 503.639.4171 Fax 503.59$ ' ,� _1960 G ,�' Other Pennitrra. � 1 7 A y f ""
24- Hour Inspection Line: 503.639.41755u `'" -11,1; , i � J ` ' Mc c Rc a, ,,: / � {
Interneww.ci.tigaerd.or w •
Internet w ' I
e i+ r 1 =_ : r.� >,• •+.,R'.;1., � i: ._ NOtiGed!j1�o dD� � I tJ . n •..... { . _ ..�._ _
S .ep,.+s
neea larw�waoon
N w cdon 0 DcnwlitSon Forted inforasodoo we dtea st
❑ Adtuaoouhlkzatiwiteplacement 0 � N e w 1 -t on I Qtr. I E. I neat! _
New 1-2-family dt4dllmg (includes 100 ft. for each lxliry connection)
.- -L #EE-erzw:gv_7 a
�" �� ,;• , �. - ,:� - gl am ' _ O + 9.20
1. - - `2 'j°i _ �, � �h a } 'r - a-1 :! �= i' rl� • .: 4 .tf••: �` SFR 1 ttilb Z
. 1- and 2.-Sm17y dwelling 0 Coamucial/iadUSRial S> ( bath . 350.00
Q Accessory building 0 Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
0 Master builder 0 Other
]5$"r` . .� Fire sprinkler( co. ft.) Pab'e2
1Pfiliifil i! .,. ) =1 -10:410, ' ' ?' ' - ..a.1:-:,1-4 , .= site.Witis
Job site address: 7 'r 7 S iv / tS e t- I Catch basin or area chitin 16.60
aty/Stzi 77:5a r / ) t2/' 2- y Urywell. )each line, or trench drain 16.60
1 Fooling drain (no. linear 1L. _� Page 2
SuitedbldgJapt. no.: I Projectnmx: HA 6 tR� ff e 20cenVT Footing &s .linea IL: 110.00
Cross strcct/directions mirk site
M::thol s 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear f ___) Page 2
Storm sewer (no. linear ft.: ) Page 2
-
Subdivision: /P( . f f ,� L am' / kG l Lot no.: / Watt service (no. linear ft.: ) Page 2
Fixture or item
Tax map/parcel no.:
Absorption valve j 16.60
bi -.� i... t. a i IiQA1 - ell S': ftil y -E • % - " '' 1 - Baekflow Prevent= ��es I'd .- r��"tCi) / Pate 2 _ .Z� •
/ Ar ; - P te' / /Q '/ 6r1 - ? 1777'V Backwater valve ` ' 16.60
Clothes washer 16.60
Oishwashcr 16.60
.Y CSi. -! ' -,- , ....
. , ,^= .-i ;°;`' . _ s¢K� `. - 11.:R i7 = • • : 1's+rr " ' L 'te.,: F_ y =. -r =' Drinking ibu Lain 16..60
:1.11. r.;';.='.:'-j...'• .. .a- . :•Zl:.: t .. 'f41, - �Y: :1 r4 � err < . . - • P. ` tei4'
L � E)eciEjectors/sump 16.60
Name:
�T A O J ' S Expansion tank 16.60
Address: /2-, - S 5 (.&) 6o / Tf-, .11 V / . • Fixtoreisewer cap 16.60
City/Slate/MP: :5q r _c 0 C t - 7 '27.- Floor drsinrtloor sink/hub 16.60
Phone: (_9-3) C77�J - < 0 KO I Fax: (S a ) S9 S - 00 bamrbagc disposal 16.60 -
' >r� `: '' r • g . = � ► . •.4 Hose bib 16.60
'K iT ir .46 , 1 tIV i •:�.:.1 .i.P...:' Tee maker 16.60
liMinessnimc; 1-leu \V\ Se. r\AQ - 6 Ibt As 1 &N\t . bacrceptor /grease crap 1660
Cotstact name: i\ !• -t Medical as (value: S ) Pays 2
Address: P. 0 a JX , U`, Primer 16.60
City/Stated '\ 1 ■.t1,-. e 'IN(N S. ale---- 4 9 '7 )3_ Roof drain (commercial) . 16.60
Sink/basin/lavatory 16.60 ,
Phone (S 0 3) 0 /7 - ,c5 e, 7 1 Fax:: (0 ) Tub/shower /shower pan 16.60
E -mail:
.rt.il -.tt r._.-...N,- . r;.'. Urinal 16.60 • :V-9 .-= ,?7i.--'1: ?7i.--'1: 'I Ii.' 4 "• : -:j;:i '.:4. efifft- ZT' L.v�U' v.iri f!. :• " :ii"._ i `..... < •54 :CI Watercloact 16.60
ansinessname et, t)Y) ,c`L/7G 611.7c/17 Is' HA Water heater 16 0
Address: P. t) 7
Other: •
Subtotal 30 ,-z$
City/State/21P: j i›.,---- e L�.:ir ., i 0 -p__ 97 / 33 Minimum 'remit fee: S72-50
Phone (5(,l,) C(17- 5 5 ( U 7 Fax: (_S i.) tv `t 7 - ylsi Residential bar-know minimum pant fee: 536.25
., CCB Lie.: s 7 yZ Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized slgtlata c: � � State surcharge TOTAL PERMIT fen)
�s � '��-�v�/ f] � 1r4TAl. PERMIT FEE .3� , I S
, Print : Z-•- t ! � L< h e -fC l Dent 6 '. /- ()S 1 T ATS permit application expires if is perrn:t Is not obtained within
lee days after it des bow accepted as complete.
*Fee methodology set by Tri- County Building Industry Service &card.
is1 11u164 12103 a4o•.ath6r(etinatCOM/waa)