Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00522
11 � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/27/2006
PARCEL: 2S 109AC -03000
SITE ADDRESS: 13389 SW ANGUS CT ZONING: R -7
SUBDIVISION: WILSON RIDGE LOT: 004 JURISDICTION: TIG
Project Description: Residential 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 Description Date Amount
4230 GALEWOOD ST #100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 10/27/200E $36.25
[TAX] 8% State Surcharl 101271200E $2.90
Phone : 503 387 - 7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD. REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
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 010 t ugh OAR 952 - 0001 -0100. You may obtain copies of these rul- or direct questions to OUNC by
calling 5 3- 246 -6699 o 1 -8 0 332 -2344.
Issued y: /C'� (124406/27 Permittee Signat re: J� _ : c�,.i /�
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.
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Plumbing Permit Application I_oi_ol l-ict- usl :- oNI - z .
City of EDA , /mo o ® Received /� M 5a . Date /By: /0 l7 06' AO j# Permit No.: I I i/ - t� -
13125 SW Hall Blvd., Tigard, OR 97223 ll Ec Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 01,„I 7 200' 4 � I ' Dale /By: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 D . 1
Internet: www ci.tiganl.or.us --.. Date Rcady.By: i ' • 0 See Page 2 for
® � '�� G • - 4 Notified /Method: I 1/t Supplemental Information
TYPE 1 p%V%SIU« FEE" SCHEDULE
® New construction ❑ Demolition For special information use checklist
Description [ Qty. I Ea. J Total
❑ Addition/alteration/replacement CI Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
® I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
El 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: 13389 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 Lot 04 Footing drain (no. liner ft.: ) Page 2
Cross street/directions to job site: SW Bull Mtn Road
Manufactured home utilities 1 10.00
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 I Lot no.: 04 Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: 655 A7
Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK
Backflow preventer 1 Page 2
g'
Landscape Backflow Device Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER ❑ TENANT
Drinking fountain 16.60
Ejectors/sump 16.60
Name: Don Morissette Flames
Expansion tank 16.60
Address: 4230 SW Galewood Fixture/sewer cap 16.60
City/State/ZIP: Lake Oswego, OR 97034 Floor drain/floor sinklhub 16.60
Phone: ( ) Fax: ( ) Garbage disposal I6.60
® 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
City/ State/ZIP: Tualatin, OR 97062 Rooldrain (commercial) 16.60
Phone: (503) 692 -5945 Fax: : (503) 692 -0768 Sinklbasintlavatory 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: $72.50 5 -
Phone: (503 -) 692 -5945 Fax: (503) 692 -0768 Residential backllow minimum permit fee: $36.25 "4-
C Lie.: 7804 Plumbing Lie. no.: Plan review (25% of permit fee)
Authorized signature:
State surcharge (8% of permit fee) e:;.. , c f C1
TOTAL PERMIT FEE 3?.A5
Print name: Ellen Sparrow Date: 10/27/06 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
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CITY OF TIGARD
BUILDING DIVISION
PERMIT #: PLM2006•00522
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1012712006
Phone: (503) 639-4171 A
.
Inspection Requests (24 Hrs.): (503) 639-4175 l L L .
INSPECTION WORKSHEET FOR DATE: 11/8/2006 TIME: 7:03AM PAGE: 37
SITE ADDRESS: 13389 SW ANGUS CT CLASS OF WORK:
SUBDIVISION: WILSON RIDGE LOT #: 004 TYPE OF USE:
PROJECT NAME: WILSON RIDGE
DESCRIPTION: Residential backftow preventer for irrigation.
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OWNER: DON IvIORISSErt HOMES, PHONE #: 503.3874538
CONTRACTOR: LANDSCAPE OREGON,INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 11/8/2006 Pour Time:
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Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 039416-01 503.692-5945
Corrections/Comments/Instructions:
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II PA S I I PARTIAL APPROVAL E CANCEL III NO ACCESS
• FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
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Inspector: N
/(/
Date: ■ / Phone #: (503) 71" • 8--'----••