Permit r. CITY OF TIGARD
PLUMBING PERMIT
-III DEVELOPMENT SERVICES
PERMIT #: PLM2004 -00048
' ^- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
DATE ISSUED: 2/4/04
SITE ADDRESS: 12438 SW ASPEN RIDGE DR PARCEL: 2S110BC 08000
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 051 JURISDICTION: TIG
CLASS OF WORK: ALT 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 INC
4230 GALEWOOD ST #100 [PLUMB] Permit Fee 2/4/04 $36.25
LAKE OSWEGO, OR 97035 [TAX] 8% State 2/4/04 $2.90
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 d/1 ,e 1 ,4C'J Permittee Signature: z �yf a ..,, , '� Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next b ea)
i ness day
Feb, 02 04 11:47a dan edmonds 503 - 692 -0768 p.
: F•OR USE ONLY ::
• t A ®u Received -0 .1� p arnit N
Datei o. ` -04 0 i
Plu ._.-- Permit
Ve
Sewer r �- •� r {41
Planning APPro`� Permit No.: '°'
Da • Other
City Of Tigard • PL Review Permit No.:
F a- O 2 1044 Da R • • !need Use
Tigard, , Oregon Hall Blvd Post-Review Case Use
Phone: 6n 97223 q P�D Date/8 . ` .,r See Page 2 for
OI
Phone: 503-639-4171 Fax: � lV % `` " °�'E ti a A Co,ttact St• .iementatit[ormatfon.
4 G l S. _ .. a l
Internet wwwtion Request: r.us 9: ! ,�i 'i1' ' .' Name/Method: Faill
24 -hour Inspection Request: �
9 "-4175
foruiation�tise checklist)` ; .-
IR ' FEE SCHEDULE�(for:sPeCia1 in Total QtY. UM
p - _
E'OFWORK`
; " Descri � tion • Demolition ; i New - 8c 2 - i a< i tll y d w eliiags
New construction Other: -,.:.‘2.--,'',::- ;: _ is ad aao.ei: ror-e c il l 249.,0
CI Additionlalterat O • F .CON nt ❑ NM 350.00 r
;:" CATEGOR'1Y:OF..CONSTRUON ::'' •:`: :'` "; `; ` SFR 1 bath
• C 1111111 399.00 -
1 c sso B dwellin: De M ulti Famt1 SFR (3 bath 399.00
• as ter Buildin' Ea ad A�
_ ditional bathlkitchen
Master Builder _ ❑ Other: I:OCATION = 7: ... - - ,. - :.Site; Dtilities III - : =" , :
: :TOB SITE`INFORNIAT10 5:2. ;: . ` ;.r: "`. .
:, 16.60
g S [.t 11- � ` . Catch basin/area drain ' 16.60
lob site address: BId :,./A • t..#: D elUleach line /trench drain r
- Footin: drain no. linear ft. Pa Le 2 -
110.00
Pro Name: a. , w • d ` Manufactured home utilities 16.60 WNW
Cross street/Directions to Job site: Manholes r 16.60 e IIIIIIIIII
i Rain drain connector ��
S i tj �' t T� Sam sewer no. linear ft. _
Storm sewer no. linear ft.) -
Lot #: Water service no. linear ft. . :.:• : ::.
Subdivision: Ci __ n t col. ,.: or
rRIMlta . .. - t o n v valve '
•
' "•' Future -Ytem" �
16.6
. .. Abso tion v al �'�
; DESCRIPTXOli� I . Q Backflow .reverter r 16.60 -
ld C L ♦ Backwater valve 16.60 -
Clothes washer 111111 16.60 -
Dishwasher 16.60 r
Dr
rowan_ founta 1111111 16.60 0
E 16.60
hat N ' ne: Di CY:OWI�I • '.:;.: ': ': �® Ex' ion tank ON 16.60
� 7S ' 4 ■s ` Fircturersewer ca. 16.60
Name: s:4 v.
Floor drauJfloor sink/hub 1 6.60
Address: i 3O Std ,00 CI-
Q-103< Garba: a di l •sal - MN 16.60
Ci /State /Zip :•�''�- � �� Hose bib 16.60
phone: gElisoN; ; "-' ` lee maker 16.60
�_
�-O Medical Las 'value' S ME 16.60
Name: C.9`)
Address: l �-Q o S- YYl Lim � Primer NMI 16.60
�/-1 0 91 to Roof drain co Mil 16 6 0
P (
/State/Z• : "t 0710 g Si*/basin/la'vato _ 16.60
Fax:5a3 tog &.- c0710 16.60
E , .. = 16.60
::`CON7.'RAGTOR.. "�.:.�: = : � '� ::i:- :; :'s.;,�,::: water closet � 16.60
", Business Name: La -i'� ' •: 0 � � � Water heater _-
��-UQ .� ru • - other.
Address: _ R- , -/at Other: i 1 1 ,; 11111 ,- 1
Ci !State /Zi • :� �`- a •- . :'4quilibin _"pest.
Fax�3 fold - o • �:::' Subtotal S
Phone�ta3 l>� - S M inimum Permit Fee $72.50 S
Plumb. Lic. #: ,3 (� . a 5
CCB Lie. #: ��`� n Residential Backfiow Mtntmum Fec 536.25
orize � 04 Plan Review inim of Permit Fee 4 , r
Sign i_ 0 Date State Sure : e 8% of Permit Fee /
,��.y,� TOTAL PERMIT FEE 5
Eli L' n 1 e p require 2 sets of plans with isometric or
(Please Print Hama) obtained within All new commercial buildings u
ices i[ a permit is not obtsi riser m for plat renew. Industry Service Board
180 days This permit application expires *Fee di agr a m o pit rev Cotnty Building
- l8t) days after it has been accepted as completes
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
lei BUP
l
Received 6 0y r Z 2$ a Requested �/1 q /0 AM PM BUP
Location / ZJ •• ��� 4 - -� �/. ite MEC
Contact Person _ � Ph _ 9Z 5 ` � �
Contractor mss% _.■ _ -G 64L _ 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 /
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole •
Storm Drain
Shower P n
PART FAIL
M ANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Li 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
ADA D ate 21 ( Gi �, o I nspector - Jt t) P Approach/Sidewalk Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL