Permit CITY TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00189
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/15/2007
PARCEL: 2S109AC -02900
SITE ADDRESS: 13407 SW ANGUS CT ZONING: R -7
SUBDIVISION: WILSON RIDGE LOT: 003 JURISDICTION: TIG
PROJECT: WILSON RIDGE 03
Project Description: Landscape backflow device.
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 Description Date Amount
4230 GALEWOOD ST. STE.100
LAKE OSWERGO, OR 97035 [PLUMB] Permit Fee 5/15/2007 $36.25
[TAX] 8% State Surcha 5/15/2007 $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 By: 7 J ! / / j J # Permittee Signature: Sec, /1 i t( saki crIA
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.
May 15 07 09:39a Ellen 503 - 692 -0768 p.1
Bonded - InsJred
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' Plumbi t,r ,a.ti,- _. i L,, ,_ % FOR OFF CL USE -ONLY '
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^�' Received 5 f � 5 I
.� Permit No
.3125 SW'' Hall 131 I i" COX." '
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1 a °`� ,, Plan evicw
Phone: 503.639.41 Fax. >t • 6 Ail
24- Da -c /B
Other Peruut No.:
24 Hour Erlspeciio❑ Line. 503.63'_41 "Sr ITV ) e ' 1 Dave Re tdy /By: ki See Page 2 for
Internet: www.ci.ligard.or.11s ' i _es I % i'- - Nnnficd(Method: �ef Supplemental Information
L Pk ..O i. . UTYgfl )1\ • I .. FEE" SCHEDULE •
® New construction ❑ Demolition
! For special information use checklist
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: 1 New 1- 2 - family dwellings (includes 100 0. for each utility connection'
CATEGORY OF CONSTRUCTION • SFR(1)bath 24920
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath , 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45,00
❑ Master builder ❑ Other:
Fire sprinkler ( sq_ ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 13407 SW Angus Court Catch basin or area drain 16.60
City/State/ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Wilson Ridge 03 Footing drain (no. linear IL: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SWBull Mtn & SW 133 Street !
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) . Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Wilson Ridge Lot no.: 03 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax mapiparcel no.: 655 A6
Absorption valve 16.60
DESCRIPTION OF WORK Backtlow preventer / Page 2 ..- . C
Landscape Backflow Device •. • Backwater valve 16.60
l Clothes washer i 16.60
Dishwasher 16.60
7 ® PROPERTY OWNER .9 TENANT Drinking fountain 16.60
Ejectors/sump 16.60
\ Name: Don Morissctte Homes Expansion lank 16.60
1) Address: 4230 SW Galewood Fixture/sewer cap j 16.60
CityfStateiZIP: Lake Oswego, OR 97034 Floor drain/floor sink /hub 16.60
I Phone: ( ) Fax: ( ) Garbage disposal 16.60
® APPLICANT Hose bib 16.60
® CO NTACT PERSON
Ice maker 16.60
Business name: Landscape Oregon, Inc. Interceptor /grease trap 16.60
Contact name: Ellen Sparrow Medical gas (value: S ) Page 2
Address: 12200 SW Myslony Street Primer 16.60
City/State/ZIP: Tualatin, OR 97062 Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60 .
Phone: (503) 692 -5945 Fax: : (503) 692 -0768
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: $72.50
Phone: (503 - 692 - 5945 Fax: (503) 692 -0768 Residential backtlow minimum permit fee: $36.25 • " - •
CCB Lie.: 7804 Plumbing Lic. no.: Plan review (25% of permit fee)
,• State surcharge (8% of permit fee) .T , '7
Authorized signature: - t - Y7 ljG.,��L,-tk) TOTAL PERMIT FEE '
Print name: Ellen Sparrow ' Date: 05/15/07 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
phone: 503.692.5945 • fax: 503.692.0768 • 12200 SW MysttraynShodctoQiTtactiscitiocaosvcirch10662try s Board
ii', dui .i]ng\Petmits.PLM- PennitApp.doc 06105 440.4616T(I0.:02T0\VWEB)
CITY OF TIGARD
BUILDING DIVISION .
PERMIT #: PLiv12007- 00189
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/15/2007
Phone: (503) 639-4171 1 ik
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/6/2007 TIME: 7:01AM PAGE: 3
SITE ADDRESS: 13407 SW ANGUS CT CLASS OF WORK:
SUBDIVISION: WILSON RIDGE LOT #: 003 TYPE OF USE:
PROJECT NAME: WILSON RIDGE 03
DESCRIPTION: Landscape baddlow device.
OWNER: DON IVIORISSETTE HOMES INC, PHONE #: 503-387-7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 6/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 049735-01 503-692-5946
Corrections/Comments/Instructions:
I.
*ASS PARTIAL APPROVAL I CANCEL NO ACCESS
FAIL 0 CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: i471..i Date: Phone #: (503) 718-