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Permit CITY TIGARD PLUMBING PERMIT 4 *S I DEVELOPMENT SERVICES PERMIT #: PLM2000 -00311 ----- ' I+ 13125 SW Hall Blvd., Tigard, OR 97223 ( 639 -4171 DATE ISSUED: SITE ADDRESS: 13520 SW 122ND AVE PARCEL: 2S103CB -10200 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5 BLOCK: LOT: 060 JURISDICTION: TIG 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 Remarks: Installation of residential backflow prevention device. FEES Owner: Type By Date Amount Receipt DON MORISSETTE HOMES PRMT DEB 8/18/00 $25.00 0004585 4230 SW GALEWOOD ST 5PCT DEB 8/18/00 $2.00 0004585 SUITE 100 LAKE OSWEGO, OR 97035 Total $27.00 Phone 1: 503 - 387 -7538 Contractor: PROGRASS LANDSCAPE SERVICES 29895 SW KINSMAN RD WILSONVILLE, OR 97070 REQUIRED INSPECTIONS Phone 1: 682 -6076 RP /Backflow Preventer Reg #: LIC 00006136 Final Inspection PLM 11558 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 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. C Issued B y , ,k■ Per mittee Signature: „ y,, ' - 0 ` /1j dal__ e_ � � „ � c Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day • 06%06/99 TIE 10:57 FAX 503 595 1960 CITY OF TIGARD x002 CITY OF TIGARD Plumbing Permit Applicatip Flan Cr 13125 SW HALL BLVD. Commercial and Resid l R d TIGARD, OR 97223 Da :e Rea:: 'g (((-00 (503) 639 -4171 pUG 1 $ Zoo® Da :e to P Print or Type Date tc Incomplete or illegible applications �d'�b Fermit4 p (a-t; -cod // Related .Ss/.'R # Called 1 Name of Deve,opment/Prcjec: FI (1.050ida aI). ' _ Qt( ! PRICE j , 4MTi.. Job .LLtUJ' (yv3 L r (PO Sink I 11.50 Address StreetAddress I p$uiite, Lavatory j 11.50 (� sr' -C .� ) LL) iaaat''1Gi I rim Tub or Tub /Shower Comb. 1 11.x. I Bldg City/State /State Zip e i g FT j ,(.�, I 0.. Oa. `1 7 2- Z. Shower Only 11.50 Name Water Closet I 11.50 7) 0.11 /1" Sc cfte.. h' TGS Ctshwasher i 11.50 Owner Mail ng Address Suite Garbage Disposal 1 11.50 Lf a30 Sly 6ei /e4CCGC(._ Washing Machine • 11.50 CltylSate Zip Phone , Fl Crain/Floor Sink 2" 11 50 /..J.:4-Kt. i S Ucc O , . 79o- byS I 11.50 Narre 3„ I 4" 1150 Occupant Nailing Ad Ss Suite Water Heater O conversion O like kind 11.53 Gas piping requires a separate mechanical permit. City /State Zip Phone Laundry Room Tray 11.53 1 i Urinal 11.5) ame Other Fixtures (Specify) 15.00 nctscr�c rv Lu ll Cape..., Contractor Mailing Address Suite • 198 `i S Site /(tri rItt/L i) i Prier to permit City!State Zip Phone bp — Sewer - 1st 100' f 35.00 issuance, a copy W &fl /hilt 01Z97070 L,U70 of /-7 Sawer- each additional 100' 3200 of all licenses are , Oregon cnst. Cont. Board Uc.# Fes. Dare required if (p v 1 $ /3 /)aOo Water Service - 1st 100' 38 00 expired in COT Plumbing Lice Exp. Dale Water Service - each adcltlonal 20C' I 32.00 database 1 Storm & Rain Drain - 1st 100' 38.00 1 Name , Storm & Rain Drain - each additional 100' 32.00 Architect Mobile Home Space 32.00 or - Mailing Address Suite Commercial Back Flow Prevention Devise or Anti- 32.00 I Pollution Device En 9 inner I •y/5tate Zip Phone Residential Bac cflow Prevention Device" 19.00 0 oti (Irrigation timing devices require a separate Describe work to be done: restricted energy permit.) Ne:v O Repair 0 Repace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 11.50 Residential C Commercial 0 Catch Basin 11.50 Additional description of work: ^ Inap. of Existing Plumbing 50.00 • per/hr Specially Requested Inspections 50.00 Are you capping, moving or replacing any fixtures? per/nr Yes 0 No 0 Rain Drain, single family dwelling I 45.00 If yes, see back of form to indicate work performed by Grease Traps I 11.50 fixture. FAILURE TO ACCURATELY REPORT FIXTURE WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL I 11,-, , I hereby acknowledge ee nowledge that : have read this application, the: the information Iso rie cr riser diagram is required it Quan�it- Total is > 9 r i . given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL •' - • r . that plans submitted are in comp lance with Cregen State Laws. - �S S1yAettrr -ef ern Date � ^ 2, S% SURCHARGE _ , n -'- . :-'..• Contact Person Phone 'PLAN REVIEW 25% OF SUBTOTAL !' Requi-ec only it `ixure qty total is > 9 7>3f[T2{tic'}LLSE:3lZ$:Q0 �`1 . � r - TOTAL � / 7 ' °F '; 273ATii1 2Sd4R ' T a r4 8 .q.Xi Hi tJSt? $2B45) _ w t ;, _ -;: s- _, 'Minimum permit fee is $ + 5% surcharge, except Residentia: Ba -kflow x a rteJy e's da11)*Iiit�irsgfi�dures the r 1.**in l'rttsfti*f ti Prevention Device, which is $25 75'4 _ surcharge - -100faet.ofaanrtn er412nii evveratld :v2iucseftic§ ' "A11 New Commercial Buildings regr:Ire plans with isometric or riser diagram i . a , : sevr — _— r te _. : :� and plan review :ldstsf.rms'.plumaps do: 5(2.'99 • CITY OF TIGARD BUILDING INSPECTiON DIVISION MST G '' 15- 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP -A 7L Date Requested � - / AM PM BLD Location / 3 5 2 ' S N' Suite MEC Contact Person Ph 2 4/1e.3 5 PLM ,? e566 _- 66 3 1( Contractor Ph SWR `BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation l� FPS -;idu Ftg Drain �' SGN Crawl Drain Inspection Notes: 6z� "v Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: ‘.(ji))11)\‘ Final P PART FAIL cyLUMB Post & Beam Under Slab Top Out Water Service Sanitary Sewer • ains d oi i r PART FAIL ECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date Inspector r ��..� Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. BU P - Building Permit ELC - Electrical Permit J Inspection Description Date Passed By 4 Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing 4 Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing � Inspection Description Date Passed By Post/beam mechanical Suspended ceiling Gas line • Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Fireproofing Lab Final Mechanical final Structural observation Final inspection PLM - Plumbing Permit - 4 Inspection Description Date Passed By BUP - Fire Protection System Permit Plumbing underslab 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer J Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final � /7/?f Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC SIT PERMITS A , CITY OF TIGARD PLUMBING PERMIT ~ DEVELOPMENT SERVICES PERMIT #: PLM2000 -00311 _ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: -- SITE ADDRESS: 13520 SW 122ND AVE PARCEL: 2S103CB -10200 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5 BLOCK: LOT: 060 JURISDICTION: TIG 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 Remarks: Installation of residential backflow prevention device. FEES Owner: Type By Date Amount Receipt ON MORISSETTE HOMES 230 SW GALEWOOD ST PRMT DEB 08/18/200 $25.00 0004585 UITE 100 5PCT DEB 08/18/200 $2.00 0004585 AKE OSWEGO, OR 97035 Total $27.00 Phone 1: 503 - 387 -7538 Contractor: ROGRASS LANDSCAPE SERVICES 9895 SW KINSMAN RD ILSONVILLE, OR 97070 REQUIRED INSPECTIONS Phone 1: 682 -6076 RP /Backflow Preventer Reg #: LIC 6136 Final Inspection PLM 11558 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 1 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 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. ssued By: Permittee Signature: Now Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day 9/13/00 Activities for Case #: PLM2000 -00311 1:33:38 PM Assigned Hold Updated + Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes PLMA003 Application received 8/18/00 DEB MAIL No Hold DEB 8/23/00 PLMA005 Create Permit . 8/23/00 DEB DONE No Hold DEB 8/23/00 PLMA750 RP /Backflow Preventer No Hold DEB 8/23/00 PLMA799 Final Inspection No Hold DEB 8/23/00 PLMA060 (F) Issue permit 8/23/00 DEB DONE No Hold DEB 8/23/00 PLMA055 (F) Reprint Permit 9/13/00 AMS DONE No Hold AMS 9/13/00 i R I Page 1 of 1