Permit CITY TIGARD PLUMBING PERMIT
�1�� DEVELOPMENT SERVICES PERMIT #: PLM2004 -00059
�. DATE ISSUED: 2/10/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12432 SW ASPEN RIDGE DR PARCEL: 2S110BC 07900
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 050 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 2/10/04 $36.25
LAKE OSWEGO, OR 97035 [TAX] 8% State 2/10/04 $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: :/ /' Permittee Signature: 07 0-72/ill: 2 ��
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Feb 0` 12: 10p
don edmonds 503 - 692 -0768 p.2
�PF robin Permit Application c .:.:...::::::•::,!:!::::::.::'..,::::•:: FOR 0010E USE.A \L' ;
I 7atelB}r -! O-O-/ [JD p �O Plumbing
.
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(ty of Tigard RECEIVE!) Pens& PL41 Do-DV-00o 9
Pi amnng Approval Sewer
13 225 SW Hall Blvd Dat e / Br Permit Na.:
Tigard, Oregon 97223 �' BC . other
F 9 200 - . Permit No - :
Phone: 503- 639 -4171 Fax: 503-598-1960 Post Land Use
Internet www.ci.tigard.or.us f ` ` ' ;. '^ � r� Case No.:
24 - hour Inspection Request: 503 " '
�'� See Page 2 for
T5
WILDING Dl r • " rr�,,,�Merl,«l
t ! Suppi P e a ntal Information_
New ., ` `<'- ?: -" - FEE'*. SCB ED1 UI:; E( forspeditInfo ciaiation :use:checklist). - : '•i :
Demolition
r AAddition/alteration/replacement 1 0 [3 Other: :. - . , .::: , Description Qty. P� (� -) Toted
t~ !_ : &?= faritity_:dwetiings :' :_;
CATEGORYO .CONSTRUCTION.:::::::‘,.:;y: ,:;. ' ', 7 r : , Onc!u It. ' , for each an Tty connection) .:,> .:
II I & 2 -Famil dwellin : SFR (1) bath
• Commercial/Industrial
2.49.20
(%Accesso Buildin r SFR (2) bath 350.00
111 Master Builder ■ Other: SFR (3) bath 399.00
'JOB SITE:IIN]FO Each additional sq. I L : itchert age 2
Job site address: %
RNiATION ani1LOCATZON:_:�
a �f C'll Fire sprinkler - sq. R: Page 2
Suite #: gtel e , ,,,-.: : r _: `.. i :c,_;,; ; , ..:S1ii tit hies:: f:•�, :::::-,:..,:...s .. .
BldggJApt. #: Catch basin/arca drain 16.60
Project Name: T weer ! t, (�i �� (� Brywelllieach line/trench drain j 16.60
Cross street/Directions to job site:
Footing drain (
Manufactured (no,. linear R) P 10. 2
d /l home utilities
L Mirk" p ,, e ! 10.00
Manholes
Rain drain connector 16.60
2
Subdivision: 7h rp Sanitary sewer (no. n linear
rf � Pap ft) Page 2
�� � Lot ,#: S U Storm sewer (no. linear �
Tax map /parcel #: Q
Water service (no. linear ft n Page 2
. .WORK ".•. % `: :•. ..
• " •re:or tern ' . .
• . RUPTION OF:
L4J 1GLg ce) C. ( L3 Absorption valve
ice) Pa Backflow preventer Page 2
2 �,', sy
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
O. ' ROPERTYAVYNER`: Drinking fountain 16.60
�i;�rrrrvvAN�r ::
Name:O�m M CjlYIss -��"� I YY)�.S Ejectors/sump 16.60
Address: A 30 & u.3 Expansion er tank cap 16.60
`�' '+�� -t�/JO al, Fixture/sewer cam 16.60
City /State/Zip: L43 0.4-kg-re.. 36 Q-70 Floor drain/floor sink/hub
F ax; Crarbage disposal -
osl 16.60
Phone: 16.60
?�,APPTTCANT:':.•;. .:;.:' ; Hose bib
'L CONTACT: PERSON I �� I 6.60
Name: el l e) Spa-n-
16.6
Address: / O ,C-4.4.3 p� u In • .rot /: 16.60
on RD Medical ?: - value: S Pa: 2 -
City /State/Zip: - T1,1`A -J�Q�} 11L, O r2. ?O (0 a_., Primer 16.60
Phone S3 (e9a -9't/$ Fax fo3 cal - 07/0 Q Roof drain commercial 16.60
E-mail: Sink/basin/Lavatory 16.60
_,, •:::r , , TuWshower /shower pact
: :;- : : :, :i. " G ONTRAGT`OR: ' . - ::: :.. • , :;.,__ > " Urinal 16.60
Business Name: L . s q Water closet 16.60
Address: a- O o v 1 �J Z U
Water a 16.60
� -11-20(0 let). Other 16.60
City /State /Zp: •;,_ --b g a_. Other
Phone !tea - S$ YS Faxs33 (.09.1 - 6710 -
�1 :'Pluru6i ": ;P e t t is b t ot al ; : S -.
CCB Lic. #: `7
`J Pl um b . L ic. #: S S
Authorize Minimum Permit Fee $72.50 S
S El!' do ,C �� Datt� /010� Residential Backflow Min Fee $36.25 •3(0 . �-S .
V tau Plan Review 25 of Permit Fee S
State Surch : 8% % of Permit Fee
Notice Tilts print name) TOTAL P : app{iatloa expires if a permit is not obtained within ERMIT FEE $ h9. / S
180 days after it has been accepted as complete.. All new commercial buildings require 2 sets of
riser diagram for P revie+r• plans with Isometric or
-
'Fee methodology set by Tri- Conuty Building Industry Service Board.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Receive A 1� �� Date Requested L3M1 v AM PM BUP
Location / 24z3 a zd .e. 'utte MEC
Contact Person efa Ph ri ) — dr, c/ c5 9
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: 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 n
O r: •
a
PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
•
Service •
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line ,/�
ADA / / ' ;P
Approach /Sidewalk Date I nspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL