Permit C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00237
'�' �'' I I ` 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/26/2006
PARCEL: 2S 109AD -S4131
SITE ADDRESS: 14987 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 4 LOT: 131 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 5/26/2006 $36.25
[TAX] 8% State Surcha 5/26/2006 $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: !J�1 Permittee Signature:
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.
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t I lding Fixtures `' C
-ibing Permit AppliC CEI V ED
FOR OFFICE USE ONLY '
city of Tigard MAY 2 5 20� DateIBY. / l 6 L J 1 \\7v'u g�
1
13I25 SW Hall Blvd., Tigard, OR 97223 � �, Peraut No
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
CITY OF TIG : :.. 11 u' (')
i"t\ Date/By: Other Permit No.:
BUILDING D
24- Hour Inspection Line: 503.639.4175 .t.
Date Ready/By: lu e 2 for
Internet: ww�v.Ci.tigard.or.us l {�` Notified/Method:
/ /�� 0 See Page
Supplemental Information
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;TYI'E' OF .- WOT21C` 1tEE *'•
EkNew construction ❑ Demolition P f
�,
For special information use checklist.
Description I Qty. 1 Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1 2 family dwellings (includes 100 R. for each utility connection)
.. ".. :; ;;',: i ?.. , CATEGORY OF COSVSTRUCTION• :`;• SFR (1) bath
.... . ..:.: .. • �.:.. 249.20
❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath ' 350.00
Accessory building SFR (3) bath 399.00
❑ ry g ❑ Multi -family
❑ Master builder ❑Other: Each additional bath/kitchen 45.00
i' t .. Fire sprinkler ( sq. ft.) Page 2
is •r .4 SIr 1N .ORMATION "'.ANIS''LOCATION '!;',.:I'''''''.'.:...'..''.:: ' ' Site utilities
Job site address: tw g 9 7 ,s Lit) G tit e La Catch basin or area drain 16.60
City/State/ZIP: T I (-/ u/le C� / '7 ?c Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no -: L Project names - u rn M /Q___& 6t �j Footing drain (no. linear ft.: ) Page 2
/ r ) Footing
home utilities 110.00
Cross street/directions to job site:
U.) Manholes 16.60
t-' e e,/ 9 e -e__# _,,t. Rain drain connector 16.60
Sanitary sewer (no. linear ft.: -) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Smarr ne) L - # (i( I Lot no.0 Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: �s Fixture or item
.:,,. .. .:.. , s tion valve 1
�., Ab or 16.60
p G
','DESCRIP.ITON :OF;�VO,RT.:`.'::.:'.:::. I.--,:,...:' , • Bachflow preventer 1 Page 2 c )- -- 7 , S
- r)( _ C' 7 _t" i r-!-/ ( (% (..:7-, ' ..0.. c!<,- � :/(:'',!_' :' :)r'i_; ( Backwater valve 16.60
Clothes washer 16.60 •
Dishwasher 16.60
I'RO •. RTY" -� .• .. • - Drinking fountain 16.60
1 l 0
"' Effectors /sump 6.6
Name: J e -)./1 ir/;l ., ..s. r .t 1 -._s Celli NIL 1/1,( t_S L,LCFsxpansion tank 16.60
Address: . / . - - / . 2 3 ( . . , � t. c (2.'lc ( e C. C_'+ CI t 'ct Fixture/sewer cap 16.60
. City/State/ZlP: LCL kL . L ; ' i, (i t' yr) C.) t ' 4 1 / Lt c:'> Floor drain /floor sink/hub 16.60
Phone ( ) Fax: ( ) Garbage disposal 16.60
�IiPPLICAIVT ONT'A P Ice maker
Hose bib , 16.60
: :: CT" RSOIY
, :::. - . a .� ,. �. - ' : , r , 16.60
Business name:
� r • Interceptor /grease trap 16.60
Contact name: -) J ,I f -- (L ' :' Medical gas (value: S ) Page 2
Address: � 4,.
3 ) () LL. f fl ij l ry, .f 0_U Primer 16.60
Ci /State /ZIP: J J ' ��' Roof drain (commercial) 16.60
n Tu 11.1 a. t - !r_ GiL 7 ,
Phone: (Sc' h i �% �' n Sink/basin /lavatory [6.60
.� / -_ -a / ty ci Fax:: (;c :5) 6-:- v" , - ,~_-..;.,
Tub /shower /shower pan 16.60
E -mail:
Urinal
CON 1'I2ACTOlt "'' Water closet 16.60
Business name: r ), Water heater 16.60
Address: /;,,:
}
GG S i3O rp,
Other:
City/State/Z1P: aU - , J6).. r7L '-, Subtotal
Minimum permit fee: $72.50
Phone: (;jZ3) &1Q ,..S Fax: ' c/3) 6 •=? - vr] ( n Es Residential backflow minimum permit fee: $36.25 •3(a • �S
CCB Lic.: Plan review (25% of permit fee)
�(..) Plumbing Lic. no.:
a // ,r State surcharge (8% of permit fee) /'/ b
Authorized signa '1 f' �� .r / aV / TOTAL PERMIT FEE 39 - (S. I,
Print came `l en ,c- �!t62,1 ll * Dat ( / s /Oln This permit application expires if a permit is not obtained :thin
1811 days after it has been accepted as complete,
°Ft:e methodology set by Tri County Building Industry Service Board
i:\ Building \Permirs\PLMF- PcmtitApp.doc 12/03 440 -It itT(I0 /OJCOM/wnii)
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CITY OF TIGARD
BUILDING DIVISION . PERMIT #: P1_1%42006-00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2006
Phone: (503) 639-4171 4lleip
Inspection Requests (24 Hrs.): (503) 639-4175 _34'
-......
INSPECTION WORKSHEET FOR DATE: 5/30/2006 TIME: 7:16/1/4M PAGE: 67
SITE ADDRESS: 14987 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 4 LOT #: 131 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 4
DESCRIPTION: Backflow preventer for irrigation.
OWNER: DON MORISSETTE COMMUNITIES, LLC, PHONE #: 503
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 6/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 030713-01 503-6925945 N
Corrections/Comments/Instructions:
Zki 5) ' '-1"( •
.
1 eK-&-- ‘i..... - 7, -- , - --.1,,,,--
(_,O3 ) 1,d----
c t a c i 4A ri PARTIAL APPROVAL 0 CANCEL El NO ACCESS
FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
W:'(fr
Inspector: Date: 4 ,4 Phone #: (503) 718- 7.--