Permit '.
ICITY OF TIGARD PLUMBING PERMIT
\
COMMUNITY DEVELOPMENT
, � PERMIT #: PLM2008 -00095
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/7/2008
PARCEL: 2 S 110 C B - 08100
SITE ADDRESS: 12488 SW AUTUMNVIEW ST ZONING: R -
SUBDIVISION: MOUNTAIN VIEW ESTATES LOT: 006 JURISDICTION: TIG
PROJECT: MOUNTAIN VIEW ESTATES
Project Description: Installing backflow preventer for landscape and irrigation.
CLASS OF WORK: ALT 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
ACCENT RESIDENTIAL HOMES
12583 SW AUTUMNVIEW ST Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 3/7/2008 $36.25
[TAX] 12% State Surch 3/7/2008 $4.35
Phone : 503- 670 -4939 Total $40.60
Contractor:
PRO LANDSCAPES OF OREGON INC.
PO BOX 261
ST. PAUL, OR 97137 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 633 -3400
FAX 503- 633 -3401
Reg #: LIC 7326
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.
/ - `� P ermittee Signature: C` �y / /// � �
Issued By c",.....— l
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.
- 03/06/2008 13:59 15036333401 PRO LANDSCAPES PAGE 02/03
•
, . P Permit Application
Building Fixtures RECEIVED VOR 01:1 1 SIC ()NI .1
-
IN City SW Ha B R - 6 2008 F c/h ne Permit No.: -Pt- n. Y' - 13125 SW Hall Blvd., Tigard, OR 9 ° '
i m : ' Phone: 503.639.4171 For 503,598.1960 DateBy: Other re,,,, Nn.. , -•- 3
Inspection Line; 503.639,4175 CITY OF TIGARD DateRcedy/Ry; lurk ®
1' I ,� is I? Internet: www.tigard -or.gov . . . a + Notified/meshad supplemental Infnnnation
TV11 i'2 "+1 p . „ - .. a'E* SCHEDULE
[; New construction ❑ Demolition For special information use checklist
Description I Qty. 1 Ea. I Total
❑ Addition /alteration /replacement ❑ Other: New 1- 2-family dwellings (includes 100 ft, for each utility connection)
' : CATEGORY O1 er1Nshi7C'1'1<ON SFR ()) birth 249.20
•
VI, I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Multi-family
SFR (3) bath 399.00
❑ Accessory building Each additional bath/kitchen 45.00
0 Master builder ❑ Other: Fire sprinkler ( sq, ft) Page 2
+YOB STT E INFORMATION ANII)' LOCATION • .. Site utilities
Job site address: t'Z. • : PskU ryln v a- e„\•. -? Catch basin or area drain 16.60
City /State/ZIP:17' + O.f (> - I ell, leach lint, or trench drain 16.60 NMI
Footing drain (no. linear t _ ) Page 2 MIN
Suite/bldg-/apt. no.: Project name: IVV VI CAA) Fs i
anufactured home utilities ME 110.00 NM
Cross street/directions to job site: Manholes 16.60 Mill
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ,. ) Page 2 Ill
' Storm sewer (no. linear ft.: ,,, Page 2
• t/ % dl ` V \ e � e - Lot no.: Water service (no. linear ft, ) Page 2
M
Subdivision: Fixture or item
Tax map /parcel no.: Absorption valve 16.60
D1vSCRi1' T1C71!l OP WORK Backflow preventcr Page 2 ' to '' •
Backwater valve 16.60
' ,,.,+�' � "`1•` - k n � Clothes washer 16,60
4f/ Dishwasher 16.60
Drinking fountain 16.60 •
' DOPER IX OgVNR.. ❑• TENANT
T Ejectors /sump
Name: At C_‘,..-CS-1 \ C..Jr1 Expansion tank 1 16.60 IMIll
Address: t l j a r- _rf i_ r7 Fixture /sewer cap EINIMINI
City /State/ZIP: I 1,..)2. 4 1 V\ b■ Floor drain /floorsink/hub 16.60
Fax: ( il •, , -• ti Garbage disposal IM �
� '�' teL r+ Hose bib � 16.60
.. 0 CONTACT PERSON
y
Ice maker 0 16.60 MNI
Business name:Pet) .r t 0 be ' 0 Ctrl interceptor /grease trap 16.60 W
'ryv�
Contact name ; r^" t .-.1, 1 c „f Medical g as (value: $ __) Page 2
Address: . 0. e 2.1Q I. Primer 16.60 ININ
- { Roof drain (commercial) 16.60
City/State/ZIP: �`i'- . Fe 1..71 0✓ art k *�
Sink/basin / lavatory 16.60
Phone: (rotO (rot 11,40) ' S k OLD Fax:: (5t''' I - 34 t Tub /shower /shower pan 16.60
E -mail: Urinal IIIII 16.60 NMI
CONTRACTOR • . '
16.60 NIM
Business name: .(C) • C!-V Q D • b• • EZZI 16.60
t . , : `"' 1 Other,
Address: Subtotal ,4 ,
City/Stale/ZIP; , pz- V l 0 'f al 1 1 Minimum permit fee: $72.50
Phone: (733 t Jf i * C) 'd Fax: ( ) Residential backflow minimum permit fee: $36,25 Ip.1
tiP" Plan review (25% of permit fee)
CCB Lic.: 1�l.... r 1r1' �, o `� Plumbing Lic. no.:
State surcharge (12% of permit tee) ii.; ,
Authorized signs.
Print name: C \ \ � Date: l 't 3 This permit application expires if a permit is not obtained within
�r `- ` ` 180 days after it has been accepted as complete.
*Fan methndoincv set 1w Trifinnnty Rnilclino indnctry Service Rtnard
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: • PLM2008- 00095
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: W/200t3
Phone: (503) 639 -4171 A ��r
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/12/20C)13 TIME: 7:00AM PAGE: 9
SITE ADDRESS: 12488 SW AUTUMNVIEW ST CLASS OF WORK:
SUBDIVISION: MOUNTAIN VIEW ESTATES LOT #: 006 TYPE OF USE:
PROJECT NAME: MOUNTAIN VIEW ESTATES
DESCRIPTION: Installing hackflow preventer for landscape and irrigation.
OWNER: ACCENT RESIDENTIAL HOMES, PHONE #: 503.6701 -4938
CONTRACTOR: PRO LANDSCAPES OF OREGON INC. PHONE #: 503 -633 -3400
Inspection Request Scheduled For: Date: 3/1212000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
39 ' Misc. inspection 066576-04 503-1310-0534
Corrections /Comments /Instructions: she' - 1 - e�n
Carne �b ✓a �`�
•
14 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 67) bA)\ Date: 3 (2 4.o Phone #: (503) 718-