Permit C ITY OF TIGARD PLUMBING PERMIT
l DEVELOPMENT SERVICES PERMIT #: PLM2006-00297
414
��f I� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/7/2006
PARCEL: 2S109AD -15200
SITE ADDRESS: 14939 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 4 LOT: 134 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 Description Date Amount
4230 GALEWOOD ST #100
LAKE OSWEGO, OR 97035 [TAX] 8% State Surcha 6/7/2006 $2.90
[PLUMB] Permit Fee 6/7/2006 $36.25
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:' E I Permittee Signature: y.f� p , \ �
J
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.
•
t: Building Fixtures
lik4. , AIED
Plumbing Permit A e,d, FOR OFFICE USE ONLY - - • - "
, .
City of Tigard I 20
Tigard, OR 97223 ito Received
Datel 6 Y,-/ )-- , Pe-it 1 -- ieuzi 1,
13125 SW Hall Blvd., 1\
Phone: 503.639.4171 Fax: 503..598. l 966' , -TIGAR° Ak* ?4 , 01140 Date/By: Plan Review Other Permit No.:
24- Hour inspection Line: 503.639.4175 o v kr rot s% ir , ,,.,, ,,,. , 4 1 ,
Date Ready/By: Juris: i 0 See Page 2 for .
Internet: www.ci.tigard.or.us s imirAG I ' d ' - Notified/Method: -- 11 ( Supplemental Infmnoraon
- ...•;.::'•,:.:•.•?-':: • '' :i. .%. .''.
TYPE 6i .f'' . ! '';.'... , .: . . , i' 7 . ; ... '.:'7:: ; :.]:',*:: '.:. '.. • .'; FEE*i ,§610 • ', y ' . ... -'' -
b ],New construction 0 Demolition For special information use checklist.
Description I Qty. i Ea. I . Total
0 Addition/alteration/replacement 0 Other:
New 1- 2-family dwellings (includes 100 ft. for each utility connection)
.- :• . ....::',,,-...-- '''.z..' , CATEGORY OF t:CO1§TRUCT1ON .. s :. - - '; .,: - ' !“•• • SFR (1) bath I 249.20
I SI I- and 2-family dwelling E1 Commercial/industrial SFR (2) bath 350.00 ,
0 Accessory building El Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
El Master builder 0 Other:
.,.. .. Fire sprinkler ( . sq. ft.) Page 2
R ., .T00 '
:!''#r*:',* n ;'
Pq l" O ifAT . I6: N . • ;;ki4i1).,:. 'l t ,4 ti qP* : 1 1. T .. ' : ! l -'`, i ' 1.',. ' ....: ...Y: Site utilities
Job site address: / Li q3 ci s4.2., ,--e.4,, 7 e-ec4._ Catch basin or area drain 16.60
City/State/ZIP: 77 gal_ q 0 R 6. - 7 ,D._?- Drywell, leach line, or trench drain 16.60
S uite/bIdg./ap t. no.: Project na __I
■ Footing drain (no. linear ft.: ) Page 2
ni rn. c„-t iet_61 9 , /..D1
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
S CA) 6 e e C 6 RD
Rain drain connector '16.60
Sanitary sewer (no. linear ft.: 1 Page 2
Storm sewer (no. linear ft.: ) Page 2
I
Subdivisior L Water service (no. linear ft.: ) Page 2
iS try))14_,,,y- R. L6i q e..... I Lot no.: )3 fl
Fixture or item
Tax map/parcel no.: Le, ... -
Absorption valve 16.60
::•.-:.. . :. • • '...-. i . .; -. -:•-,...:.. :. - i . . , .-„ . . . .. - • ....- 1!...... . -. ,.. • :, ..• .. Backflow preventer f Page 2
,
, r r ., 0 ( .‘,. ;TT.- 7 c -- ,' L .1,j; ...- i,,,,, i ,, , ,.. Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
16.60
. : •, ; ::', ;:' ',, iIi'' '',' . : r , 'IN; 1 ;' 14 P , X' : i.c s. ‘ t .. ': ....i . ':.: .. .'- :. .'". !'';':■1."; ''.■ ...::...:..;-...„:;,.:,. Ejectors/sump
16.60
Name: b /2. ityw-vi s ,.,_-; .±.- . ,,r. /t:=,-az-_ nrynryliiruti CS I-LC:Expansion tank 16.60
Address: d-1,Q_ 3(1. ..S C..1_.% 6 •-• cl' l. (.. ' Cl < '. s( Fixture/sewer cap . 16.60
City/State/ZIP:Lc& /<t (_-: \ i_ ti e y 0 c A.... 7 L. :> :....:.) Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60 Hose bib 16.60
: ■: . . , •?.k.er:.:.P, PS 9..., :-:.... Ice maker
16.60
13usiness name: bl.,-, d . .r'. '%1( .777,- ''...::, Interceptor/grease trap 16.60
1 .
Contact name: ;=- f:,'/) ,..Si) a .1 ,;.?,:-.:,C) Medical gas (value: S ) Page 2
Address: i 1.? ..)- (..) (2) 4. u..) ryi L i S Iry,j. RD Primer 16.60
City/State/ZIP:- a to a. h 6 .. c, /2_ • '7 . X: '(-. Roof drain (commercial) 16.60
,..----
Sinlc/basin/lavatory 16.60
Phone: (ScI 3 ) (. ./,.>2 - 5)- II- f/ . Y El Fax;: (5 I) (.,..-. .; - ci. .. . '
Tub/shower/shower pan 16.60
E-mail:
Urinal 16.60
CONTRACTOR Water clost.t 16.60 ..
. .
Business name: L zIS r iyi .(. .027-.9'0-7- . z. 7 -) c Water heater 16.60
Other:
Address: i r ;1- , S to ri) L i ,:,-/ Ly , L.1 R-0
Subtotal
City/State/ZIP: 7ita_ZZLI ` I9 /70( .:...)--
Minimum permit fee: 172.50
Phone: ) t s-yeis- Fax: 0 .3) (e1c - _ Residential bacicflow minimum permit fee: $36.25 3 (,:, ,
CCB Lic.: 7 gz) Plumbing Lie. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee) -
Authorized si L, gnat t A,v.e...1.
,...4 cP.- "70
TOTAL PERMIT FEE 3c, - /sr
Print name// e,- ,c I Dab i'7 I •--.1-' 0( n This permit application expires if a permit is not obtained v i chi n
. 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board,
i! i2/03 440 16T(10/02/COMPNE13)
I -01 89LO-Z69-ED S U 9 I 13 et,I:Lo 90 Lo unr
CITY OF TIGARD �� ua (Q - t® -)
BUILDING DIVISION PER MIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE IS
Phone: (503) 639 -4171 nipu��u� /
Inspection Requests (24 Hrs.): (503) 639 -4175 =��
INSPECTION WORKSHEET FOR DATE: A (0 7 TIME: PAGE:
SITE ADDRESS: I ' I J c i G %I- - Q/\ (+. 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
g VIVA/NI b k g
Corrections /Comments /Instructions:
1j1C// .
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: r/( Date: LA / 7 Phone #: (503) 718- 7