Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #. PLM2006 -00336
. 4 1 DATE ISSUED. 7/10/2006
13125 SW Hall Blvd , Tigard, OR 97223 503-639-4171
PARCEL: 2S103BD - 11300
SITE ADDRESS. 11688 SW ERROL ST ZONING R -4 5
SUBDIVISION CAPPOEN ESTATES LOT: 004 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
Owner. FEES
FOUR D CONSTRUCTION CO
PO BOX 1577 Description Date Amount
BEAVERTON, OR 97006 [PLUMB] Pei ma Fee 7/10/2006 $36 25
[TAX] 8% State Surcha 7/10/2006 $2 90
Phone: 503 -590 -0805 Total $39.15
Contractor
CROWN LANDSCAPE INC
STEPHEN HARMS
PO BOX 883 REQUIRED ITEMS AND REPORTS
WILSONVILLE, OR 97070
Contact # . PRI 682-1100
Reg #: LIC 6181
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 Permittee Signature. � - tom ,
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.
Building Fixtures
Plumbing Permit Application RECEIVE I " ,
FOR OFFICE, USE ONL1 ,,,
City of Tigard Received 7 U �j0 Permit N b
D aze /B
• 't 13125 SW Hall Blvd, Tigard, OR 97223 JUL 1 0 2006 Y S �r -3
II
Phone 503 639 4171 Fax 503 598 I96 Plan Review p � lr it N Qo5 cellos
ITY O F TIGARD Dale/BY
503 639 4175 03 63 41 ARD y y /� El See Page 2 for
-fig kRD Internet on L
ternet ww tigard-or 41 BUILDING DIVISION Date B run:
Noufied/M e[hod Supplemental Information
TYPE OF WORK FEE* SCHEDULE - •
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty I Ea I Total
❑ Addition/alteration/replacement 0 Other New 1- 2-family dwellings (includes 100 ft for each utility connection)
CATEGORY' OF CONSTRUCTION ' SFR (I) bath 249 20
❑ 1- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350 00
❑ Accessory building ❑ Multi -family SFR (3) bath 399 00
Each additional bath/kitchen 45 00
❑ Master builder ❑ Other
Fire sprinkler ( sq ft) Page 2
_ JOB SITE INFORMATION AND LOCATION Site utilities
Job site address //G 4 37_ Catch basin or area drain 16 60
City /State /ZIP • 776 4,2-.to ■ G a _ Drywell, leach line, or trench drain 16 60
SuRe/bld /ate( Cer" 41 Project name ( >4. 7 0 4 ,0Z9a // Footing drain (no linear ft ) Page 2
Cross street /directions to job site /T � Manufactured home utilities 110 00
7 Manholes 16 60
//-J 4 tri //6 Thi sour7 Rain drain connector 16 60
7 7y "71 'a 4 -Cr Sanitary sewer (no linear ft ) Page 2
Storm sewer (no linear ft ) Page 2
Subdivision I Lot no Water service (no linear ft ) Page 2
Tax map /parcel no Fixture or item
Absorption valve 16 60
"" - . DESCRIP�T OF WORK` Back flow preventer Paget
� ,cLO(n/ �ir�f- �/L Backwater valve 1660
Clothes washer 16 60
Dishwasher 16 60
`PROPERTY - Drinking fountain 16 60
• OWNER;; =( ` ' .:4 _
•• Ejectors/sump 16 60
Name �8)L A) Coy sr. ro
Expansion tank 16 60
Address
P, O , �crx /r7 7 Fixture/sewer cap 1660
City /State /ZIP , Z) ta O t C 707$ Floor drain/floor sink/hub 16 60
Phone (503 5 7 0 _ Din sr Fax ( ) / Garbage disposal 16 60
, APPLICANT ' g CONTACT PERSON, , Hose bib 16 60
Business name Ice maker 16 60
Interceptor /grease trap 16 60
Contact name Dffl/7� 6 l S Medical gas (value $ ) Page 2
Address N .n d. � �• Primer 16 60
City /State/ZIP Roof drain (commercial) 16 60
7
Phone (52,3 y 70 — 0O 1 Z Fax ( ) Sink/basin/lavatory 1660
E -mail
7 Tub /shower /shower pan 16 60
Urinal 16 60
CONTRACTOR Water closet 16 60
Business name AS D_
Water heater 16 60
Address \ . a ,-, V • ... Other
City /State /ZIP Subtotal
Minimum permit fee $72 50
Phone ( ) --flax ( ) Residential backflow minimum permit fee $3625
CCB Lie 0 i 7 -e.. • i L ' Plumbing Lie no Plan review (25% of permit fee)
Authorized signamr-, State surcharge (8% of permit fee)
/ a— „Ss - TOTAL PERMIT FEE
Print name ,J nA- n L _ � S Date 7 / o 4 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tn -County Building Industry Service Board
i 4 Build ingWermits4PLMF- Perm:tApp doe 04/06/06 4404616T(10/02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #. P2006.00336
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED. 7/10/2006
Phone (503) 639 -4171
Inspection Requests (24 Hrs) (503) 639 -4175 "' II LM
INSPECTION WORKSHEET FOR DATE 1/25/2007 TIME 7:03AM PAGE 19
SITE ADDRESS 11688 SW ERROL ST CLASS OF WORK.
SUBDIVISION CAPPOEN ESTATES LOT #. 004 TYPE OF USE
PROJECT NAME CAPPOEN ESTATES
DESCRIPTION Bacldlow preventer for irrigation.
OWNER FOUR D CONSTRUCTION CO, PHONE # 603 - 0805
CONTRACTOR CROWN LANDSCAPE INC PHONE # 682 -1100
Inspection Request Scheduled For Date 1125/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
39 Plumbing final 042517 -02 503720-0012 Y
Corrections /Comments /Instructions
%PASS n PARTIAL APPROVAL CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION fI ADDITIONAL FEES ASSESSED
/ L
Inspector U12j'� Date. / /Zi 6 Phone #: (503) 718- Z6 yY