Permit •
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CITY OFTIGARD PLUMBING PERMIT
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DEVELOPMENT SERVICES PERMIT #: PLM2005 -00393
DATE ISSUED: 8/16/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 112 C D -11400
SITE ADDRESS: 07711 SW ALDER ST ZONING: R -12
SUBDIVISION: HAMBACH GROVE LOT: 012 JURISDICTION: TIG
Project Description: 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
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Owner: FEES
LEGEND HOMES
12755 SW 69TH Description Date Amount
SUITE 100 [PLUMB] Permit Fee 8/16/2005 $36.25
PORTLAND, OR 97223
[TAX] 8% State Surcha 8/16/2005 $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: ` J Permittee Signature: c:2)?
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.
Rug 16 05 08:27a Martin Sander 503 - 647 -9151 p•3 '
Plumbing Permit Application, J 1:OR OF t� 1( i; 1 NI. (r\l.\ �j
City of Tigard AIR] 1. 200 A ,.
Date/ B y: ` O •) Permit No.. . OQ -[/ () 93
Plan Review
13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
Phone: 503.639.4171 Fax 503.598.1960 ,tip a Date/By: Other Permit No_:
24- Hour Inspection Line: 503.639.4175 CITY OF TI GAR:. J ".I Date Ready/By: r °^ El See Page 2 for
Internet: www.cltigard.or.us BUILDING DIVISION Y Notified/Method: 11 (` I Supplemental information
TYPE OF WORK FEE* SCHEDULE
New construction ❑Demolition For special information use cheat
Description [ Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2-family dwellings (includes 100 ft_ for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath I 24920 I
❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building 0 Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder 0 Other: Fire sprinkler ( sq. IL) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: '-'7 -- 7 I. , S t.J ltd Si"Yt:p Catch basin or area drain 16.60 ,
City/State/ZIP: .T f ilia C P, q' Z.2_ L Drywcll, leach line, or trench drain 16.60 1
Suite/bldg./apL no I Project. name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110110
Cross street/directions to job site: -
Manholes 16.60
Rain drain connector 16.60
- Sanitary sewer (no. linear ft.: Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) I Page 2
Subdivision: liarn iCt &III L in-)5Sylnn 1 Lot no.: i .
Tax map/parcel no.: Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
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Backwater valve 16.60
Cl othes washer 16.60
L�F.�1C�.SC[�r� �ri3�si'o n
Dishwasher 16.60
I$. PROPERTY OWNER I El TENANT Drinking fountain 16_60
Ejectors/sump 16.60
lame: 1--e �r d WV" 4 A O -sue . Expansion tank 16.60
Address: 12:1 SS S Le.} ( 9 m i� . c LA e lbtr) FixtuzeiScwer cap 16.60 -
2ity /State/ZlP: p 1 ,-.1_ k r_Lj 0 ( 7 Z Floor drain/floor sink/hub 16.60
'hone: 15 ( 20 - go g) Fax- (6 59g - g 1 Garbage disposal 16.60
tig APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
3usiness name: (L 4 c--t-Nn �l y(1C�'t d !� { f' - Interceptor /grease trap 16.60 ' .
i n� ,! t1
:ontact name: [v} ex vc -(-0.,.‘ a nac,„r--, Medical gas (value: $ ) Page 2
tddness: ( () . f.,-> 3 Primer 16.60
:ity /Sfate/ZIP: tQ O � 9 1 3 Roof drain (commercial) 16.60
1��'1� � Sink/basin/lavatory 16.60
home: (.5 ) ti, L17 - s 5 v 1 Fax :: ( y? - 775-/ Tub/shower /shower pan 16.60
-mail: Urinal 16.60
CONTRACTOR Water closet 16.60
•usiness name: MA. v 1L a ,c4-, , .,--r� 62 ✓DC /3Ta Water heater 16.60
ddress: P. D , 6 a x 37:) -7 Other:
Subtotal
ity/SIatrJIIP r ( � /� c�-7
N U Y ��n I (cc_ - (Ji / i- 12) Minimum permit fee: $72.50
hone: (5Q& ( - 1 - �$ (, - ) Fax: (j0)) ({, ( -7 9 , 5 / Residential backflow minimum permit fee: $36:5
CB Lie.: 5 L Z Plumbing Lic. no.:
Plan review (25% of permit fee)•
uthorized signature: State surcharge (8 °/n of permit fee)
:��* g.- TOTAL PERMIT FEE 5
Tint name: 1A/1 G Lr' /ti [ L_ , ,1,,:_,--; _ Date: /�, (.) This permit Application expires if a permit is not obtained within
c 180 days after it has been accepted as complete.
. *Fee methodoloevset by Tri- Counts' Building Industry Service Board.
3 9./5
a
CITY TIGARD
BUILDING DIVISION PERMIT #: PLM200 00393
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: $/16/005
Phone: (503) 639-4171 $1 l�'�I�
' Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 0!18/2005 TIME: 7 :06AM PAGE: 108
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1 SITE ADD' ESS: 07711 SW ALDER ST CLASS OF WORK:
\ SUBDIVIS 'N: HAMBACH GROVE LOT #: 012 TYPE OF USE:
PROJECT NAM . HAMBACH GROVE
DESCRIPTION: 6 ckflovr preventer for irrigation.
OWNER: LEG D HOMES, PHONE #: 503-620 -8080
CONTRACTOR: MARTI -.ANDERS GROUNDS MAINTEN PHONE #: 503 - 647 - 5567
Inspection Request Scheduled For. Date: 8/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RP/backf low preventer 013746 -07 503-20.5346 N
Corrections /Comments / Instructions:
A PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 60 Date: 11 1`i0b Phone #: (503) 718-