Permit CITY OF TIGARD
PLUMBING PERMIT
PERMIT #: PLM2006
i` .� DEV W H BMEN Tigard, O R9 2CES -639 -4171 DATE ISSUED: 2/3/2006
PARCEL: 2S 109 D A -12900
SITE ADDRESS: 12980 SW BIRCH HILL LN ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 118 JURISDICTION: TIG
Project Description: Backflow preventer for irrigation.
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 COMMUNITIES, LLC
4230 GALEWOOD ST # 100 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 2/3/2006 $36.25
[TAX] 8% State Surcha 2/3/2006 $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: 1 , e `n )
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.
1
-Building Fixtures
Plumbing Permit Applit . i-1--'EIVEAt
F
0 3 2 0 .. 1 14 00, 111:11ii R OFFICE USE ONLY
•
City of Tigard Received A _ .,_6,‘, , O .....-
13125 SW Hall Blvd., Tigard, OR 97223 FEB Date/By:67G_ L., Per
mit Nci73\WAK-ay))
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 4vii: .:''. A Date/By: Other Permit No.:
2.4 Hour Inspection Line: 503.639.4175 city OF TIG ; ,iz=,-,r0r . . --' ' Date Ready/By: ior,: 0 See Page 2 for
....-
Internet: www.ci.tigard.or.us
n Notified/Method: ) i Supplemental Info, mation
' • ':"' '.•'''.:-' . ' '.' - .' '''' - ',.',' ': ' ' TYPE - QF'NVORFC' :-'5 • .:, 0 '' :, .--,:;.: --- x-'7.'-.;''ni ''. -'' :, '':-.., '. . '- •' ' • --
New construction 0 Demolition For special information use checklist.
Description 1 Qty. 1 Ea. 1 Total
I:1 Addition/alteration/replacement 0 Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
. - • - . - : ..-: • ;' -,! • '''''''' . 2-- • ' ,.., .... .7 ''' " ''". SFR (1) bath 249.20
\ IN- and 2-family dwelling I] Commercial/industrial SFR (2) bath 350.00
•
SFR (3) bath 399.00
CI Accessory building D Multi
Each additional bath/kitchen 45_00
1=1 Master builder C] Other:
. Fire sprinkler ( sq. ft.) Page 2
� ' S ••• ::*: - .!.::':';;N" , '.:..:.;:: • ? - * - ::i;':::4:-.A.,14.l.',,.., .....C!....;,,., T,X0,.::IANR.M?.. .. ....P., , 7.; ,',.;,....... - . •-.,:.. site utilities
Job site address: 1.p.Sig-0 .9.4., 6; rel._ Ii' // tan c, Catch basin or area drain 16.60
City/State/LIP: TI fet.4.ce_ 0 /2_ q - 7 ?-;-3 Dryvvell, leach line, or trench drain 16.60
-- ” Footing drain (no. linear ft.: ) Page 2
Suite/bldg./apt. no.:
Froject natzfaim-ur, Lt _Letge_.) 1 1 ?
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
,L 6e cf e 6_1)
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: )• Page 2
Storm sewer (no. linear ft.: ) Page 2
SubdivisiozELJ-A in Lf Rkilex..., 1 Lot no.: fig' Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map/parcel no.: 6, ss ,e)-2
16.60
'''•'-' •: ;'''-••':.'•:'-' : . " . ''''A - -i • ESt , f1i3N. - :Ok.W.sti.ftk:' ''":'' • - ' .'''' - :
-' ' '.' - •- • • ':-
/ Page 2 ,_7 , sy
...
( o...-/ o,--., hoi.vr-- 7 i_.,: ..),... , Backwater valve 16.60
Clothes washer 16.60 :
Dishwasher 16.60 i ., Dnng fountain ,
16.60
-
16.60
Name: b FYI. /q)(5)'/ ..S S C 7' / C "m Expansion tank 16.60
Address: L--/ 3 0 ,._ L.0 £'« : LI' .(.. C Ci oct Fixture/sewer cap 16.60
City/State/ZIP:/r, k c. 0 LI f) i y6 OA_ if 7 L.::_::.; 4 -.- - , Floor drain/floor sink/hub 16.61)
Phone: ( ) Fax: ( ) Garbage disposal 16.60
I 16.60
:' - , ;:,:' - ::!:i:: : -. ...; :...;:l',. .., -. • ,,„,.,. ... ..!.;?I-4..., ... ,,..:, . -::.:- ':-::::. lee maker 16.60
Business name: Lac, a s ( ,,_ f ,,,,. /".:)/- _7,-; <1., Interceptor/ease trap 16.60
I - ,
Contact name: 1--- i/ . ai ? (: Medical gas (value: $ ) Page 2
Address: / 'a a 0 0 ..- Lt.) rrivs I twi q iZI) Primer 16.60
City/State/ZIP:TWO a , c ,k__ , --• "7 'A:Cc ,-)---- Roof drain (commercial) 16.60
-
Sink/basin/lavatory 16.60 I
Phone: (Sc 3 ) t:e; -2. Q - - Fax: : (L;i' 3) 6.-' V ' - (-: ...-
Tub/shower/shower pan 16.60
E-mail:
Urinal .. 16.60
I I CONTRACTOR Water closet 16.60 ..
Business name:La/AS( op e orr.(//Th 1....--7-)c Watcr heater 16.60 •
_ .
2 / - ,.; - C.)0 - S (j) if) L( ,./ f - 4 Li r. - 31..::.r: I .••
Subtotal
City/State/ZIP: 7/ta_14 ,./ 0 7O& __
Minimum permit fee: $72.50
Phone: (3 ) (eQ,.,,1 S Fax: 603) 6 9,;? - 0 7 (, E' Residential backflow minimum permit fee: $36.25 .3 tr. .a...C
CCB Lie.: 7 V
L1 Plumbing Lie, no.:
• Plan review (25% of permit fee)
State surcharge (8% of permit fee) a , 90
Authorized signs - ,6( .... zit _ ./ -)
TOTAL PERivilT FEE yi , /5
1
Print name. e4 „c: D47/3/0 (, This permit application expires if a permit is not obtained ". ithin
'180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board
1:113eilding\Permits\PLMF-Perrrampp.doc 12/03 440 10/02/COMME13)
a - 0 139L0-ZG9-E0 S uaTT3 e0a:TI 90 CO cleJ
CITY OF TIGARD c ?Hi 266 6-6a
BUILDING DIVISION AV PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 ATE ISSUED:
Phone: (503) 639 -4171 �� i
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' jl..
INSPECTION WORKSHEET FOR DATE: 2/7
10e TIME: PAGE:
SITE ADDRESS: Z � 1 ( I CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
" 3 C t e ) LiAvy,k)(Al 6
Corrections /Comments/ Instructions:
C
•
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1/( //1 \ / Date: V2W 6. Phone #: (503) 718- M- --1