Permit i
CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00275
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/21/2005
PARCEL: 2S 109DA -05300
SITE ADDRESS: 15226 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 030 JURISDICTION: TIG
Project Description: Irrigation backflow preventer.
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 [PLUMB] Permit Fee 6/21/2005 $36.25
[TAX] 8% State Surcharl 6/21/2005 $2.90
Phone : 503 387 - 7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD. REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Phone : 503 692 - 5945
Reg #: LIC 7804
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503 -24. e.99 or 1- 800 - 332 -23 4.
Issued By: d / r Permittee Signature: 1 - ®�` rz, --�1�
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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( ' IF$all'illld ng Fixtures
nllllllilIllbin Perwut Abp_ Pm `TCIl I' 11E V l LI f1 , r .., . : ,,, . - ,,:, om 7 ��.r:� -�.,� .
(City of Tigard d JUN 2��5 p' s _ � ,�, C+�E U +' .'.',`:-.W.. :sue +.:, ' F�..
Received , . ,' r ,'u'
13125 SW Hall Blvd., Tigard, OR 97223
Date/By: / .i /&.s thR M Permit No -_______400_6°°();e :
Phone: 503639.4171 Fax: 503.598.1960 Plan Review 7 �
24 Hour Inspection Line: 503.639.4175 � " °0,•,01,"1 t Date/B
CITY OF TIGAP a Y Other perm;[ No.
Internet: www.ci.tigard.or.us • c -1---a"--- ;nl'1't a Dace Read : B
BUILDING DIVISI Y Y: lu : p See Page 2 I'or
1 Notifi ed/Method:
• I Supplemental Information TYPE OF . WORK
Ng New construction F b:E ' A• SCHEDULE
❑ Demolition For species/ r'njortnation use checklist.
❑ Addition/alteration/replacement ❑ Other: Descr .tion
Ea. I Total
New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OP CONSTRUCTION
SFR (1) bath 249.20
►` 1 - and 2- family dwelling
❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building
❑ Multi- family SFR (3) bath 399.00
❑ Master builder Other: Each additional bath/icitchen 45.00
JOB. SITE INFORMATION AND LOCATION Fire sprinkler ( sq. ft.) Page 2
OCATION
Job site address: /s,�� (�, .S.:1-4...) /} ,� Site utilities
C4
�'� �� �+ Catch basin or area drain 1 6.60
City /State/ZIP: 7 - 7
0 i - y ' vD-.. - Drywell, leach line, or trench drain 16.60
Suite bldg_ /apt. no.: r Project na�m YYl Footing drain (no. linear ft.: `
'Cf- k�dy� 3 Q ) Page 2
Cross street/directions to job site: Manufactured home utilities
1 10.00
gi<<F �0.a �7 Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
' ■
Subdivisi�:[ t rya y� dg 'L. Water service (no. linear ft.:
l Lot no.:3 Q ) Page 2
Tax map /parcel no.: (0 Ss ,¢ r j Fixture or item
•
DESCRIPTION OF WORK
• valve 1 16.60
/'° / � J %i tYl �. �• Backflow preventer
..). , , / .y C�� (..)y) / /L..4 -y,' �-/ L' 1 _ ('!'�ii / r Backwater valve I Paget �� ] SS
16.60
Clothes washer 16.60
Dishwasher
El: PROPERTY OWNER: L 16.60
TENANT Drinking f ountain 16.60
Name: ? , / �/ c ;
Ejectors /sump
fY 1 - 16.60
Address: Z 3 L, ` (..:::::e- C c' Ot Expansion tank
16.60 t
City/State/ZIT':,�G Fixture /sewer cap ] 6.60
,i 0.c C?C.) O/Q 3 S �- � 7�.� _� Floor drain/floor sink/hub 16.60
Phone: ( ) ` Fax: ( ) Garbage disposal
{ 16.60 • `Q AI'PI CC�,NT" JJJ E],COIVTACS PER Hose bib 16.60 •
Business name: j�J1^ (' Ice maker 16.60
1. C�r) c C. �/_Tn') .
Contact name: / Interceptor /grease trap I 16.60
�
Address: e �` „ �. / �L Medical gas (value: $ ) Page 2
� 0 S- 3 r / 14 1
1 �.. / 1 Primer 16.60
City/State/ZIP:" �i ° 641-70,_ 0r� ' /�
Phone: t a C /c I Fax: ( 7G `� "`- Roof drain (commercial) 16.60
(56 ' ) �' -'? - •S�`d j ,% - ,t5) /,,:;, ?.,:;z - C ye, I Sink/basin /lavatory 16.60
E -mail:
Tub /shower /shower pan 16.60
CONTRACTOR Urinal 16.60
me: l/
Business na Water closet
t fl /)l.'_Sr %i:�a� 0s t: /. 16.60
I
/�) Water heater
�� 16.60
o''� " S1✓J /■t' -1, ,4 / 0 u , g.in Other:
Address:
City/State/ZIP: ,
/��( /�t-4 �_ �o ' ! 7O(. ::,)1..... Subtotal
Phone: (.5?-.5) 62 Q 5ai V+" Fax: 6 / a . Minimum permit Cee: $72.50
9 y Residential bacicflow minimum permit fee: $36.25 34P - )-__S
CCB,Lic.: 7 ff. r
Plumbing LiC. no.: Plan review (25% of permit fee)
Authorized signs_ / s
�" °1i 1 �'� ,7i �/ /! ,y, A 1 State surchar r. (8% fcc` i
C. C (8 _ of permit , 9v
. . - - R. i - e, .,fi .-r:�
rint name ., i l
c f TOTAL PERMIT FEE 3 g, , 5
Q S 1 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
\ Building lPermits■PLMA- Pn'micgpp.dec I ? /oa *Fee methodology set by Trt -County Building Industry Service Board.
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CITY OF TIGARD
BUILDING DIVISION . -
PERMIT #: PLM2005-00275
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2005
Phone: (503) 639-4171 :Ntitit
Inspection Requests (24 Hrs.): (503) 639-4175 —....-3+1■ • ---
INSPECTION WORKSHEET FOR DATE: 7/12/2005 TIME: 7:06AM PAGE: 72
SITE ADDRESS: 16226 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 030 TYPE OF USE:
PROJECT NAME: . SUMMIT RIDGE
DESCRIPTION: irrigation backflow preventer.
OWNER: DON MORISSETTE COMMUNITIES LLC, • PHONE #: 603-387-7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 7/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RP/backflow preventer 011189-01 503-692-6946 N
Corrections/Comments/Instructions: •
1 .
••.,. ,
/ ■ .
i
■
. . .
PASS [11 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
0 FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: h Date: 7/ i 2 /0 Phone #: (503) 718-