Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00222
~ �J I � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/31 /2005
PARCEL: 2S102CD -02714
SITE ADDRESS: 13530 SW ASH AVE ZONING: R -4.5
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT: 026 JURISDICTION: TIG
Project Description: Install residential backflow prevention 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
FRANCISCO SANCHEZ Description Date Amount
13530 SW ASH AVE
TIGARD, OR 97223 [PLUMB] Permit Fee 5/31/2005 $36.25
[TAX] 8% State Surchari 5/31/2005 $2.90
Phone : 503 710 - 7414 Total $39.15
Contractor:
BRUNER PLUMBING
PO BOX 23985 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97281
Phone : 503 624 - 4880
Reg #: LIC 81837
PLM 26 - 445PB
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 1 -001 ough OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calli g 503 - 246 -66 or : I / c32- 234
�� ! Permittee Si nat, e: ,. - 4.;
Iss d By d ♦ // v g _ _,.1.,
Call ..,
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.
FROM : BRUNER I PLUMB I NG FAX NO. : 6242173 May. 27 2005 12:11PM P1
, 6' - - "-.1 T • -- k.
Plumbi Permit Applie akaiC El Vi. - F. ••.,••.,: •z.. ,; , • . • .VOR• OFFICE USE ONLY - ,.. • .. %....-'...*.:',•• -:•-:: ::`,., • I. .
City of Tigard 1 ,',(`Bl' CP7 P5 Prtrrni No .
13125 SW Hall 1:1Ivc1 , Tigard, OR 9722 MAY 2 7 4,1 Pl
11 ' r ..--- ---
an Revitsw
plinmc: 503.6 at
3.4 171 Fax: 503 598 1960 fititt 44 A. De/By
. , Other Pr.nntl NO..
2 Hour Inspection Li "r
Luc 503.639.4175 CITY OF „ ., I ,. 41 Dm,. R eadyrsy: , 5 ,,, i , r E s Page 2 ro
laternet: www.ci.tigard.orus BUILDiNri flItiteate4. „ NotillecillviathOd: if ii Supplemental informn (ton
-..._.
F77 :::: .'.'.-1.;: F.KV,^ SCITEDUI.F.
.: , • • ....
V D New construction 12 Demolition • -• . , For special informayon USE Checklist.
.. , -
..,. • - -.. Descnption I Qty. [ Ea
. V.Zdditionia.lteration/replacemont CI Other: N v v 1- 21a rnily dwellings (includos 1)0 ft. fur tacit utility connectlon) i
..... ... „ -- ;
0•TISIgailillit';i1.1:41:§:ggateliPhilaidii?.P::..A.':;.':'.' SFR (1) bath __249.20
_____
and 2-family dwelling Ej Commercial/industrial SIR (2) bath :350.00
. - „
SFR (3) bath 399,00 :
0 Acce,$sory building EI Multi-family -
,, .„ Each additional bathildtchon 45.00
Master builder 0 Other: __,,-, - 55 Fire sprinkler ( sq. ft.) Page 2
N...iiiii,i1,mi 1.:9 iiN is.0:i- i:iiii.1?),....ii• i•:: iiiyi,i.,•ii v.; i,
fii•ig..i4P .. . __.
1:ii:iiii:ii:,.iiii,i.'4'iii:likiii45.,t-ti:i. ii.....-..;:,.,:1;(rfr:;:....,7-." ..,, • ..P. 1. , ..,...:::1, ■,...- .1 ,:,..` •,;;:.,.,..,,,!':,f:,;.... Site =lilt es ,... i
Job site address: 135 - _ :4 AIL& I - , Catch basin or area dram
- . - -
16.60 I
1 i
City/State/ZIP: i i I i ,„ ( 1 7 -- WD..3 „ _ Drywell, leach line, or trench drain 16.60
.. ,
Footing drain (no. linear ft.: ) Page 2 •
Suite/bldg./apt. no.: PTL)i CC t name: -..einiferttAd..")
Manufactured home utilities I 10.00 .)
Cross street/directions to job site: . _, t_ e..P.-% ' • - . i
e ' . .., .........0 Manholes 16.60
.,_
, -- -
...,.....,__ Rain drain connector 16 60
- ----- ; .
-
Sanitary sewer (no. linear ft.: ) Page 2 1 .
- , ..-.
Storm sewer (nO lint:at' ft.: ) Page 2 1 •
Subdivision Lot Water service (no. linear ft.. _ ) Page 2 I
: no,: -.. .-
•.- ------ - ..-- Fixture or item
Tax map/parcel no.: -. ....--- I I
fz'rvi,,,,:qr i6 i
1-.. giii.4 ".;.S ,
B ac k ,., Absorpt ._..... on valve 16.0
1
:: -,,,,E,.:,.. back now preventer t Page. 2 167,,
--, -
Backwater valve 16.60
. - -
Clothes washer 16.60
- -
- . - -
Dishwasher 16.60 r
Drinking fountain 16.60
.,,,.,..,..:,„,,,,„••,,, ,.....t...„„.. 0. 1r ,, , P''''' l'g.,{i'..),Mfi;anip4,4pri:,:;%1W..,;,:..Z,V34.4.'17,jelt;',..,'''',..:,,,,,,, :=:';.T.';5,..,.7,.1,i,:i''..*:.,,,,.
•••
:::.,,,,!:::,!rge. :T.AA i'0'.1 - Ej 16.60
-„
Name. Al 1 A
-. . • " . - ; • _ Cs iOn tank 16.60
Address: Fixture/sower cap 16.60 •
,...,. -
I City/State/ZIP: ' Floor drain/floor sink/hub I 16.60 i
... .,.....
..... ._.,.., --- I
Phone: 6 7/0 _ 7 / Fax: ( ) Garbage disposal 16.60
1
...,.: ,,:• ft.V1:1 Hose hih
PT,t.•';'T'r:4:, Weq; 011P.1 8:in11 atKiv •
.?".; . ;IT,, - 06:*4'. - :: , : , ,,i,...4.).,-,-..or.L 2 v,'"ii'7....':4 , &,4, 11 - 6.4 ::::..'•-a ,, !': 21 -Yv: , T 5 A , i P Ice makcr 16.60 I
„ -- -
Business name:
Interceptor/grease trap 16.60 1
.....
... - ...„__.
Contact name: Medical gus (value: $ ) Page 2
„
•
Address: - Pfl mcr 16.60
--
_
City/Staie/ZIP: Roof di in (commercial)
- 16.60 ......-
..- ' ...._
Sink/basin/lavatory 16 60 I
Phone! ( ) Fax: , (
--- . * ) - •.'
_ - - - Tub/shower/shower pan 16.60
E-mail; Urinal . t 6.60 .■
-.. . •'- '•';5'..ig116".":P.';•f57•4*W0to:!gas3i.F.4...i:.;05 : • ' . Water closet 16.60 I
..... ., .
I Business name: ... ' - „ A / ' - ili 1 /Ail ,
. L. . , Water heater
' . 1 •
-•i
_ • ••
1 ' --.
I Address: o 6 or4 2' _,, ?fl 3 JO ....._.
__....... ..... 6.60 f -
Subtotal
City/Stare/ZLP: ' o Ne__ArLal - '_3_q1.15
,....... Minimum permit fee: $72.
.. I •
•
Pb.Otle: (5)3 toa y g . (-) Fax: ED-a ( ,..„//7 ,....„ Residential backflow minimum permit fee• S 36.2 '± 6 .
CCB Lie. ... <- 7 - Plurnbing Lie. tioa 4.44,4 se _b i piarrrevicw (25% of permic fee)
_ ,...
.- State surcharge (8% of permit fee) 1
Authorized signature: ...-- .. - __,-
- TOTAL PERMIT P120 ' 3, ..„941.-
Pnnt name: A It I 1.: (A, ne-r- Ti, Date: 1 -.. 05 This permit application expires if a permit is not outained vv1thin
- 180 days after it luiS been accepted as complete.
*Fee methodology set by - in-County Building Industry Service Board,
..‘EttiOding\Permics\PL.M-FtsrmitAop cloc 12)01 440.46167( 1 °in/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: PLM2006 -00222
Phone: (503) 639 -4171 5/31/2005
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
6/1/2006 7:16AM 46
•
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 13630 SW ASH AVE LOT #: TYPE OF USE:
PROJECT NAME: FREMNGS ORCHARD TRACTS 026
DESCRIPTION: SANCHEZ
Install residential backflow prevention device.
OWNER: PHONE #:
CONTRACTOR: SANCHEZ, FRANCISCO PHONE #: 603.710 -7414
BRUNER PLUMBING 503- 624 -4880
Inspection Request Scheduled For: Date: Pour Time:
6/1/2005
Code # Inspection Description Confirm # Contact # Message
325 RP /backflowr preventer 008079 -01 503.624 -4880 N
Corrections /Comments / Instructions:
•
•
_ tp,IIIIpPr 1 6
SS %PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: Date: Phone #: (503) 718 -