Permit 'CITY OF TIGARD
PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2004 -00445
J11 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/24/2004
SITE ADDRESS: 12480 SW ASPEN RIDGE DR PARCEL: 2S110BC -08700
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 058 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: Irrigation backflow
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES
4230 GALEWOOD ST [PLUMB] Permit Fee 9/24/2004 $36.25
STE 100 [TAX] 8% State Surchan 9/24/2004 $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
P RP /Backflow Preventer
Phone : 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. �c
Issued By: �I�. Permittee Signature: al / •I
Call (503 39 -4175 by 7:00 P.M. for an inspection needed the next business day
Building Fixtures
RECEIVED
C
Plumbing Permit Applicafijn "
FOR OFFICE USE ONLY
City of Tigard SEP 2 2 01 Received ,
13125 SW Hats Blvd., Tigard, OR 97223 Date/By: , Pe rm i t No it, (� /LL
Phone: 503.639.4171 Fax: 503.598.1960 CITY OF "-•. -' � , Plan Revie
y' T✓
24- Hour Inspection Line: 503.639.4175 t ? ` Date/By: Other Permit No.:
Inspection
Internet: w pect: tigard.or.us BUILDIN c. ? ► . .A . ,.c Date Ready/By:
cd/Method• �� ! 121 See Page 2 for
"'•' Sn PPE meat( Information
Ott
New Construction 0 Demolition For special information use checklist.
❑ Addition/alteration/replacement 0 Other: Description Qty. Ea. Total
_ New 1- 2- family dwellings (includes 100 ft. for each utility connection)
- :. :_.,`
:- : :
.,_ . .. 4 ..;( TEGOR3f •OF'?CO.IVSTRIICTJoN ... . ..,• . SFR (1) bath ( 249.20
l._i.l- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder 0 Other:
.... Fire sprinkler ( sq. ft.) Page 2
'. :� ..:... ' :. `JOB. 5 LE:.OM 9ND ATxtA ,LOCA'TI0N
U
c.l '�:-•': ' . ' . ' Site utilities
Job site address: /' t-.f ,E' L) • I ` ' �� ra ^
` Catch basin or area drain 16.60
City/State/ZIP: s l1 cjek,,Ick ei oQ. 9 `2 L
Drywell, leach line, or trench drain 16.60
Suite/bldgJapt. no.: 1 Project name: • Lc) L r 5 cV Footing drain (no. linear ft.: ) Page 2
Cress street/directions to job site: Manufactured home utilities 1 10.00
S� p L � t t (LP Manholes 16.60
� 1 Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ,) Page 2
Storm sewer (no. linear ft.: 1 _ Page 2
Subdivision: ��'1D1• r� U a� I Lot no.: Ito Water service (no. linear ft.: _ ) Page 2
Tax map /parcel no.: (4:, S U 5 Fixture or item
�;" ) .' ' .. DESCRIP.TION -.OF WORK ' .:::,4:...:' : ,
Absorption valve 16.60
., ... . ....... ... ..: '' =' Baekflawpreventer Paget
L�/')dSC i / ) , d r r / 9Q_t 7 ✓r? / i t Backwate valve
I 9 - r/C ��C��C�C, r. f'�� /C.f 16.60
Clothes washer 16.60
Dishwasher 16.60
:.PRUtEBTY° Wl yER: - :': ;J: .[] ,' A : Drinking fountain
�E1V' 16.60
/ .0 t--7L.74 Ejectors/sump 16.60
Name:
Ch /)')f; /��7 J Expansion tank 16.60
'
Address: - 3 G' S L.L S L7lc -e c L& :: 0 oc
L- Fixaue/sewer cap 16.60
-
City/StateZIP:L. J<C, C .&.- it) 't' %Ci 4- k_ 6f •7 L3 5 Fl or drainJfloorsjpkjub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
i .. Hose bib 16.60
:.:. -: .: :, • . :'..�. t COI • :
/r _ SON Ice r
make
` Business name: l�r C/ S (`C r T /mss' (j� rya 7 'if't 16.60
Contact .' y J t
ontact name: Interceptor/grease trap 1 6.60
, c•-1) � arirti! i
Address: Medical gas (value: $ ) Page 2
/ 3 3 DU S.' TflLj /�`Ytt.J 1'G Primer
1 e 16.60
City /State/ZIP:
��.. [ �'1r>,. L j�L• 7 76' U ,l -- Roof drain (commercial) 16.60
Phone: (56 ( L C f - J � %V S I Fax:: (.5.='5) & f• : � - C' 'A - - Si Sink/basin/lavatory 16.60
E -mail: Tub /shower /shower pan 16.60
Urinal
_ 16.60
::. '; . . :, CONTRACTOR '. - Water closet 16.60
/ � -
Business name: Lc .. 07- -e9/i7 t7 ,j - C Water heater 16.60
Address: /' � - - to hi L S- r n 1V Other:
City/State/ZIP: ((t f-? ) � 4706 -r - Subtotal
Phone: J-/, a -S-94-45".
7 `�, ( •-� Minimum permit fee: 572.50
�� 3) Y Fax: G3) Co ( d ) - 07(o Q' Residential backflow minimum permit fee: 536.25 3C, - s
CCB Lie.: 7 O(� n Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized sig f l �, X 7 State surcharge (8% of permit fee) c , GjQ
/ Le ...6A f �d / TOTAL PERMIT FEE 3 �
Print name`/ y'a- Z� Dat / 1 /// �' (, 11
This permit application expires if a permit is not obtained :‘ toxin
180 days after it has been accepted as complete.
t_1aQiwi° *Fee methodology set by Tri-County Building Industry Service Board.
plPermitstPLMF- PamiiApp,doc t2/03 4404616T(10/02 /COM/wFB)
z - d - dD :ED 170 22 daS
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received p Da Requested 9 AM PM BUP
Location `� 11 J Sultb'' v MEC
Contact Person P ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
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 Pan
aid PART FAIL
CHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
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 . • Ej Please call for reinspection RE: El Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date - 6 - Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL