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Permit 4 . ' .I. CITY TIGARD PLUMBING PERMIT T r y I DEVELOPMENT SERVICES PERMIT #: PLM2005 -00391 DATE ISSUED: 8/16/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 • PARCEL: 2S 112CD -13200 SITE,ADDRESS: 07750 SW CYPRESS LN ZONING: R -12 SUBDIVISION: HAMBACH GROVE LOT: 030 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 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: 2 p Permittee Signature: :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. Aug 16 05 08:27a Martin Sander 503 -647 -9151 p.6 Plumbing Permit Application �� miz c)1• l-)ct.: t SI. (1\l.l City of Tigard �I(I Permit SW Hall Blvd., igard, OR 97223 �d _ [�JJ Plln Review : Y ! 6 739 V-1 75ti x e U 1)3' i Plan Re Phone: 503.639.4171 Fax: 503.598.1960 , . + + ;!� :� Datc/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 Ai U 1 6 2UUF; •'_ Date Read /B ; („I ' �• _ I BI Sec Page 2 for ra Intect: www.ci.tigard.or.us Notified/Method: ' Supplemental Information TVPECOFYWORK FEE SCHEDULE ri i I i i � • For special information use checklist New construction BU I LD I J d _I)emolrLOn Description I Qty. 1 Ea. j Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) • CATEGORY OF CONSTRUCTION SFR (1) bath 24920 ❑ l- and 2- family dwelling 0 Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other. Fire sprinkler ( sq. ft) Page 2 .LOB SITE INFORMATION AND LOCATION Site utilities Job site address: 1 O $ W C . . , L 0.n e Catch basin or area drain 16.60 City/State/ZIP: 1 tiara (..) ,R Cj'l 2-2- Li Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: QtrYl ti Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes . 16.60 Rain drain connector • 16.60 Sanitary sewer (no. linear fl: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: �Grn bb c...1/1 I I Lot no.: '60 water service (no, linear ft.: ) Page 2 ������ Tax map /parcel no.: Fixture or item Absorption valve 16.60 DESCRIPTION OF WORK Baekflow preventer Page 2 Backwater valve 16.60 //88 Clothes washer 16.60 �J Dishwasher 16.60 Imo. PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 ( Ejectors/sump 16.60 • Name: Le_�� ` � e 11 o 1r.f `; e__A{ . Expansion tank 16.60 , . Address: (Z SS S , . ) Li T( fcqrj, . ( e 1 bi) Fixlure/sewer cap 16.60 City /State/ZIP: bD -*- ` e _A O v -7 'Z-7 3 Floor drain/floor sir 16.60 • Phone: 6c3) (, 2_,D - d g Fax: (57?j) Sci g gci co Garbage disposal 16.60 81 APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: 1l (c ,,,..--t-t .4 --• G, yuci S 7` - . Interceptor /grease trap 16.60 Contact name: ivi p,_ r / "k- sci c ...., Medical as (value: $ ) Page 2 Address: to () i' - - 3(>-7 Primer • 16.60 City/StateJZEP: ) „„4-k e/ A_ . S 0 1.4k q -7 , 3_:_ Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: (5a3) to L17.. S S 6_,-7 I Fax :: (5J8) 6' y7 - 5 Tub/shower /shower pan 16.60 -mail: Urinal . 16.60 CONTRACTOR Water closet 16.60 3usiness name: A4 e_11.11 _.5 y1G[---7'j 62 14JC/9..a•' Water heater 16.60 kddreess: .1 D . I S p x .. z= -.) Other • � .r./1 ' .7'- Subtotal :ity /State/ZIP: lv l UY��n �{° (�.-'h 5 t Ji'1 Minimum permit fee: $72.50 'hone: (5O to t-f 7 - S5 E , .-) Fax: (5D.) (o' ••1 _- 9/ 5 / Residential backflow minimum permit fee: $36.25 :CB Lie.: 5 •.) L. f z_ Plumbing Lie. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) ---H lutharized signature: TOTAL PERMIT FEE , ,, 'rint name: 1 a izi sir ,. - Date: Z - «-- US This permit epplieation expires if a permit is not obtained Within 180 days after it has been accepted as complete. *Fee methodoloev set by Tri- County Buildinc Industry Service Board. CITY --OF TIGARD i . BUILDING DIVISION , :. PERMIT #: PLM2005 -00391 , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1&2005 Phone: (503) 639 -4171 / Inspection Requests (24 Hrs.): (503) 639 -4175 __.. INSPECTION WORKSHEET FOR DATE: 8/18/2005 TIME: 7 :06AM PAGE: 111 • SITE ADDRESS: 07750 SW +YPRESS LW CLASS OF WORK: SUBDIVISION: HAMBACH (.2' OVE LOT #: 030 TYPE OF USE: PROJECT NAME: HAMBACH GR ►VE DESCRIPTION: Backflow prevente or irrigation. OWNER: LEGEND HOMES, PHONE #: 503 - 620.8080 CONTRACTOR: MARTIN SANDERS G" •UNDS MAINTEN PHONE #: 503.847.5557 Inspection Request Scheduled For: Date: 8/18/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 013746-04 503 -209 -5346 N Corrections /Comments /Instructions: • PASS PARTIAL APPROVAL n CANCEL I I NO ACCESS FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: N Q `_`y Date: 1 (IS Phone #: (503) 718-