Permit CITY TIGARD PLUMBING PERMIT
III ° '` COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00199
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/17/2007
PARCEL: 2 S 10 9AC -03800
SITE ADDRESS: 14565 SW ANGUS PL ZONING: R -7
SUBDIVISION: WILSON RIDGE LOT: 012 JURISDICTION: TIG
PROJECT: WILSON RIDGE
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.
4230 GALEWOOD ST #100 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 5/17/2007 $36.25
[TAX] 8% State Surcha 5/17/2007 $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: Permittee Signature: S . /1jI, /2,
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 16 07 01:16p Ellen 503 - 692 -0768 p.2
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Plumbin . Permit a ' i a , I FOR OFFICE use ONLY ••
City oFTigrsrd R eceived r `� �
Date; By: Permit No.: guA o e n
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13125 SW Hall Blvd.. 't igarck OR 97223 mini 1 0 2007
I P'ISTZ Q Q
Y i 1 Plan Rcvicw I
Phone: 503.639.4171 Fax: 503.598.196 A Other Permit No. '" �j
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24- Hour Inspection Line: 503.639Ad`. , /
J `` ,{ -' �i1 .�.. Date RcadyiBy: See Pape 2 for
Internet: www.ci.tigard.or.us • .. 9 E 6, .`' 1 It iii i Nolified/Methad: � Supplemental Information
1 Y 'r'.•e w� � «.
' TYP1J t<1F`tt 0 WI,Tt%rniV FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total _
❑ Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 Ji. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building CI Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
LI Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOE SITE INFORMATION AND LOCATION Site utilities
Job site address: 14565 SW Angus jL P(c c -. Catch basin or area drain 16.60
CityiState/ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60
Suite/bldg, /apt. no.: Project name: Wilson Ridge 12
Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SWI3ulI Mtn & SW 133'" Street
Manholes l 6.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Wilson Ridge [Lot no.: 12 wafer service (no. linear ft.: ) Page 2
Fixture or item
Tax map/parcel no.: 655 A6 -
Absorption valve 16.60
DESCRIPTION OF WORK. Backflow preventer / Page 2 er • sS
Landscape Iackflow Device Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER I 0 TENANT Drinking fountain 16.60
Ejectors'sump 16.60
Name: Don Morissette Homes Expansion tank 16.60
Address: 4230 SW Galewood 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 APPLICA ® CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Landscape Oregon, Inc.
Intern epiorlgr MSC 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
Phone: (503) 692 - 5945 I 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 /Z1P: Tualatin, OR 97062 Subtotal
Minimum permit fee: $72.50 f
Phone: (503 -) 692 -5945 Fax: (503) 692 -0768 Residential backtlow minimum permit fee: $36.25 .0 .0.
CCB Lie.: 7804 Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (8% of petmit fee) a, 90
Authorized signature: ...c% G LZAA_ tr - L--kj TOTAL PERMIT FEE al, is
Print na rnc: Ellen Spar Date: 05/16/07 This permit application expires if as permit is not obtained within
ISO days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Sery ice Board.
P.Butldin Perraisr.PLM•PermiWppdac 06!05 440-4615T(Io,n2'COht'wER)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007- 00199
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/17 /2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/6/2007 TIME: 7:01AM PAGE: 2
SITE ADDRESS: 141 565 SW ANGUS PL CLASS OF WORK:
SUBDIVISION: WILSON RIDGE LOT #: 012 TYPE OF USE:
PROJECT NAME: WILSON RIDGE
DESCRIPTION: Landscape backflow device.
OWNER: DON MORISSETTE HOMES, INC., PHONE #: 503 -367 -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 049736-01 503- 692 -5945 N
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Corrections /Comments /Instructions:
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1 Gj
ASS ❑ PARTIAL APPROVAL ❑ CANCEL . NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ) Date: 1 Phone #: (503) 718-