Permit •
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PLUMBING PERMIT
I �E VEL\' . :'. ` ;'''.' a Si g .(VICES PERMIT #: PLM2005-00617
' �I � 1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11 /2/2005
PARCEL: 2S 109DA -02600
SITE ADDRESS: 15211 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 003 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 [PLUMB] Permit Fee 11/2/2005 $36.25
[TAX] 8% State Surchaq 11/2/2005 $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 503-246-6.'9 .r 1- 800 - 332 -2344.
/ - / . Issued By: AP _ ` e / Permittee Signature: �� , / _` ( iwr IL
- -
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 Tiding Fixt , . ''
Plumbing Per mitt " FOR OFFICE USE ONLY
City of Tigard ' . NOV
i5 Received
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: 1‘ / P.40 S ef3 Permit No.: j� \ ` 4 _a0 /
Phone: 503.639.4171 Fax: 503.598.1960 /4y.,' Plan Review r o.
24- Hour Inspection Line: 503.639.4175 CITY O' f•1P itAl Date /By: Other Permit No.•
Internet: www.ci.tigard -onus BUILDIN elL Date Read cis ® See Page 2 for .
NotiFied/Method: , Supplemental Information
TYPE OF WORK
IT EEC SC -DUX
LE
New construction ❑ Demolition For special information use checklist.
El Addition/alteration/replacement Description Qty. Ea. f Total
❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath j
I+ 249.20
I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath
❑ Accessory building SFR 350.00
❑ Multi- family (3) bath 399.00
❑ Master builder Other: Each additional bath/kitchen 45.00
Fire sprinkler ( sq. ft.) J Page 2
JOB SITE INFORNLATION AND LOCATION
sal I Site utilities
Job site address:, )'Iti! ` jrc � -c ,( G ( ,��}}
rC Catch basin or atca drain 16.60
City/State/ZIP: T ' a_c,i_ 0 k G 7 a--.3 Drywetl, leach line, or trench drain
16.60
rt�l,l,t �� 0." Footing drain (no. linear ft.: ) • Page 2
Suite/bldg./apt. no.: I Project na
Cross street/directions to job site: Manufactured home utilities 1 10.00
cw 6 c e it B en� n Manholes 16.60
V Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: c (LY71 Yyl. l R-4. (LQ Cr I Lot no.: 03 Water service (no. linear ft.: ) I Page 2 J
Tax map /parcel no.: (p s , r te ' A. . / � j Fixture or item
DESCRIPTION OF WORK Absorption valve 16.60
/ Backflow preventer Page 2 02 7. S
/P c �f . �t'� i rr/ 9 ('/ 6-y / C4 f ;/G? <,i <•I`e.ZY i c Backwater valve 1 16.60 .
Clothes washer 16.60
Dishwasher 16.60
PROPERTY, OWNER.. TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name:
b 1sx /'Y)aV ? S s f f / �
, Expansion tank 16.60
Address: Lfo Q. 3 CJ S L L"1 6v t . ( L., 0 nc:
c Fixture/sewer cap 16.60
City/State/ZIP: , , e 0 S' W C c'G O - tI '73.3 J Floor drain/floor sink/hub
16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
APPLICANT 1,COtrTACT' PERSON
bib 16.60
Business name: ���, Ice maker
-D rr (� /1' 16.60
„SF T�� � ' Interceptor /grease trap
Contact name: el/ .� � � Medical 16.60 Page
`� �� U ,i, r � gas value: $
-C, � �
g ( ) Page 2
Address: J
� y � -,� ['6l". t.� Primer 16.60
City/State/ZIP:Ilk/ itti YL , Gle- , 70 (c t.)--- Roof drain (commercial) 16.60
Phone: (5[ ( -' ' -S %y� I Fax: : (5 / £':.2 - 6 7G+ ,�' Sink/basin /lavatory 16.60
E -mail: Tub /shower /shower pan 16.60
Urinal 16.60
'CONTRACTOR
Water closet 16.60
Business name:La)�_SC`, v 1 2 ?_ _9C/71 Z,� G Water heater
� 16.60
Address: / ,?- -o' ✓ .S i) f “.� �i.�� 1.1 p Other:
•
City/State/ZIP: !-? ✓ /� Q 7 �� .. Subtotal
�
Phone: a(-4.3 ) &Ya C� V Fax: (503) 6,9c;? e 7� g • Minimum permit fee: $72.50
Residential backflow minimum permit fee: $36.25 3ro • 6Z S '
CCB Lie.: 7 to Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized si a / State surcharge (8% of permit fee) L)
/�` I TOTAL PERMIT FEE 12 , / s
Print name `l 1) . a ) ` Date ' -- ! - t 5
- I ` C I This permit application expires if a permit is not obtained l+ !thin
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board .
iN lPLMP- PermitApp. doe 12/03 4 40.4516T( I OiO2JCOM/WEB)
T 'd - 89L0- Z 69 -EOS UaT I3 efe2 =80 SO TO "°IJ
I -- • - .-
CITY‘OFTIGARD
t
BUILDING DIVISION PERMIT #: PLM2005-00617
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/20005
Phone: (503) 639-4171 A 1 1
. 47 #4101 : it
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11/9/2006 TIME: 7:09AM PAGE: 69
SITE ADDRESS: 16211 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 003 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Baol4low preventer for irrigation.
OWNER: DON MORISSE I I E COMMUNITIES LLC, PHONE #: 603
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-6925945
Inspection Request Scheduled For: Date: 11/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 020694-02 503-692-5945 N
Corrections /Comments/ Instructions:
( .12– (i ---- — Xk-----
/1 t
/
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PASS fl PARTIAL APPROVAL ri CANCEL 0 NO ACCESS
0 FAIL fl CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
______ Date: r (/
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Inspector: Phone #: (503) 718-