Permit .
CI TY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00448
^`? 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/2/2006
PARCEL: 1 S 134DB -DG004
SITE ADDRESS: 11295 SW 110TH PL ZONING: R - 4.5
SUBDIVISION: DAKOTA GLEN 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
DON MORISSETTE HOMES
4230 GALEWOOD ST. STE 100 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 10/2/2006 $36.25
[TAX] 8% State Surcha 10/2/2006 $2.90
Phone : 503- 387 -7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 692 -5945
FAX 503- 692 -0768
Reg #: LIC 7804
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: j_4_171 Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. y\"
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 .., FOR OFFICE USE ONLY •
City of Tigard \!1':cr Received
/� Perm No. : �
! / V 7 C /
13125 SW H all Blvd., Tigard, OR 97223 r, ^ LOO` Plan Review
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Phone: 503.639.4171 Fax: 503.598.1960 ". ' ' "'"41,q,4 ' Da R Other PerrtuNo. 4 -Hour Inspection 503.639.4175 ` • t_� f�.�( P1a Y•
�P `� ='� � Date Ready/By: s� ®
y: Juri See Page 2 for
Internet: www.ci.tigard.or.uS 'Aid 1"-...-r 1 .4w J Notified/Method: Supplemental Information
' i �ti �.. , � � e'' :�'. _%lt , y � ... �, ^i :: , iJ -:
i�''f'. Fie' �y' t �* �' ���� `r'da= <'<i: ? .. .. ... .. .. .�..4. , Ktn _:i'F,�S:.'",i�* :: C � •( {!i: ...... ...1::::.,: .:: ... ... ... ;.. .��.
New construct �- ❑ Demol i t i on For special information use checklist.
Description I Qty. Ea. Total
El ddition/alteration/replacement El Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
a.;;i: A y a`rjs 1 .;' , 4', ° - y - . s :: I SFR l bath I 249.20
' kn
' E� .sOR Q 4'.O I Ftlr4' X01V; ;` ;' ( )
l 'EL1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 1 350.00
CI Accessory building ID Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other: Pag 2
Fire sprinkler ( sq. ft.)
dw ra :•,r .i. ., 1 . . � - n J ,q "'A• i i . t } ...: ...,, :.
° •t"•il ti rl f r 4,v !:! !:17: ;F D[ tuvl�4` C tA, I�I FI Ct "PI _1V _ a,+ . ..
y'.. • , .v -.•. ,.• �'�.;. � �:. y ,,;�:. ..,a: ' ' ._y �•�'= Site utilities
Job site address: l f oL_g S s-ti. I f C) i Catch basin or area drain 16.60
City /State/ZIP: / 1 Gi/LOL_ 0 /_- 9 7 • -3 Drywall, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project namDakO*� C-46 del Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities I 1 10.00
Cross street/directions to job site:
Manholes 16.60
,cA.A..) 71 e z -A- Rain drain connector 16.60
Sanitary sewer (no. linear ft: _____) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: a_ oi-rx. & (. c./\ -- I Lot no.:Cjt Water service (no. linear ft.: Page 2
Fixture or item
Tax map /parcel no.: (p S.S G 3
Absorption valve 16.60
': '':`1,4FSCR :TIQ , ;i i , • :.. i eve ter Page 2 a , ,"
:l.....?::::: . : ,." ... ..• .. ,�;:,• . :. .:,.. • .T
� _• ., . ..,. � ..,, ..:.. ' , , Backflow pr n / ' g 7 31
Lai-4 Se + . (,(/)(!• i rr / ti 0-1' 0 bock. 1 e,-.1c) /! C . Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
;rr. ,t:r> y; •s.: �.iot u, i , ,;rs. n:, Drinking fountain 16.60
..�,,1,, _�_a -,�.t ,. �. � .. , 1ta...;:.r,.,.,,..,;.,: • . .a, .,...t.,. : ,:. ... Ejectors /sump 16.60
Name: b Cy1 /) )f /7 s S ; - -1• 'S -UM in1111.4,47 ES L.I..:Sxpansion tank 16.60
Address: 2-f oZ 3 L+ ,S [_.Li (>l._ (C f. o U Oct Fixture /sewer cap 16.60
City/State/ZlP: [ _ ' , o k (1.� LC C �7Ci O /2.._ �7 / (��$ S Floor drain/floor sink/hub 16.60
Phone: ( ) gam(: ( ) Garbage disposal 16.60
r : - : a ,, Hose bib 16.60
' :y - 4:rt,. ri(: o .,: fil T :r'1''I,'.1 S�f.�1'.:.r
e-
.7-ie ;.r. f .� f:• "" _.. ���FC,i� :�Rq,:.!;'1'd!� -r �..., "!!:..... •'t',""'''''' .a,ur�:...., .. ,�.,.:.�. .... Ice maker
1 1660
I Business name: La") d / ! C -� _3/- )t r Interceptor /grease trap 16.60
I �
Contact name: �7 J -,......."1 � r a Y� Medical gas (value: $ ) Page 2 RD Primer 16.60
Address: i at) C1 S U) rn vS' 1 i+Yt l-j
City/State/ZIP: tlJ /,� �j,ti J L j f2_ , J 7 ` 0 CC' ` Z _ Roof drain (commercial) 16.60
Sinldbasin/lavatory 16.60
Phone: (563) CG'C /:_ S�V 5- Fax: :($2 ) r': y':. - 6 1r<._4'
Tub /shower /shower pan 16.60
E . Urinal 16.60
2 .11iy::, r. 7''' ,i, G ..r"•1 • :y 16.60
}: tr: :., Orl:katAG'It;; 'Y' .:,.. Water closet
Business name:Lai)aSe Or
O .C%o7 Zn 6 Water heater 16.60
f a
Address: ?-- J O) r ' -- �' // � // � Other:
�U rn �l Subtotal
City/State/ZIP: -t
� 7r't � 0/2. 70& :II- Minimum permit fee: $72.50
Phone: (54)3) ietQQ S Fax: 6O3) C 9? - 07 Co S. Residential backflow minimum permit fee: $36.25 3e, • Q__S
CCB Lie.: 7 gC.) Plumbing Lie. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee) , ... ' p
Authorized sign Lt 'i ��20? - TOTAL PERMIT FEE
31 ' i S
Print name a en r ? ( , i -- Z7 t ( ) I Dato! .Ia This permit application expires if a permit is not obtained ithin
/ 180 days after it has been accepted as complete.
"Fee methodology set by Tri- County Building Industry Service Board
id Huii ding\Permits \PLMF- PcrmitApp.doc 12/03 - 140- 4616T( 10l02/COM/WBH)
2 ' d 89L0 a69 -90S uaii3 e6E :90 90 z0 100
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200&.00148
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/212006
Phone: (503) 639 -4171 4 n1tillt
Inspection Requests (24 Hrs.): (503) 639 -4175 I^..
INSPECTION WORKSHEET FOR DATE: 10/1812006 • TIME: 7 :06AM PAGE: 8
SITE ADDRESS: 11295 SW 110TH PL CLASS OF WORK:
S UBDIVISION: DAKOTA GLEN LOT #: 004 TYPE OF USE:
PROJECT NAME: DAKOTA GLEN
DESCRIPTION: Dackflow presenter for irrigation,
. OWNER: DON IvIORISSEIIE HOMES, PHONE #: 503- 387 -7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 603-692-5945
Inspection Request Scheduled For: Date: 10/18/2006 . Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 030426-01 503-692-5945 N
Corrections/Comments/Instructions: .
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PASS a ' - -TIAL APPROVAL I I CANCEL Il NO ACCESS
FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: "Ike-- Date:4 /�/0 Phone #: (503) 718-
(