Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00512
c 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/4/2005
PARCEL: 2S 109DA -06100
SITE ADDRESS: 15076 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 038 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. STE. 100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 10/3/2005 $36.25
[TAX] 8% State Surcharl 10/3/2005 $2.90
Phone : 503 387 - 7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD. REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Phone : 503 692 - 5945
Reg #: L1C 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 -66' • or 1-800-332-2344.
Issued By: Ap ` C �'`� ' f ' � . ( ) Permittee Signature: 1—).7 "'' "' (gl ,17) -,
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.
, .
:
•-'i
fl Fixturres
. . .. .
.
p g22448C."1 nithLra Permfit A 11" L EIVE P oR
.. .. •
.. - . •F. Q Fticf. USE ONLY
.. • . . :....,:._ : .. „1"„...„...!,.......,....:
City of Tigard Received ID d „,,,-- v m
Date/By: / 7 V W Penni( NO. ij ... 5 7,3,,
1'3125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 SEP -
9. 8 2 Plan Review
Other Permit No..
24 Hour Inspection Line: 503.639.4175 n p4'1111111 0, Date/By:
',.., ... E. : Date Readv/By• i'-`* CI Sec Page 2 for
Internet: www.ci.tigard.or.us cITV - ILL TI '1. - •'. Notifiedn,&tho'ci, /A supplement.l faro rma tion
TYPE 1 44b90 (3 DIVISION.
. . . .
. FEE* SCHEDULE
. . . . • . . ,
.. .
New construction 0 Demolition • For special information use checklist.
Description I Qty. I Ea. I Total
0 0 Other: • New 1- 2-family dwellings (includes 100 ft. for each utility connection)
• • • . CATEGORY OF • cci..Ngrgocrp:msr. . SFR (1) bath 249.20
. • - .. . . •• • ••.., •
---.
1-and 2-family dwelling El Commercial/industrial SFR (2) bath 350.00
SFR (3) bath 399.00
El Accessory building 0 Multi-family
Each additional bath/kitchen. 45 00
0 Master builder 0 Other:
Fire sprinkler ( sq. ft.) Page 2
TOR SOF,
• - ' . r ' ''. ' . INFORMA N� k rib •Ii.oCA.To*' . • • . *. * '. •
Site utilities
•
Job site address: / SC.3761 .„c , .f .cd___ Dg.._ Catch basin or area drain 16.60
City/State/ZEP: yi 9 e . t ...t4L 012 ,-; 7 .
??-e-/- Drywell, leach line, or trench drain 16.60
Footing drain (no. linear ft.: ) Page 2
Suite/bldg/apt, no.: Project name5uin 'rut itisell 6 3 si
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
AC C-r 15,e,u2L 1?_t, Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: S u tvi t.-1 g c., Lot no.: 8 y
Fixture or item
Tax map/parcel no.: tO 5 ,4- 7 Absorption valve 16.60
r ' '.- ' . ' :1,.. . ' -'• :•••• . '. DESCRIPTii* . .
OF WORX .. • - . Backflow preventer / Page 2 ,P•
1-.Z-21.41.4.g apr:: Irr/ 9at7 /...37 ,9 fi ow a e.x.-1, / .,- Backwater valve 16.60
(i r Clothes washer 16.60
Dishwasher 16.60
• : • - •.• • .... ... -.. • - • . • Drinking fountain 16.60
0, PROPERTY OWNER, , : . ..-.'• ..-. ..u.:,THE.. : 1■T...#N.T
_ ..: .. . • - • • Drinking
. , .
Ejectors/sump 16.60
Name: 'D Din /Y) (j S S C"--= 7 + Hr.1 ..` Expansion tank 16.60
Address: L/ 3 C .S LA-! ,.._(. C-e_...t) 0 Of.t. Fixture/sewer cap 16.60
City/State/ZIP:LC.1-k C 0 .0 e..A..) -C7c) 0/Z_ i . 7 ()3 S Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
- ..,••• - - , -. • . . - • •
- aAPpLICANT : '. ' 0,..CONTACT •••PERSON• Hose bib 16.60 • '-
Ice maker 16.60
Business name: Land .;.' 0,,t orzi, -e 0 sr c
• Interceptor/grease trap 16.60
,--., /
Contact name: Eli (Z ,,.,. 0 69 Medical gas (value: $ ) • Page 2
Address: i ' --(:) 0 .,c,../i) r ri, t sA nytu it0 Primer 16.60
City/State/ZIP:Tikkt tiLt-in , 0 ,2_ , j 70 (0.;)- Roof drain.(commercial) 16.60
Sink/basin/lavatory 16.60
Phone: (503) (! c 1 c _; - S7 y 5 Fax: : (5 .. ,..R - 0 / 74 - -".?
Tub/shower/shower pan 16.60
E-mail: Urinal 16.60
• . • •..* CONTRACTOit ' .
•
• • Water closet 16.60
r•
Business name:Lae) 41se . e... , 07- - G Water heater 16.60
Address: / L )--D-00 S to NI L, /4,t4 12---1.0 Other:
• i Subtotal
City/State/ZIP: -li 0.e -- .4706,:-- minimum permit fee. $72.50 .,,,,,
Phone: 51:3) ky6 ,C.. . Fax: (
'• 03) ( - .07(. E Residential backflow minimum permit fee: $36.25 ,j(e...,- :2_.,....c
CCB Lie.: 7 gel.) y Plumbing Lic. no.: Plan review (25% of permit fee)
_i f) State surcharge (8% of permit fee) ;:a.cp..)
Authorized sign,iref / _e .../4 .. ,....;.1 9 a4...4.....177.--(2
- i.--- , .- -, '
_ ''''..,.' TOTAL PERMIT FEE , ",.‘"•? . Print name nainn %1 1 ,,-17) Dat" k/C,S his permit application expires if a permit is not obtained ,, ithin
. . 180 days after it has been accepted as complete.
'Fee methodology net by Tel-County Building Industry Service Board.
i:11111ilding\Pernits%P LMF-P ermit App.doc . 1243 440-46 i 6T(loro2/CONIMUB)
- - - - - - - -
. d 89L-0-269-EOS ua 1 1 3 dtra:EO SO 82 daS
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005.00512
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1014/2005
Phone: (503) 639 -4171 a�e/Al��ll
Inspection Requests (24 Hrs.): (503) 639 -4175 =$' `__—
INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 85
SITE ADDRESS: 15076 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 038 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Backflow preventer for irrigation.
OWNER: DON MORIS SE TE COMMUNITIES LLC, PHONE #: 503 -387 -7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503 -692 -5945
Inspection Request Scheduled For: Date: 10/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 018974 -02 503-682-6076 N
Corrections /Comments /Instructions:
Cow i .
M PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , A•/+ 1 U Date: /0/ / c- Phone #: (503) 718-