Permit C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES
DATE ISSUED: PLM2006-00064 06
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PERMIT #: PLM2
PARCEL: 2S 109DB -03400
SITE ADDRESS: 13086 SW HAZELCREST WAY ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 072 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
4230 GALEWOOD ST #100 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 2/3/2006 $36.25
[TAX] 8% State Surcha 2/3/2006 $2.90
Phone : 503- 387 -7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 692 -5945
FAX 503- 692 -0768
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.
Issued By: )7—
Q Permittee Signature:
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 Fixtures tig,°
Plumbing Permit App cation
FOR OFFICE USE ONLY
City of Tigard FEB 03 2006 RecDat n '_ �� erm Pit No.: ` `���
13125 SW Hall Blvd., Tigard, OR 97223 B J 0� � U (
Phone: 503.639.4171 Fax: 503.59 4 , ..i,� Plan Review
t, c
Date R
24 Hour Inspection Line: 503.639.4 OF'"Ik I j i � ;rw ; f . Date/By: Other Permit No.:
ae ead /B Juru
Ready /By: See Pa
Internet www ct ttgaz+d onus t - : e 2 for
Page
�, 1t IL i, , a Notified/Method: , Supplemental Information 7. er, 4' � z >!1` S�Rn�,l. "� + A•�� �i�`' � i ,� � - � a,.x�' :,,, 4 � ` mow � ;:r, : . � �;,'� - ..,;;�.: •r: �'4�' ;r�a .. .�;r�,.
..1 � .f. 1: t'iifi - �t(t4• 1M Virtu 1 ' ` .f d ` .}1 'r` *, , : 14 . y .4�'
..taiLiv .e. • Y i S' f , Y] [71.. �d : n 4 .A'. �� .. L.l i'_.i.. , f :J. I • "v:.t.
■ ew construction ❑Demolition For spec i nformat i on use checklist.
-
st
Description Qty. Ea. Total
❑ Addition /alteration/replacement ❑ Other:
"�?v1F rT�.1 t _ T; 'a �nr.;;;i • z,;'., New 1- 2- family dwellings (includes 100 ft. for each utility connection)
'f i ✓ t ,•.. r . f � � 'fIJ, Lie 0 =Q 9 0. , P, 1KPa ? . ;,v , ,� • t7,1 r
. _., a.� .�::.tii� �_'P' ast:.,'r,�� =;�, _���'P,a/n'. °+�"�,,.� .,i w. SFR (1) bath 249.20
1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
SFR (3) ath 399.00
❑ Accessory building ❑ Multi- family )
❑Master builder Each additional bath/kitchen 45.00
❑ Other:
C trs , >, t t si ,� Fire sprinkler s . ft. Page 2
r 7 �`„ v t 't.i. t ' 1.t ",c * ^+ P ( Q )
". tt ) i C' r E+ (' •/ t 0 i D d a 4 f 0 1' ".
..._, _ , _ a- ..�� ..�.- � ..w , ,...r. ��• r � ;r�sm;'s�,� �.,a.., ��_1ir.,ai�3f„� �„ . r .: • Site utilities
Job site address: 1 30 g2& Suw L-EeL 2-e (T.YC,S_T 0- Catch basin or area drain 1 6.60
City /State/ZIP: �1c-l. 0 g. C 7 2 .. (_ t Drywell, leach line, or trench drain 1 6.60
Suite/bldg. /apt. no.: Project nanl (.4.1yl WILY- 4_c[Ci� l Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site:
� Manufactured home utilities 110.00
Manholes 16.60
SAA) eeF faLtAzt rep Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision /) /7\ 14-- Lot no[7c . Water service (no. linear ft.: ) Page 2
` - /� C Fixture or item
Tax map /parcel no.: L_!' t 5 �.
< a� : r ek- ,,:,:r',y y� a•' , ,r w Absorption valve
i i . 4{gp : ., . :n.!- .:.,- 16.60
R yE �1 ro, �} ���y (tS 1•'. ' 0 t' p' preventer 2 r�7. � �
,;. J igti 1 k r-: t . r,. , :; ? l: ._ M ," ; s.> , r
,/ a r M �n. r `tr^ .:. ; .., :: : ¢ f „ . .,..• ,1 r., Backflow reven[er
�n�'1 SCE aj ' „rr� q 7 (.5).1 hu�Jle flue,() G�, % /CX Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
�if fy layy a i, a + ,T ti „�� y • , g 4 r Drinking fountain 16.60
i l ,L ?1u.: r.*cs lt, MM7 e v -, w .:. - .!' s . : . •%i T1 � 1 V 1 09 - 4 �.- ) : i'• -
.f�YES3 - Ejectors /sump 16.60
Name: D a / /( l SS C f / Yy) e_S
Expansion tank 16.60
Address: L-fa 3 C.' S Lc Glt -( i.0 -(,_1 0 OCL Fixture /sewer cap 16.60
City/State/ZIP:Lot_kc 0 c - L C C / , G O. , '7 c33 S Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
�cs• y� i3a � r i r. u ra.r�c }•... > -t.,.F f Hose bib 1 6
�, J J 1 m_ ) C�ir r' 1 J z+ �.., hr r re;�' t ilt 1 ii ,: i- l. .i: A.
6. 0
L.....:.. ... - Vic.. -rs�. s.. ,,,.,a sstvi, ,. .i.; z , a : Ice maker 16.60
Business name:
/-‘i-ti (t s Clx f 'G 0 rP7 U , r- Interceptor /grease trap 16.60
Contact name: .. err ..) Medical gas (value: $ ) Page 2
Address: / -- 0 -Lt) m t I,' y y 1W Primer 16.60
Ci / State/Z1P: Roof drain (commercial) 16.60
Phone: - c , . Sink/basin/lavatory 16.60
(563) (;9 -mi l(1S Fax: E l,.q -C /(c•,y-
Tub /shower /shower pan 16.60
E -mail:
rr s r F Urinal 16.60
d
:a >: rL.,� e.;:� r /.: t. ~ ..
- ,m t . • .,1 fi r rt 1 ) ,: g 'i. , .(l�f k >iAt� w'., �I r g, 1,. jd �iC�:::
-r „ : _ .t i:" Szo ti att'�rt•.. � or?3, ?k h ! !t l 'L ^'r.� ^: ;i `:'.' `'•,•in: 7� . Water closet 16
Business nam *
�C -�� %i ' 7:; ,-- 1 ;� Water heater - _ 16.60
Address: / ,2-,>-00 ..'1r ,. ? ;,0 -.. - - - I Other:
City/State/ZIP: 7� � 0/z. /70& Z subtotal � 7 SS
Phone: /� /, a S � -f5 _ Fax: 5- ( / o9 /� a •- O'7 Minimum permit fee: 572.50
-
3 ((/Y Cog' Residential backflow minimum permit fee: 536.25 360- .S
CCB Lie.: 7 eU Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized signa �-�/
� l State surcharge (8% of permit fee) C70
TOTAL PERMIT FEE 39 . e 5
Print name`) ef) �raCW)-u, Dat / 3/ Co This permit application expires if a permit is not obtained within
,' 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Boarc
i'\Building\Permics\PLMP- Permit App. doe 12/03 440- 4616T(10 /02JCOM/WEB)
' d B9L0- 169 -EOS ua1T3 di70=ZT 90 E0 clad
CITY OF TIGARD
BUILDING DIVISION ,.. PERMIT #: PLM2006-00064 I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: .2/3/2006
Phone: (503) 639-4171 Aw11141,ilil ,
Inspection Requests (24 Hrs.): (503) 639-4175 A. - -IL
INSPECTION WORKSHEET FOR DATE: 2.1 14 n 6 TIME: 2:22PM PAGE: 39
SITE ADDRESS: 13086 SW HAZFLCREST WAY CLASS OF WORK:
SUBDIVISION: TYPE OF USE:
SUMMIT RIDGE LOT #: 00 1
PROJECT NAME: SUMMIT RIDGE ll
DESCRIPTION: Badcflow preventer for litigation.
OWNER: DON Iv1ORISSEI IE COMMUNITIES, L.I..C, PHONE #: 5 03 .3 87:7 63 6
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #:, 503.692_5w .
Inspection Request Scheduled For: Date 2/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 026047 503 N
Corrections/Comments/Instructions:
i. .
,/• i
•
6 - i t _Le6SS El PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
El FAIL I I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: 11/1 \, C/ Date: IF 1/ h Phone #: (503) 718-