Permit •- Vv
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III a CITY OF TIGARD PLUMBING PERMIT
: COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00217
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/24/2007
PARCEL: 2S110DD -05000
SITE ADDRESS: 15650 SW OLD ORCHARD PL ZONING: R -
SUBDIVISION: SUMMERFIELD NO.3 LOT: 141 JURISDICTION: TIG
PROJECT: BARKER
Project Description: Installing residential backflow device for landscape.
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
BARKER, CAROLYN M
15650 SW OLD ORCHARD PL Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 5/24/2007 $36.25
[TAX] 8% State Surcha 5/24/2007 $2.90
Phone : Total $39.15
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Contractor:
LANDSCAPE ENTERPRIZES INC
PO BOX 436
WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 682 -3345
Reg #: PLM 5331
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: Permittee Signature: ( 4 //(�k
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.
FRQM : LE I _ . ..� FAX NO. : 36823343 May. 23 2007 10: 27PM P3
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1 u mb Pe ' t ,a = '
Site Utilities (1
FOR Frli r. 1.:4 oNi.`•
City of Tigard mg 2 Ll 2001 ,J a rmie,l ti n P f 6 _ 111 __ T
pi 13125 SW Hall 31vd„ Tigard. OR 97223 �{�� � pynRat¢w
Phone: 503.630.4171 i t.34O 1 s , j r11 i- 1 WOW. Permit :
Inspection Line: 503.6394175N TT TI F l Dabs Rattly/By: Fria 16 Seen. i rat •
' . n Werner www.egard. • T ,..T• 1 1 1 , a bketr�leenne• rii i s1 ao[oemmen
l ' >a wall ... .1 1_ l . > ,. .....
o Now econalnaltiOn ❑D Q Q U11ttlan
/ • D i0 •� $a. .0r81
❑ Ad�sion lsltuati0nheplaeoment [ Ot ! 1.2rtap79dw p (tn hide 100 R for each utility connection)
` �'— 2�9 zo
:::,Cit`1E60RY OA F.'. • .�r:i �j�Qt1
hor . New SFA(1)bath
1 • and 2- family dv)eiting /` l Comm - - Ynidtstriel 350,00
399.00
O ac�Bory building / O LSu11t•fatnily
Each additional baWJcxbet 45,00
❑ Master builder 0 Other ____
,: (.,r;4 It) p one 2 •
S • : 0 : j II41:FORM ON RID LOCATIO7C .. • - i . ' Site ut,Tities
• Catch basin 6r , 16.60
Job site address: c` $la b i Q % A► - AMIN I Drywcu. lt:sch Imo, t (latch drain En 16.60 '
City; StaklZTP: ,_,.L. �y 1 - . -
,,Footing drain (no,1' � •
Sac/bldg./apt alai. Project name: . . Vallai 11040
.�, .. bonne
Cross street /dire d COS to}ob sate: - 16.60
MEOW .... R • 16.60
• Sanitary ES - .. ft: _J Page 2 1
• S +oar. s+Ewet R ' _ ' Page 2
. --emmor' Yana cervix ( . ft: Pagc 1
Subdivision: Q0" _ _- _ __-
11
.• - Fixture grits* i ,I
�
Tax ma,/parcel • ` ; f Abed valve ' 16.60
• r. C R� i It71 ! i t7P t�ygWC . Beddow prCVea -, Pais 2
/ Back abscr valve 1660
-- Gotha washer - 16.60
- Dishwasher 16.60
:. ift I =
16.60
i .. : e pa : OVP14Uk ' .0.. . .. t... EiecaxdsuraP - 16.60 • Name: � _ .. expensi4•t sank I �_� 16.60
15650 . " _ _ Fixnrre/ • j: 16.60
1::::1 �' ■ Ala • . 4 t�!dtain/flvot s' 16.60
Phone. tate� a ` �P _ _ _ . �`' ' Garb= disposal 14.60
1 ?bate: (� i �� 1? Fax: ( �'— H bib 16,60
.. . . t �1YTACr.Pr il $ '
i].: iPel[,YCAIV'1?. :.::. Q • • to ouch 16.60
Intercepts; 16.60 1
Business name: - - Fee - -_
i Medical gas ( Page 2
Canteen mote: ...._
: A _ ■ 'Prima 16,60 _ ..
Roof drain (..., . 16.60 _.
: City/State/2W: 1660
Siek/bariWlav � �.
PhOSUn ( ) _ Fa ( ) Tub/showuls • 16,60
E-mail: Urinal t6.60
OO
N1RnGTOR,'. VYarercl _ 16,60 •
Business home! , _ « e - • 1■ .- Water 16.60
_Address: CitylStnte /ZI CFI . ■ '"�� - Snbtowl "°'
1vfinimwo fee: $72.50 i
>' � • s _ 6 � — � Pm
' Free ( ) j Residential backlit. mmutintp�t emit fee: S36 25 $�O.ZS
r ph...:(ga) (OtrCZ -. -3,3_5(5 r .— ---•+» plug wimp" (2554 of permit fee) _
// ��) • he ! ' c. uo.:
a KfStsw Ca+nh u! S Wit ge (896 of permk 4x) 2.9 6,
authorized signatw+r, . ._ . —
TOTAL PERMIT FEB 139 1 S
` � . 7 T his Pamit'D>' " n endive its p 'ton la not obtained wtsbin
Ps uamw T4, J t Sc ST Data 2 Z O
1110 days eras' it rat been accepted as colligate,
*Fee methodology bet by Tel -County Bunning Industry Swim Board
tsuitoinstrre ,aart.st1- rcrehePPeoe 11d27 a0�:e]�IOAL�YY4+E6)
FCC. 9130 I $ •
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: PLM2007- 00217
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 5/24/2007
Phone: (503) 639- 4171I�
Inspection Requests (24 Hrs.): (503) 639 -4175 F_
INSPECTION WORKSHEET FOR DATE: 6/5/2007 TIME: 7:01AM PAGE: 72
SITE ADDRESS: 15650 SW OLD ORCHARD PL CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.3 LOT #: 141 TYPE OF USE:
PROJECT NAME: BARKER
DESCRIPTION: Installing residential backflow device for landscape.
OWNER: BARKER, CAROLYN M, PHONE #:
CONTRACTOR: LANDSCAPE ENTERPRIZES INC PHONE #: 503 -682 -3343
Inspection Request Scheduled For: Date: 6/5/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 049585 -01 503-682 -3343 N
Corrections /Comments /Instructions:
V /
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1 W , A r .- : -1ZINIgr - O / r 7
Tij;ASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / 1/ Date: v . . 2_ Phone #: (503) 718 -
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