Permit CITY TIGARD PLUMBING PERMIT
i DEVELOPMENT SERVICES PRMIT
2/26/04 4 -00086
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12426 SW ASPEN RIDGE DR PARCEL: 2S110BC 07800
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 049 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: Install irrigation backflow preventer.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES
4230 GALEWOOD ST [PLUMB] Permit Fee 2/26/04 $36.25
STE 100 [TAX] 8% State 2/26/04 $2.90
LAKE OSWEGO, OR 97035 Total $39.15
Phone : 503- 387 -7538
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062
' REQUIRED INSPECTIONS
Phone RP /Backflow Preventer
hone : 503 - 692 -5945
Final Inspection
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.
Issued By: Permittee Signature: T)1
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Feb 26 04 08: 00a dan edmonds .// 1. 4 / 6 503-692-0768 p . 2
, : . .., FOR OF ICE.USE ONLY' ' • . , '
P1UMbiEl. ' Perin !!! IA' I il 0 . c a. 1 ■• ij t
Receivecli, P umbing a^3
, . .._,,
4 /0 1 ,11/5 Permit No.: ri 0
Cit of Tigard FEB 2 6 2004 Planning • pproval
Date/By: Sewer
Pernit No.: '
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF TIGAR41 Dateff3y:. Permit No.:
Post-Re Land Use
Phone: 503 Fax: titiffffitleft...,,,
Date/B
y: Case No.:
Internet: www.ci.tigard.or.us ..Jt.i I Contact • Juris.: CE) See Page 2 for
24 Inspection Request: 503 NamelMethod: Ti , Suppicuientat Information.
• "
'. ..' . t.f WokIC ...., ..,-. ;. :,.. ;:,i ?i; -..„... 'YEE11';SCHEDULE1roijiitekOliifoiiri4tioalieekliitY
New construction 0 Demoli :is it Description I QtY-1 Fee(ca4 I Total
Addition/alteration/replacement 0 Other: ,.:. i:;"- .:::t.'.,"4',.--,:. -- ;;' , :.istewl:::..te:Vfainity:dViellings'; --.. - ..;:: , v: , .- : : ... • .- :
,:,f'.,:-.:;::;,,,:':: . itility:cothieitioU).:.: ,. •, .::•,.: ,-. : ,.
• - :-.• ••'::::', CATEGORICOF:CONSTRUCTION::,;::::::e3;-:',:-:;.;-!:
SFR (1) bath __, 249.20
MI) 1 & 2 dwelling 0 Commercial/Ind a - .1
SFR (2) bath 350.00
0 Accessory Building JJ Multi-Family . SFR (3) bath ' 399.00
Master Builder • • 0 Other: Each additional bath/kitchen 45.00
• :': ,.. ...JOB SITE INFORMATION and LOCATION ...,.-,r..., Fire sprinkler - sq. it: Page 2_
Job site address: /(3 ..c24..) ,.., fat_ (, e, - - : .- */;::•::,:,-'2:,.•:::',1.:, - .., ,,- ; siwtrtiutii : ::..:,',..
Suite #: Bldg./Apt.#: Catch basin/area drain 16.60
Drywell/leach line/trench drain 16.60
Project Name: 7Z4) z__•_> 7 / /7
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job site:
Manufactured home utilities 110.00
- 64_■C 1/ MTN k A _ Manholes
Rain drain connector 16.60
16.60
Sanitary sewer (no. linear ft) Page 2
Subdivision:77) arli u..)0c_)C.X._ 1 Lot #: -AP Storm sewer (no.. linear R.) - Page 2
Water service (no. linear ft.,) Page 2 _
Tax map/parcel ft: (v. S - 5:: 6 (c9
DESCRIPTION DENVORK:: ,'.i.:'::::-....,'-:',1-',••'''.."-::,'-.1:-.-
Ab lion valve 16.60
tzuldgcape.. Ilka.cic -rioui cte . .; 0 ice) , Backflow preventer Page 2
Backwater valve 16.60
Clothes washer , . 16.60
'
Dishwasher -
Drinking fountain : 16.60
Nal'ROPERTVOWNEIt's,: '-'-' :1: 0 TENANT: ',':';::::,';',.::::. ''.2:;.''.1:'. Ejectors/sump • 16.60 •
-
Name: *61.-k in OYi‘.,s_t&lie kietyn<S Expansion tank 16.60
Address:4-A 30 %Tu.) &a-La./J.30o cf...) Fixture/sewer cap
- - 16.60
City/State/Zip: 1.,0-4(.-. 04-weffs 9 7c)2,..S' Floor drain/floor sink/hub • 16.60
Phone: Fax: Garbai .... ..... ___ . 16.60
Hose bib 16.60
:. : 4 1RAPPLICANT:' '.! .::. . ::....:: :',.'.:'", .•'.: : iaCONTACT.PERSON . lee maker 16.60
,
Name: El I I:_n spo-nino Interceptor/grease trap 16.60 .
Address: / D...)-0 0 ‘ nly.CIDIA9 .12D Medical gas - value: S. . Page 2_
Printer 16.60
City/State/Zip: mA.C4.1.0.shk.,' 0 A_ .97 0 (.0 -a-.-
-
Roof drain (commercial) 16.60
Phone933 (,)91.. - Sq4.5 I FaxSi3 lag sk- ori to g sintdb2sin/lavatory ._
16.60
E-mail: . Tub/shower/shower pan 16.60
!, ;:., :::.....-, .7 r.:,..:: ..,'.; ::',:::::!CONTRACTOR: :I:: ..: :;-- : :;' Urinal 16.60
0 ray Water closet 16.60
Business Name: L.p.M...CCape...., , -- r - n . c _, '
Water heater 16.60
Address: I-OC) sw ry A-Ciimj ie- r i - Other: '
_
City/State/Zip: --6 R roan a_. Other , .
Phone. (cficl - Viki5 I FaxS)3 URA - 6710 k .,:
CCB Lic. #: - 7el.) 4 4 I Plumb. Lic.#: Subtotal S
Minimum Permit Fee $72.50 S 2 / -i - ,
Authorized dzlzdi __,jfia,L,LaL, D at? 7 i l
Re
sidential Backflow Minimum Fee $36.25 •--' to ' ' .
Plan Review 2_5% of Permit Fee $
Eli er? kcpar ma st_i / . & ,, c Surchar mon..., 0 itFee S c7 ,
/ (Please print name) TOTAL PERMIT FEE $ ..,*3_,. /
Notice: This permit application expires if a permit is not obtained within AU new comnieocial buildings require 2 sets of plans with Isometric or
180 days after it has been accepted as complete. riser diagram for plan revievv.
-
*Fee methodology set by Tri-County Building Industry Service Board.
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (• • 9 -4175
INSPECTION DIVISION Business Line: • _ •_, MST
,} / / BUP
Received 7 �. �� Date Requested 3 / ( �/ 64 AM PM BUP
Location /Z<Z Zh �� Ja Gj, : Suite «9' MEC
Contact Person (�D� Ph ( 0 9? ' - Sl PLM�U ��
Contractor ... i� ' ,� Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: •
Final
PA PART FAIL
UMB G 0, •
Beam V j
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower n
in
PART FAIL
' ME CHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL •
ELECTRIC AL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm •
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line r
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL