Permit CITY TIGARD PLUMBING PERMIT
, DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00059
-, tt �i1�1 DATE ISSUED: 2/3/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA - 12800
SITE ADDRESS: 12956 SW BIRCH HILL LN ZONING: R - 7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 117 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:—Th, i _ %/ _ Permittee Signature: �; f
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.
, Building Fixtures
Plumbing Permit Applica4sG CA FOR OFFICE USE ONLY
City of Tigard ;■% D 6 , _ Ire:
13125 SW Hall Blvd., Tigard, OR 97223 p e, in i t N . „ t... , a i cio d
Phone: 503.639.4171 Fax: 503.598.1960 V.R) ''',,,,.„.';''' Plan Review
Dateay: Other perrnit No.:
24- Hour Inspection Line: 503.639.4175 _U.' 1,01
Date Ready/By:
Internet: www.ci.tigard.or.us CO 01-''---- a I Notified/Method:
i V S 1 1..■ r tof too tint.
: •.- --: .;'?.::.::..;,.,,,,..:.,.- i.' .:,, FE1 ' . . . •
'(New construction El Demolition For special information use checklist.
Description I Qty. 1 Ea. I Total
0 Addition/alteration/replacement P Other:
New 1- 2-family dwellings (includes 100 ft. for each utility connection)
. '. •J - ..'..Z •.', ':. c''
CATEGORY OF 'COPISTRUCTION•:,i'', ,•• • .-', - : ••: v. •••: -:" '..l • SFR (1) bath 249.20
. )N 1- and 2-family dwelling 0 CommerciaUindustrial SFR (2) bath 350.00
SFR (3) bath 399.00
0 Accessory building El Multi-family
Each additional bath/kitchen 45.00
Ei Master builder 0 Other:
-:: Fire sprinkler ( sq. ft.) Page 2
'
- ' , .l..:;.1: - ,.•..'illi , ::::!:•l'.-l?.? - ..l'Y:•:-. ..' • •-Y■ -..;.,•;
t,'Fl1i j
::::,. • '''...l'A. - - • ' '.. ','''''''•'' ' • ; Site utilities
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Yob site address: (p.c.? s - c ..5-tv 0 rch 1/ t( if-i-ne-- Catch basin or area drain 16.60
City/State/ZIP: s n C4./1_C-1.. 0 it-- 97P-2-4 -. Drywell, leach line, or trench drain 16.60
Suite/bldg./apt. no.: Project.6ntetjyVyj Li le-Lag& / /7 Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110 00
Cross street/directions to job site:
Manholes 16.60
S U.) t f.tE Ia_x_iNzt_ g_
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
SubdivisionCUrY1/11. Lt lat_c . g ei I Lot no.: / / 7 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map/parcel no.: Ca ,
Absorption valve 16.60
...'-:',;•: • - .• '.,::: ...:i'•'• :l..... Ae:::•.'•:: :...:::., .,- .' : :•.: :;P ' '9..Y:).,' ...P. .,... .A::!-...:'.,,: .-. ... :,-..:: Backflow preventer / Page 2 1..). S....c
i r r / 90./7 , J?", bo .e.fr- t- / :.. < 1,,, i : , „. 4 , Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
*iii.0*i-?:• , Drinking fountain 16.60
Ejectors/sump 16.60
Nam D C iThi.. S .--'; t '7 i ' / - ' Expansion tank 16.60
Address: 1---/Q 3 (2 .. u___, 1- / (:' k i..: c (--,4-L Fixture/sewer cap 16.60
City/State/ZEP:LX1_ k C .,. C) L t C" y CI 3/?. ' 7 e_:. :-; ..-2., Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
16.60
..; ,,,i,. - ,,. ■ ! A' .. , . l . ....., PERSO 'I ...'.. '. '!
.. .. • ' ' ' ke maker 16.60
Business name: b r a f e 4 . , t 0 ,--, „ , •, 27 <e
Interceptor/grease trap 16.60
Contact name: .,i ,-) ■:S/2„ (.1.. ,:y i- ;:...• - 7_0 Medical gas (value: $ ) Page 2
Address: i :9 D L:. C .c. EL) 11')V_S. I (Wit 1 ,zt Primer 16.60
City/State/ZIP:7u ,, a h A , c l a , --1 7 . X.,' Roof drain (commercial) 16.60
Sink/basin/lavatory l 6.60
Phone: (0 - .3) /..z; (/: ---,? - 5-) S Fax: : („S' .5.) - .,-' _ - (..' -- ,k . :...c . '"
Tub/shower/shower pan 16.60
E-mail:
Urinal 16.60
CONTRACTOR Water closet I 6.60
Business name: b-,..„ , (.. (77-7...( , r Water heater 16.60
fi_. `-----
Address: i ? .,...., /0 ipi-o-1(AL-f r<J;) Ottwr
Subtotal
City/State/ZEP: 7Ztae1440-?/-1: ' '--t-/-704„, 2..-L..... -
Minimum permit fee: 572.50 .
Phone: 6C-3 ) (4/,1 _S Fax: 603) (e,9<;2 - orl (0E- Residential bacldlow minimum permit fee: S36.25 36,-
CCB Lie.: 7 .c.....)
,/
.0 Plumbing Lic. no.:
i Plan review (25% of permit fee) o
State surcharge (8% of permit fee) a .c
Authorized signs _ Le .../. 2 . 71 . _ __,..... / 4a .:, .L
TOTAL PERMIT FEE 13• , /s
Print name// eil S Da/3/() . This permit application expires if a permit is not obtained v. ithin
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
i:\Building \Pamirs \ I'LMF-P errn it App. d oc )2/03 440 I6T( II3/02/C OM/3 II)
a - cl 89L0-269-EOS uaiT3 et,2:IT go 60 qaJ
CITY OF TIGARD
BUILDING DIVISION ,- ,
PERMIT #: Km20
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/3/2006
. Phone: (503) 639-4171 1444/401Ali
Inspection Requests (24 Hrs.): (503) 639-4175 - 12..
INSPECTION WORKSHEET FOR DATE: 2J 14/3006 TIME: 2:22PM PAGE: 38
SITE ADDRESS: 12956 SW BIRCH HILL LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2. LOT #: 117 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: Backflovv preventer for irrigation.
OWNER: DON MORISSEfTE COMMUNITIES, LLC, PHONE #: 50.3_387..7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 2/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 026848-01 503-692-5945 N
Corrections/Comments/Instructions:
, f
4 1 9 ASS fl PARTIAL APPROVAL 111 CANCEL LI NO ACCESS
n FAIL 0 CALL FOR INSPECTION . Ti ADDITIONAL FEES ASSESSED
Inspector: P 1:1 Date: ''.( 6 ‘ Phone #: (503) 718-
(