Permit s CITY OF T I GA R D PLUMBING PERMIT
46, DEVELOPMENT SERVICES PERMIT #: PLM2005 -00588
°�J DATE ISSUED: 10/20/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109DA -05400
SITE ADDRESS: 15198 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 031 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 10/20/200E $36.25
[TAX] 8% State Surcha 10/20/200E $2.90
Phone : 503- 387 -7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
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 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: SZ5`
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.
4- ' Building Fixtures
Pl[d1CIb3i1e Permit Appl�EI E® FOR OFFICE USE ONLY .
City of Tigard R eceived
Permit N ,+1
C Q �Q
OCT 2 200 ? Date/By: - 'OJ 1 !/
13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
Phone: 503.639.4171 Fax: 503.598.1 960 1
lG its a s4 Other Permit No.:
♦I I
24- Hour Inspection Line: 503.639.4175 `'r 1' J ' Date/By to for
Internet: www_ci.tigard.or.us CITY OF TIG . - Date
Notified/M cthlh d/M Sce Page 2 ..or / ,� S pplemental Informat
TYPE 1�. to UW SiON FEE S CHED S U LE
c l New construction ❑ Demolition For special information use checklist.
Description Q Ea. Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
1- and 2- family dwelling 0 Commercial/industrial SFR (2) bath 350.00
Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: / S/ q g (,ter f j aa . DR._ Catch basin or area drain 16.60
City /State/ZIP: r iciGtAzi 0 C J p.cw,;L L Dtywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name,,S1. 'yl /Y l f- Ct �, 3/ Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
" C-E _ / ' Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Su.rn rn iJ ` (LC/ C. I Lot no.: 3, Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: S S I Fixture or item
Absorption valve 16.60
DESCRIPTI N OF WORK . Baekflow preventer Page 2 0:7 , SS
•ild -CC' LcC; i r / Cat/ fir^, :' />. -t ' i f Cu .+' ; i (r" Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
• . El. PROPERTY. OWNER. .. Drinking fountain 16.60
❑ 'T ENANT
Ejectors /sump 16.60
Name_ bet ^_ rf)C"Yl Ss Tr' 4' /-/c1 C'S Expansion tank 16.60
Address: X 30 S L.t_t 6<< ( e CR.t 0 C tCi Fixture /sewer cap 16.60
City/State/ZIP:Ln.,k . C%S W t'gcI C1k. Gf . 7 3.3 S Floor drain/floorsinlc/hub 16.60
Phone: ( ) J Fax: ( ) Garbage disposal 16.60
.APPLICANT 'i\ ONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: i �
��r1Cl l -C "L G! e/ ' 1� %' Interceptor /grease trap 16.60
Contact name: ; i fin .S,..0 £L'lit(..J Medical gas (value: $ ) r Page 2
it
Address: . 0 0 �• Li-) 1` yy (( r Primer 1 6.60 Art
City/State/ZlP: --fl / a,; O k_ , J 7 , 7 6, / �
„ � Roof drain (commercial) 16.60
Phone: (50 3) (.7.-- 9, j -S % r Fax: : � _ L• ;, Sink /basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
_.r___ ,•
Business name: Lan 6 ( .7...90 27---7)C- Water heater 16.60
Address: Si) 14 Si : 1- g. r) Other: •
City /State/ZIP: 4 Subtotal
�'�� ✓� ��� '� Minimum permit fee: $72.50
Phone: 5..•;3) 6 , j 3) e.p9O
Fax: 60 _ 07 0 S Residential backflow minimum permit fee: $36.25 3io • a►S
t CCB Lie.: 7 g-c)V Plan review (25% of permit fee) Plumbing Lic. no.: ,00. /
Authorized si a ` �' State surcharge (. ,� of pe -� , fee) i
VL / i `' a% + TOTAL PERMIT FEE 39, / S
Print name// .2a,,�1 j D40• mi -0...S This permit application expires if a permit is not obtained ""lthin
/ 180 days after it has been accepted as complete.
`Fee methodology set by Tri-County Building Industry Service Board,
•
i. lBuilding \Pemuts\PLMF•PcmtitApp.doc 12/03 440.46l6' (10 /02 /COMIWEB)
- 2 • d 89L0 -269 -COS uaii3 e9E =60 50 02 100
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200500588
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/20/2005
Phone: (503) 639 -4171 � I t Inspection Requests (24 Hrs.): (503) 639 -4175 J 4,441 .L.
INSPECTION WORKSHEET FOR DATE: 10/2612005 TIME: 7:07AM PAGE: 103
SITE ADDRESS: 15198 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 031 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Backflow preventer for irrigation.
OWNER: DON MORISSEI IE COMMUNITIES LLC, PHONE #: 503- 387 -7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 10/26/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 019308 -02 503-692 -5945 N
Corrections /Comments /Instructions:
. 692-5945 N
C(* .
\./ I (1...yt.27:e_..-: . .
• PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Ii
Date: 61-7(/P7-'''-- Phone #: (503) 718