Permit CITY TIGARD RD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00431
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/6/2005
PARCEL: 2S 109DA - 08000
SITE ADDRESS: 15007 SW HAZELCREST TERR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 057 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 9/6/2005 $36.25
[TAX] 8% State Surcha 9/6/2005 $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.
Issued By: _`�� ^ D Permittee Signature: 3„/ ,f_ 9)-Q
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. 1
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.
r'
Building Fixtures
PCC OVF®
Plumbing Permit Application
FOR OFFICE USE ONLY
CI of Ti and Received ,/ Ha 131 SW Hal Blvd., Tigard, OR 97223 SEP 1�0� Plan Date/By: �' j J 6( }
', Permit N° 11 ,?oD'S �v t
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review J
, 14'AlVi �+ �' Date/By: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 CITY OF T_,r '' or
--°-` '-''. Date Ready/By: s See Page 2 for
Internet: www.ci.tigard.or.us BUTT lfN(', flRFlQ Notified/Method: -/}wi El Supplemental Information
TYPE OF:WORK FEE* SCHEDULE
New construction . ❑ Demolition For special information use checklist.
Description • I Qty. J Ea. I Total
❑ Addition/alteration/replacement ❑Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF. CONSTRUCTION • SFR (1) bath 249.20
1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB. SITE INFORMATION AND LOCATION, Site utilities
Job site address: 15007 j zeLc.,- C T - t J Catch basin or area drain 16.60
City /State /ZIP: 7-7q6, l�_ O)Q. 9 �� y Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project! iattrifet Li-- p_A..a.7 , 5 7 Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Be e-49- ) �" � �j � Manholes 16.60
C tom`-' - / W Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision L,1 Jt fl y)L,_f Rate/ e.- 1 Lot no.: S'7 Water service (no. linear ft.: ) Page 2
A- Fixture or item
Tax map /parcel no.: ii / 1
Absorption valve 16.60
DESCRIPTION OF WORK
' 5�
• ha ac:- Backflow preventer / Page 2 � ' 7, S
/ c
` lty '- cJ I fir / q cc.h (5) ,..„ ,
I - fi!_R,(, aet) t fX , Backwater valve 16,60
Clothes washer 16.60
- Dishwasher • 16.60
Drinking fountain 16.60
:ISI,PROPERTY. . • .l '.❑- TENANT
Ejectors /sump 16.60
Name: b Dye rnoyi s S t • f- 7 How e _s Expansion tank , 16.60
Address: L1 3 0 ..S Lti G lc_• ex.-L.) 0 Oc :L. Fixture /sewer cap 16.60
City/State/ZIP:`..cs / _e_ 0 S -cc76 Qi2. / 7 33 . 5 Floor drain/floor sinlc/hub 16.60
Phone: ( ) / Fax: ( ) Garbage disposal ' 16.60
Hose bib 16.60 • . "&f AYPLICA,NT -. CONTACT PERSON
Ice maker 16.60
Business name: /_ j j a r , ( ,„ 10 .,,_,, 06'"e_L T�„
X444 y
f Interceptor /grease trap 16.60
Contact name: ) re i Medical gas (value: $ ) Page 2
Address: / - 3 -()U ,L.W rn ys -Iii'' Pp Primer 16.60 • City/State/ZIP:1 _( , e- - ip - 0 12_ , '70( Roof dram (commercial) 16.60
Phone: (503) (G.' t/ - S /(15 Fax:: (S / Y,2 - 6t 7&,,S."
Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60 • • ' CONTRACTOR . . • • Water closet 16.60
Business name: 4c S(rJr.� 0 -r� , Water heater 16.60
Address: / ,).-D-OG S / NI i4 Sitm,� Other:
City/State/ZIP: Q � -7 `rOI '4 70(0 Subtotal
_ Minimum permit fee: $72.50
Phone: Cf 3) &Q,;„1 ,S S Fax: (503) (o - 07 (, g' Residential backfow minimum permit fee: $36.25 (Q , as,,
CCB Lic.: 7 eUy Plumbing Lie. no.: Plan review (25% of permit fee)
a IC /� �-t State surcharge (8% of permit fee) a , 9_1
Authorized si
��� �/ 0 4 1c7 �% TOTAL PERMIT FEE 13, S
Print name`/ .. , 'C -r --,, Data- This ■C) S 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 Board.
i:\ Building \Pernuts3PLllF- PermicApp.doc 12/03 440- 4616T(10 /02/COM/WEB)
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00431
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/6/2005
Phone: (503) 639 -4171 : rr�d4Pi'IP�IIilit.
Inspection Requests (24 Hrs.): (503) 639 -4175 �� &J `__..
INSPECTION WORKSHEET FOR DATE: 9112/2005 TIME: 7:04AM PAGE: 96
/ 5 —Z) ° 7
SITE ADDRESS: 1 j 7 SW HAZELCREST TERR CLASS OF WORK:
SUBDIVISION: SU T RIDGE LOT #: 067 TYPE OF USE:
PROJECT NAME: SUMMI k' IDGE
DESCRIPTION: Backflow pr- enter for irrigation.
OWNER: DON IVMORISSE COMMUNITIES LLC, PHONE #: 503 -387 -7538
CONTRACTOR: LANDSCAPE ORE N, INC. PHONE #: 503692 -5945
Inspection Request Scheduled For: Date: 9/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final s' 5367 -02 503 - 692 -5945 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 8 "' Date: '1 l 1 Z l Phone #: (503) 718 -