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Permit CITY TIGARD PLUMBING PERMIT PERMIT #: PLM2005 - 00642 DEVELOPMENT SERVICES DATE ISSUED: 11/18/2005 I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 109DA -03300 SITE ADDRESS: 15371 SW GREENFIELD DR ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 010 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 11/18/200E $36.25 [TAX] 8% State Surcha 11/18/200E $2.90 Phone : 503- 387 -7538 Total $39.15 Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD. TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS Phone : 503- 692 -5945 Reg #: LIC 7804 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. .ia Issued By: `�1��'�� Permittee Signature: )Q Q Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building ` EI !! ED • , r 14 1l�If11 l Ii:�' Pl'•�lr.l'.i�11� 4tlp q_'.�^I�r V 11 Atli i • _ ' .. •-•-* S l • - • 4 bi, V FOR OFFICE USE ONLY i ; , L$y of Tigard ! s}i- C IGARD 'ecetvcd . ; / 13125 SW Hall Blvd., Tigard, OR' 9 Y2 t �' I Date /By: - ZEO�1; Permit No. i\ _ .._14 - d x Phone: 503.639 -417 Fax: 5(1i- �98' -1311h I Q 1 7 A 7 Plan Revi w Other Per =a V U g uII ' '�I� 1 �1 Date/13y: No.: 24- Hour Inspection Line: 503.639.4175 ` *,: t -, , f ii. Internet: www.ci.tigard.or.us CITY OF TN •��- :: Date dy /: J / I S'or VISION Notitie d/t Rea vtcthod: By 1 C - - •1• tNG DfVISIOt' �l Supplemental ee Page 2 I dorma - - Oh t�-Iti 9. FEE' SCHEDULE_ _ New construction I ❑ Demolition For special information use checklist. ❑ Addition/alteration/replacement Descri I Qty. 1 Ea. 1 Total ❑ Ot her: New l - 2 - family dwellings (includes 100 ft. for each utility connection) IN CATEGORY OF CONSTRUCTION SFR (1) bath I ' -. 249.20 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ID Accessory building ❑ Multi - family SFR (3) bath 399.00 ❑ Master builder Each additional bath /kitchen 45.00 ❑ Other: 1 - -- - "- Fire sprinkler ( sq. ft.) Page 2 Jar; SATE iNFORfv1A A.NI) LOCATION - - - - - - - Site utilities Job site address: a3'7/ / - -- _ ' L \ G'r u 7 tiI (� Q�' , Catch basin or area drain 16.60 City /State/ZIP: .` -. Oc_ 2 G L. GL 0. `Z , 7 y .p---/ Drywell leach hne, or trench drain 16 60 Suite/bldg. /apt. no.: Project tale j)yr _-j- l c, j © Footing drain (no linear ft.: ) Page 2 i Cro to job site: Manufactured home utilities 1 10.06 i &Lk; ��i ;1 ( f2p Manholes 16.60 ['t ` - Rain drain connector 1 6.60 Sanitary sewer (no, linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision:,j,t_L-yk) ,L T 1s LLI t Lot nolQ Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: C / Fixture or item 42 ...C.:; %I` 1)ES :_.2[_ I' ±`, O WORK Absorption valve 16.60 J Bacltflow preventer / Page 2 ‘2- 7. SS g__.<-1,-;(- C( </. _ . ; . /I. ' T - 7" ` c : ' 1 e): ,7 i , Backwater valve 16.60 Clothes washer 16.60 ' Dishwasher 16.60 -- -- . -- - -- - -- Q P1fOPlC•I'V OWNER I El TENANT Drinking fountain 16.60 Name .. /.. - - ..._....- Ejectors /sump I 16.60 1 ;'-'1::":"--) � Expansion tank 16.60 Address: y '' ' Fixture /sewer cap 16.60 City /State /ZIP :L - /-_ . - , , ( ; :_ : t „\ G 7 L. =.2) Floor drain/floor sinkthub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 A1'Pl,lt': >�i;' CONTACT PERSON bib 16.60 Ice maker Business name: / .. ; . a . r" -- - - =- -... -- 16.60 /; .77,,,,; Interceptor/grease trap 16.60 Contact name: '- ' - i .'-` .. s. Medical gas (value: $ _) Page 2 Address: ,' J .. ' t ' ' . Primer 16.60 City/State. /ZIP: --1 i,; • 7, , r , '1 Roof drain (commercial) 16.60 CF.: c. ; ( ) -_ .. Fax:: (! ;c -5) - ' ;l _ C...' ,,7/_ ink /basin lavatory 16.60 Phone: h b / Tusower /shower an E -mail: P 16.60 Urinal 16.60 - Water closet 16.60 B • usiness name: / , , ' . , r i! i r /' r Water heater r' l 6 60 Address: -,4 t p 'n Other: City/State /ZIP: 7,741(..,.!.•.:, j../.:••,:.. gL - 7/-/ Subtotal �= - s Minimum permit fee: $7250 ' ..:) e�,l F ax:(r' ,t) 6, /� 7(,E Residential backflow minimum permit fee: $36.25 3 Phone: � aS CCB Lie.: <,_= Plumbing Lic. no.: Plan review (25% ofpermit fee) al}lt v State surcharge (8% of permit fee) • / V Authorized sign • '- • • .- - - ' r!- /ice ter, TOTAL PERMIT FEE 5 Print name:i_r e/ .,: y ; - .) ; : • Date l 7 ia s This permit application expires if a permit is not obtained , :thin 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building. Industry Service board iAnuildin igi.m : P,rnm„ ., ao.; i.., " 440- 4616T(1 0102/COM/1vLB) a - d B9L0- 269 -EOS u dBD :TO SO SI AGN CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM200 -00642 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 1/1 812005 Phone: (503) 639 -4171 kohdq@ u °, Inspection Requests (24 Hrs.): (503) 639 -4175 : !,L f 1 INSPECTION WORKSHEET FOR DATE: /1121/2005 TIME: 7:13AM PAGE: 80 SITE ADDRESS: 15371 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 010 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: EtarkflorrpraVenter for ifigati$iT ) OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 - 387 -7538 CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-6915915 Inspection Request Scheduled For: Date: 11/2112005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 021988 -02 503- 692 -5945 N Corrections /Comments /Instructions: -- r — Je, 5 -..,,-,A — e3A-z- . 4 t 4 6-- s (. ;,. , 1 . ' / i , 4"• _CeelS.2L;)__rey L i i lLe a.4i �e • 'R n PARTIAL APPROVAL El CANCEL n NO ACCESS 1 I FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Zk vt /�/vs -- Inspector: �- Date: Phone #: (503) 718- •