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Permit Er C ITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00021 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/24/2007 PARCEL: 1 S134DB -10100 SITE ADDRESS: 11279 SW 110TH PL ZONING: R -4.5 SUBDIVISION: DAKOTA GLEN LOT: 003 JURISDICTION: TIG Project Description: Install residential backflow prevention device 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, INC. 4230 GALEWOOD ST # 100 Description Date Amount LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 1/24/2007 $36.25 [TAX] 8% State Surchaq 1/24/2007 $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 , ,4114 Permittee Signa• re: i& 0 .,• i �m.1 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. ` 1 S a0o6 - Gv a 3 7 Plumbing Permit A icat'orn City of Tigard f � i Date j ' D 7 Permit No .: tl %d / n rC.�� � 13125 SW Hall Blvd_, Tigard, OR 97223 c- (7.� Y1/1 � Plan Review Phone: 503.639.4171 Fax: 503.598.1960 bra r i DatelT3y. Other Permit No 24- Hour Inspection Line: 503.639.4175 JAN 2 , .: ,.. 2001 . I Date Ready /Ay: �t El Sec n t 2 For w Internet: ww.ci.tigard.or.us _ NNotified/Method: / ( r� � Supplemental rnfnrmattnn tY$4 RC jU FEE* SCHEDULE g New construction (IT in d ?..,r oirt�von ni\ For special information use checklist. Description 1 Qty, I Ea. j Total ❑ Addition'allerationlreplacement © Other New 1- 2- family dwellings (includes 100 ft. for each utility connection) • CATEGORY OF CONSTRUCTION SFR (I) bath 24920 ® I - and 2 family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building El Multi-family SFR (3) bath 399.00 El Master builder Each additional bath/kitchen 45.00 ❑ Other. Fire sprinkler ( sq, ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities 1 Job site address: 11279 SW 110 Place Catch basin or area drain ! 16.60 I • • City/ StatciZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60 Suite /bldg. /apt. no.: Project name: Dakota Clen 03 Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 ' Cross street/directions to job site: SW North Dakota Street Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear It.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Dakota Glen I Lot no.: 03 Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: 655 C 2 Fixture or item Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer / Page 2 a') . SS Landscape Backflow Device Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 E PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: Don Morissette [Tomes Expansion tank 16.60 Address: 4230 SW Calewood Fixture /sewer cap 16.60 City /State /ZIP: Lake Oswego, OR 97034 Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ® APPLICANT ® CONTACT PERSON Hose bib 16.60 Ice maker 16.60 - Business name: Landscape Oregon, Inc. Interceptor/grease trap 16.60 Contact name: Ellen Sparrow Medical gas (value: $ ) Page 2 Address: 12200 SW Myslony Street Primer 16.60 CityfStateJZIP: Tualatin, OR97062 Roof drain (commercial) 16.60 Phone: (503) 692 - 5945 Fax: : (503) 692 -0768 Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: Landscape Oregon, Inc. Water heater 16.60 Address: 12200 SW Myslony Street ' Other: City/State /ZIP: Tualatin, OR 97062 Subtotal Minimum permit fee: S72.50 Phone: (503 -) 692 -5945 Fax: (503) 692 -0768 Residential backflow minimum permit fee: $36.25 CCB Lic.: 7804 Plumbing Lic, no.: Plan review (25 %ofpermit fcc) State surcharge (S% of permit lee) Authorized signature: TOTAL PERMIT FEE Print name: Ellen Sparrow I Date: 01/23/07 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by'fri- County Building Industry Service Board. i\. Bui lding\Pernia'l'LM- PermitApp.dac 0611)5 440.4616T(IC/C CO\tfwED) 9•d 89L0 Z69 Uell3 e9Zt80 LO bZ ue CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2007 -00021 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/ 2007 9 112 Phone: (503) 639 -4171 ttV Inspection Requests (24 Hrs.): (503) 639 -4175 ,.14i " INSPECTION WORKSHEET FOR DATE: 2/20/2007 TIME: 7 :09AM PAGE: 74 SITE ADDRESS: 11279 SW 110TH PL . CLASS OF WORK: SUBDIVISION: DAKOTA GLEN LOT #: 003 TYPE OF USE: PROJECT NAME: DAKOTA GLEN DESCRIPTION: Install residential backflow prevention device for irrigation. OWNER: DON INMORISSLI IE HOMES, INC., PHONE #: 503-387-7538 CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503 - 692 - 5945 Inspection Request Scheduled For: Date: 2/20/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 043568 -01 503-692-5945 N j Corrections /Comments /Instructions: ,,,i5ii iiii i .,,,•--- / ■ .% / � _ I" of / / al PASS ❑ PARTIAL APPROVAL I I CANCEL ❑ NO ACCESS FAIL ] CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED • Inspector: (,1 (1 Date (d 6 /b f) Phone #: (503) 718-