Permit ' b ITY TITIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00542
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/17/2005
PARCEL: 2S109DA-03800
SITE ADDRESS: 15481 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 015 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 10/17/200E $36.25
[TAX] 8% State Surchan 10/17/200E $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 -66*! or 1- 800 - 332 -2344.
Issued By: APO Permittee Signature: as p P,'c r j - yL_,)
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.
1
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?Jumbling i�tIC:iTITilt }'d 2'�f`t FOR OF?F10E USE ONLY 1
City of Tigard Date/By I D // 770 0 , 6 6 P ermit N,V 1 la ..... 0-4,
13125 25 SW Hall Blvd., Tigard. OR inirl. 1 7 2005 i Plan Review
Phone: 503.639.4171 Fax: 501.59g F M'' !1� t� Other Permit No.:
' 1: Date/By:
24- Hour Inspection Line: 511:1 6.19 4175 a':(_�._�,. /Juns.
Internet: www.ci.tigard.or.us CITY OF TIGAR .. • W Date [n See Page 2 for
Notified/Method: , , c- Supplemental Information
- - - $V;('r, M t FEE` SCIIEDULE
Kew construction - ❑ Demolition For special information use checklist
Description I Qty. I Ea 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
_ " - '::;:3" :( ;Ciie t' t:1' CONSTRi_iC CON SFR (I) bath 249.20
\\ N( . 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath j 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath I 399.00 I _ -
Each additional bath/kitchen j 45 00 j
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) + Page 2 I j
JOlt Sfhts INFORMATION AND LOCATION Site utilities
fob site address / j 5 L, 17 I ` i. L. L .'i 2'e .ri T ( LI 1L Catch basin or area drain 16.60 '
/ _ 7 t _/ Drywell leach line, or trench drain • 16.60
City /State/ZIP: T- 1 �. C /� �! 7 l
_ = � . - Footing drain (no. linear ft.: ) I Page 2
Suite/bidg.iapt. no.: I Project name:_SLLmi t:,4 l taq ( 1 S
Manufactured home utilities 1 1000
Cross strecl/directions to job site:
Manholes 16.60
S I. 1/4' b c ( { k' )t i t ( ( / \'. U Rain drain connector 16.60
Sanitary sewer (no. linear ft.: Page 2
Storm sewer (no. linear ft.: ) Page 2
s Water service (no. linear ft.: ) Page 2
Subdivision: j t.>_ry ; vv.-, :i-' ids ;.i `j Lot no.: I Fixture or item
Tax map /parcel no.: Lk t. t -`•''.t '^
_-. _ Absorption valve 16.60
' li t?S_IZ! i' l'ION 0.1; WORK Backflow preventer ) , Page 2 ;1-7 S S
rr /' ; (.1, : .., i ,/ , _ . ^ ' - . ��%. - ' - .` r, . � ,!.i ' - / .. Backwater valve 16.60
Clothes washer I I6 60
-- Dishwasher 16.60 • Ci PROPERTY OWN..,:, OWN..,:, r CI TENAN TENANT - Drinking fountain 16.60
- Ejectors /sump 16.60 l
Name: /��•._ .'r'r' ) Expansion tank 16.60 '
U Fixture /sewer cap 16.60
Address: t . ` . °� C. � _ _ ..: t -" _' t:' t'� <.
City/State/Z1P:L ' ' , (:',/2,.. 4 1 7 (` I �) Floor drain/floor sink hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal t 16.60
- - - - Hose bib I 16.60
[1„ AP P1 1] CONTACT PERSON -
_.._. ._.. --_ -- Ice maker 16.60
Business name: ' _i'.; : /1 _ /, _ .•' ,!,�% 1.----K) (.. Interceptor /grease trap 16.60
.
Contact name: _ •', N • ': ' . Medical gas (value: S ) Page 2
Address: •' ,'' t' ; • , t
Primer 16.60
i �; ' / • -� Roof drain (commercial) 16.60
City/State/ZIP: , t r',,:: 7 • . .,`
r _ L Sink/basin /lavatory 16.60 -
Phone:( ;_ ` -•''- Fax:: (_, �) �'- �„''!`.� rub /shower /shower pan • 16.60
E-mail:
- - .. -.... -. ! Urinal 16.60
f:i •';'R_:1.: OR Water closet 16.60
Business name: ' , -. ''' ;.,• -'�; ;."7 (.. Water heater 16.60
.
Address: ,- , `'1 '
City/State, /ZIP: %.': ! = / <- < :' % : = � '' " . " ;i Other: •
Subtotal
r G Minimum permit fee: $72.50
Phone: C ;f.:,
) , - ' ,' r ' - -- 4
Fax: ,v,k ±) ,/i 9? .- 070 a' Residential backflow minimum permit fee: 536.25 3 C --5 • CCB Lie.. a C.... Plumbing Lie. no.: Plan review (25% of permit fee)
r .. -. State SW'Ch fee) 1 2 , 9v
u, � �., (8% of of t' per t ;tt. _..�
Authorized signutyt ± i "/ - % i . iv i t TOTAL PERMIT FEE 3y. / S
Print name? /./ • . . rr�� Dail V ) LI ! D 5 I This permit application expires if a permit is not obtained ithin
- -. . III t t 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board
i:\ auildiagt Pcmtit .- P.t.t•iY- t'c:atir App ;bn: "y: 440- 4ii tGr(10 /02VCOtvttivEB)
2'd 99L0-269 -COS uaTI3 e90tLD SO LI 100
- • • - - • . 1
CITY OF TIGARD . ..,_
BUILDING DIVISION
PERMIT #: PLM2006-00542
D ATE
13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 10/17/2005
Phone: (503) 639-4171
Inspection Requests Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 10/21/2006 TIME: 7:08AM PAGE: 83 I
SITE ADDRESS: 16481 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 015 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Backflow preventer for irrigation.
OWNER: DON MORISSETTE 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 018976-02 503-692-6945 N
Corrections/Comments/Instructions:
Girt/ ril,-
X PASS 0 PARTIAL APPROVAL 0 CANCEL fl NO ACCESS
D FAIL fl CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: '76 ki---AJ ; I t w---- Date: JO/211 6 C — Phone #: (503) 718-