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Permit CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2005 -00276 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/21/2005 PARCEL: 2S 109DA -04400 SITE ADDRESS: 15436 SW GREENFIELD DR ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 021 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 Surchaq 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 503-246-6;99 or 1- 800 - 332 -2_! 4. Issued By: � Permittee Signature: 0) a- - df.% 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. • ID ifrag Fixtures � P E �;IUli � "bt1Il Permit 1� 13/i1� ��tC � �ilr� VE iir 1 - } •F,.ct'rr t 0, rk ,, ,i „i r; - ,.. . ...: City ,f-+ ,T'�11� ''" < ? .. F©R,,a CtE,US .. Ly,. Iy o atlgalr� (� ,::.1 .i.(i .r..:,. u..t -2 J. 'a . ' a . 2 fj JUN 21 20 (� Received :W 13125 SW Hall Blvd., Tigard, OR 97223 Datc/By; / D5 i,1 Permit Na.; bill -`' Phone: 503.639.4171 Fax: 5 03.598.1960 Plan Review OC/�� 24- Hour Inspection Linc: 503.639.q 175 � °a lt ' l -- - CITY OF TIG i e !l Date/ R O her Permit No.: Internet: www.ci.tigard.or.us -� tiG''l +• Dat Read B I3 ( p� 't� .. Y Y:ris: �iIVt3 DIVISIO Notified/Method: G�1 See pane 2 for TYPE O[ NOR]{ „awe Supplemental Information New construction FEE* SCHEDULE ❑ Demolition For special in ormarion use checldisr. ddition/alteration/replacement Descn.tion _ k ❑ Other: II Ea. Total CATEGORY OF CONSTRUCTION New 1 -2- family dwellings (includes !OD ft. for each utility connection) SFR (I) bath 249.20 1 - and 2- family dwelling ❑ CotnmerciaUindustriai SFR (2) bath _ 350.00 CI A cessory building ❑ Multi-family SFR (3) bath 399.00 ❑Master builder Each additional bath kitchen _ ❑ Other: 45.00 .1013- SITE INFORMATION AND LOCATION • Fire sprinkler ( sq. ft.) Page 2 Job site address: I 5 L(34, S t-4-3 C�2 79-61.61- S ba i n s City/State/ZIP: --- � ' / '�� Catch basin or area drain 16.60 { � Q g. ci D-� Drywell, leach line• or trench drain 16.60 Suite/bidg. /apt. no.: Project name `Lly . • y 4'� J.)-/ F ooting drain (no. linear ft.: Cross street/directions to job site: ) Page 2 Manufactured home utilities 110.00 ��e� i3 E' ,c P._40 Manho 16.00 i Rain drain connector _ 16.60 Sanitary sewer (no. linear ft.: ) Page ge2 2 Storm sewer (no. linear ft.: _�) Page 2 divisiort&LUVtryt:Lf- to . �� g rd. Lot tto.:� Water service' (no. linear ft.: ) Page 2 Sub Tax map /parcel no,: te, ss / Fixture or item DESC IPTION OF 'WORK Absorption valve 16.60 r / ./; � ` � 7, r Eackflow preventer = �� / U ` f JY• 2. �f.' 7� -A /A ` �,± %ii / v Backwa[er valve Page 2 „,-7 - �s 16.60 Clothes washer 16.60 Dishwasher 16.60 0 PROPERTY. OWNER D NN rinking fountain _ i' '' 'TENANT 16.60 Name: L (nn rnOYi .S 'f /= /11-0-r1 ,-'S Ejectors /sump 16.60 s N ame: eZ 3 S b � Expansion tank - � - (�. C..tD o pct. 16.60 C Fixture /sewer cap 16.60 ity/State /ZIP: - LC� /CG 0S i✓t_i er '/.7 MI � � ��- U�.� � J Floor drain floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 I,YCAIVT CONTACT Q APP I'ERSOIV Hose bib 16.60 a � � cir / ^ ( Ice maker 16.60 Business name: Contact name: '= / ' �i interceptor /grease trap 16.60 0 Address: v � U c r , / Medical gas (value: 3 ) pa e 2 v� ! i ` t-C. �- , 1rv1 s d`D Primer g City/State /ZIP: ° J 16.60 fAI�`- 04 ]b2 L .( ' c c„ Roof drain (commercial) - 2 7G 6.60 16.60 Phone: (561,:3 ) U C��) ` �c Fax: : (.5".. / Sink/basin/lavatory MI E -mail: r_ Y:�t - C' �G ^��' r Y 16.60 Tub /shower /shower pan 16.60 CONT1tAC3'01t Urinal 16.60 ! Water closet 16.60 Business name: ! . G'_Sc J C7s c_L'' U address: (' r Water heater 16.60 � p . _i,� . '- gin Other: __ -2ity /State/ZIP: �'t� ,� ,,.. ,i�]� 1 7 ) `� " Subtotal /3 ) & Gj� x-97 Fax: 6 /�, 7 Minimum permit fee: $72.50 'hone: (54,3 � ` �) "��Q� ' � � 7 R backflow minimum permit fe 536.25 2 :CB Lic.: 7 SC, , . Plumbing Lic. no.: Plan review (25% (25 of permit fee) auti +'ona L/ �i ! � ?% // r��9 State surcharge (8 of permit fcc) ' <j ) i horized s rint name o,n, r , I TOTAL PERMIT FEE 39, is a l'�Cl4 T r () D ® This permit application expires if a permit is not obtained within 130 days after it has been accepted as complete. 311itding1Pcrmits1Pt- Mp_pCff11itAPP dac 12(03 *Fee methodology set by Tri- County Building Industry Service Board. 4 4 0 -46 16 T(10 /0a/CO V f /wE'p ) 2• d 89L0- 269 -EOS uail3 e9S =GD SO 12 uOC CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2006.00276 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 '_- INSPECTION WORKSHEET FOR DATE: 7/12/2005 TIME: 7:06AM PAGE: 70 SITE ADDRESS: 15436 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 021 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: Irrigation backflow preventer. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 5503 -387 -7536 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 /backilow preventer 011190 -01 503 - 692 -5945 N Corrections /Comments/ Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS • ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: K Date: • Phone #: (503) 718- •