Permit CITY OF TIGARD
PLUMBING PERMIT
11. I
DEVELOPMENT SERVICES PERMIT #: PLM2003 - 00578
E 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/5/03
SITE ADDRESS: 13625 SW HATHAWAY TERR PARCEL: 2S103CC 07500
SUBDIVISION: WHISTLER'S WALK ZONING: R - 4.5
BLOCK: LOT: 022 JURISDICTION: TIG
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
Remarks: Backflow prevention device for irrigation.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES INC
4230 GALEWOOD STE #100 [PLUMB] Permit Fee 11/5/03 $36.25
LAKE OSWEGO, OR 97035 [TAX] 8% State Surchan 11/5/03 $2.90
Total $39.15
Phone : 503- 387 -7538
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062
REQUIRED INSPECTIONS
Phone : 503 - 692 - 5945 RP /Backflow Preventer
Final Inspection
Reg #: LTC LCB: 7804
PLM ALL PHASES - PLI_
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
Issued By: I' \ L � /i � I Permittee Signature:. Al/eC
Call (503) 63I-4175 by 7:00 P.M. for an inspection needed the next business day
Nov O,' 1 1 : 42a dan 'edmonds 5 0 3 - 6 9 2 - 0 7 6 8 p . 2
-,'
to '''''' • .FOR OFFICE USE ONLY
Plumbin Permit A lication Received , ,- A Plumbing j , , -, y
I
City of Tigard ECEI .( 'ED ‘ 0
DatelBy: /I 3 ci - 6 Permit No.: e..../40e,_,--a ..) / 16 I
Planning Approval
Datc/By: Sewer
Permit No.:
13125 SW Hall Blvd- , _ Plan Review Other
Tigard, Oregon 97223 NOV 20i Date/By:. Permit No.:
D !VISION .
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use
. , , O.
Internet: www.citigard.or.us CITY 0 - / 1-- INIPt;'11(14 Date/By: Case No.:
Contact
--/-..,,‘ '''' 6-1.....* jri.&,: (81 Sec Page 2 for
24 Inspection Request: 503-639-MI14M Name/Method: / /0 Supplemental Information.
.7: . -- ' . . - ;1 . :',:- , :.:i'•:' - -,: - -;:- - ‘:: : : , ::.." . TYPE OF WORK : :, fi: :f '',.:: •,, ',..1- .:TEE*SCHEDULE:(for Speelil infOrMitioniiie7cliecklist) i ; f
[New construction El Demolition Description I Qty. Fee(ea.) I Total
D ddition/alteration/replacement D Other: .,.:,.:..- :..i: :::.:.... :: New t.-.:
.:..,.„•:-:. -. .iOr each n011itYithineetiOnj:::-. '' •:;::: :,
-- s -,. •: :.;: CATEGORY OF CONSTRUCTION .:.;..:::-:::- ..:'..-."...': :.,
SFR. (1) bath 249.20
1 & 2-Fami we
ly dwelling D SFR
R (2) bath 350.00
El ccessory Building . Ei Multi-Family SFR (3) bath 399.00
El Master Builder El Other: Each additional bath/kitchen 45.00
, .JOBSIT_EINFORMATION ind LOCATION ::. : ' , ' - Fire sprinkler - sq. ft.: Page 2
. Job site address: /3C,„;/ S -,S:as, fla WIZ/66 ' • :.----:: ':. siutaiiii:'::;. : :::,.'::.:,,:,::::-. :- :'• .
• Suite #: 1 1 Bldg./Apt.#: Catch basin/area drain 16.60
Drywell/leach line/trench drain 16.60
Project Name: lehisiltys 0)0_1_4, i ( 2-a.....
Footing drain (no. linear fill Page 2
Cross street/Directions to job site: • Manufactured home utilities 110.00
St.-t---% ta_i Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: tOhiSticrS CC a-t_it-- I Lot #: .,.-D-- Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft Page 2
Tax map/parcel #: ( SG 6S
DESCRIPTION OF WORK
Absorption valve 16.60
Larldge /FtaCi-c C2-0- i.& Backflow preventer ( Page
Backwater valve ' 16.60
Clothes washer 16
J
Dishwasher 16.60
Drinking fountain 16.60
ROPERTY OWNER ::: . : ' :•• I 0 TENANT ':' ;:',..:•.;,-. .. :-.....':- Ejectors/sump 16.60
Name: )Y /110 Pie4-n<LS Expansion tank 16.60
Address:4 30 Su) • &e.t.-6Le."--)o0 a. Fixture/sewer cap 16.60
City/State/Zip:143-1L 0-g-t-i-e-56 Q-7112-C Floor drain/floor sink/hub • - 16.60
Garbage disposal _ 16.60
Phone: Fax: Hose bib 16.60
:•'ELAPPLICANT '', : :: . : • :1 '„' ••• laCONTACTiPERSON''. ' 7: •- - Ice maker 16.60
Name: el.icil .1ren_13 Interceptor/grease trap 16.60
Address: k D.=..-0 0 S. raj ..S.10y1 RD Medical gas - value: $ f . Page 2
Primer 16.60
City/State/Zip: - Rk_a_rat5nn_.. 0 tz. 9 __,
Roof drain (commercial) 16..60
Phone S:y3 (.09.1- - Si 451 Fax:S3 (0q3.- 07/0 2 Sink/basin/lavatory 16.60
E-mail: , Tub/shower/showeryan l6.60
.,,; • • :, I ..T: :_ -.::: :.:::: ,.: , ;ONTRACTOR : ::': :::';:'',...,: .:::,:-:;::, ',.“:•: Urinal 16.60
Water closet , 16.60
Business Name: l_a_ructScapt..... 0 MjelYN --- 51-1(,, - .
Water heater 16.60
Address: I.D--Och ,S,o3 ry)(+c-to-n_j ex>. Other: -
-
City/State/Zip:7- - 6 &. cr Other:
PhOne:503 (AQ - S 94-1 - S- Fax .)3 f '''' l - 6371'k ‘ :::',-,:::.: ,, ' ikiiiiiibinPerinit Fe: ' ''62'7'...S
CCB Lic_ #: .7E Plumb. Lic.#: Subtotal $
Minimum Permit Fee $72.50 $
-z 3
, - }
AuthoriZed dzz od---LA-aL, Datel 1 0 i_il Residential Backflow Minimum Fee $36.25 '---)
Signatur,....- . i qQ.-3
Plan Review (25% of Permit Fee) , $
el/ e_r) \cp64- rffu) State Surcharge (8% of Permit Fee) $ c2 , 96
(Please print name) • - TOTAL PERMIT FEE $ .39, / 5
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or
180 days after it has been accepted as complete. riser diagram for plan review.
. *Fee methodology set by Tri-County Building Industry Service Board.
CITY OF TIGARD • 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / j — / `7 AM PM BUP
Location /3C -5 HA. GI.-0 � Zr✓• Suite MEC
Contact Person I°L Ie N Ph ( ) b? 2- ,S1 3 - 00578'
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear �� w L-Gv ;CA_
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm v 7 ,7
Susp'd Ceiling
Roof
Other:
Final
PAS T FAIL
UIIIIB
'IN'S Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain � � 644 Shower Pa ,
• Other: ll�f
Fina
ASS PART FAIL
ANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next. inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call for reinspection RE: I Unable to inspect — no access
Fire Supply Line
ADA Date
Ext
Approach/Sidewalk D a , Inspector
Other: •
Final ' O NOT. REMOVE this inspection record from the Job site.
PASS PART FAIL