Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00107
Aka-
- � I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 4171 DATE ISSUED: 2/23/2006
PARCEL: 2S 109DA -08100
SITE ADDRESS: 15029 SW HAZELCREST TERR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 058 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 # 100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 2/23/2006 $36.25
[TAX] 8% State Surchan 2/23/2006 $2.90
Phone : 503 387 - 7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD. REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
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 -669 r 1- 00- 332 -2344.
Issued By: 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.
I/
,, - Bui`!ding Fixtures
Plumbing Perm# 1 1 'if* B � T_ 'l\ D FOR OFFICE USE ONLY
City of Tigard ;ve f o
❑ / Permit New
13125 SW Hall Blvd., Tigard, O1:- 7223 " - - - -- 4_01 �VD(� - 00 /U
t t� r} Plan Revie
Phone: 503.639,4171 Fax: 50.5.3V-811.90 J 2006 /`u:�;1ri 4A. ,, • ; ; f ' DateB Other Permit No
24- flour Inspection Lino: 503.639.4175 ;'
(� ._ " . 2 Cat See Page 2 for
�' • Z c No itiied/Metthod:
rfi. �• • ti t er• •� s'�- ' , , � .. . wc - r a. - - SuppEcmental
Internet: www.ci.tigard.or.us on
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le New construction ❑ Demolition For special in orrnation use checklist.
- ' - Description Qty , Ea. Total
❑ Addition/alteration/replacement CI Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
:k f m . r '� ,,
., y 'hq' .4X'r4. ,.54;0:: - 9;:
, a - � cry•$4 `,1,, ,r +. e 4- y st•,1..5,7, ,;•.:•
: n k .; i t (``t��`�. ,,„ �` ,1i7 .l 4, r x f ^ lafvap.' 5 4 : 417'.:_ ' �C SFR 1 bath
1 :x. >! , � , �� ���.. ;::.,s�dt „�t:,a<:sa�pl`r () 249.20
E 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath
_ 350.00
❑ • ccessory building ❑ Multi -family SFR (3) bath 399.00
E] Master builder El Other:
bath/lcitchen 45.00
,i ?, @I21[R a Li '�� . . }ti t rvrc'c. r. ,3:<' . n r i s: •:, Fire sprinkler ( sq. ft.) Page 2
7y � . ,1.1+4;,5 i dry :.,/: yc,'° ,', t g
yil.Vf +t' ' 1 , rt 1 O f,`1 ..:1",,' , a -40,4',1i'i..azio:MQ 4 T •'' : . D" . tl ? •- K�'i- ',..., a M r i ti: < .u � '
- :• "$' •ri "C44.F: t s i ,ql,.+ caJ'.r !. , FL7:. 2`� ,,�... � . 5. yr �t��,��
s �rir. . (tiY:J ...- vd /w'� .b...':;�rd`Jel;3:y% Site utilities
Job site address: / (:);rZ i .S.L.IJ / e ( c
-.. __-_- ... ..__ /�I�c CCU Catch basin or area drain 16.60
City /State/ZIP: '77 C' (C t J, 0 L_ 7 7 . � C - Drywall, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: f Pr n;uuc: S 1, LJ'n n Lt. Ra c _ S p - Footing drain (no. linear ft.: ) - Page 2 •
8 Manufactured home u tilities 110.00
Cross street/directions to job site: I _
t
.. -L@ / f ( ' - Manholes 16.60
!3 - j_l� -
_ c et .._ Rain drain connector 16.60
_ _ Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision �LLt Yl Water service (no. linear ft.: ) Page 2
_ i" Yl Lf kLG LC E Lotno.: �S G
Tax trap /parcel no.. C C c �_ 1 Fixture or item
: "v: " i `' -•,, v L j Absorption valve 16.60 i
.:.?i01. v{ ..t.z, 5 ftk�'`k' i. '> 111'.1: h:; :.Ic ' .;,�y� [fi St<i:! i i :;. . r
N .41'rr `Cl . • : ,tyy r� � T ' ....= l'L- XP ''I[)N WO1 .
:,. At.M..1,, :. :, .. },
•.1.•. >�.,a 2.�c,. ....e r :7. ;�:. f�.M;,, _ .. -r... ..- .'.r. ;1 r /n i�:.r �:[i?CI}utrC1 ».�. .5 ::.�,',� „� �.;
' �s� .r • .. . .. ,,... • � I , , ..., Badcflow prevente �
L / �., •„::;,,..,./ � " ' '•' � Page 2 7 . S S
- -r4 c a1' c ... - � _. _., � �t Li ow . . ,.. Backwater valve
i ((' 16.60
Clothes washer 16 60
D 16.60
'14,, n;+,= s1'' L. ': i ,� ��»!��i�:,:iz1 :/:,. {{_�]�.-zTT7. , .; %i '. - .f)11 c111 .z : a4r" ".',t.. 't h; fir: " .„ Drinking ountain 16.60
''a,,. SSSS{',''���itiii A.. +ial;!a: l: �:.pr;c\• j'11Zi,; .. r .1 1ft/<''u, n . 6f.i. i. ;.� ited , 11l:�1..'�, •• ' , iii.. p l; 1 I g
�, s` `';,,. C L9Ki �- /i'rsnv- ...tIL: ��,YVn :,;., r:1 ". d n.0 h.f, •NFi %tit�ti;'4'^"ly �•r. �iM'..�..!• +:.. - -
Name: l V -� ;< :, Ejectors /sump 1 6.60
- Expansion tank 16.60
Address: E--7 3 & 61_+ ( Y (c' {' - -, 0 C \CC Fixture/sewer cap 16.60
City/State /ZIP:LCJ- -- (' e ( \ i i. ‘. CI() O. V . f L3.. b Floor drain/floor sink /hub 16.60
- .., -
Phone: ( ) Fax: ( ) Garbage disposal 16.60
• 1 }' lM �` ` k� "I`k .a y .. to ;} ytF,a r ":` vl =` ? - t- 3s.';Frcr... ;'[t rn, >.; uwu,;. .,,:. -.: a ,/s', tiY• ":::{`'; Hose bib 16.60
r ita. :: :i:;i x. y } �� Arf.}?'tL3I f•'• r
e . 2 (9 , 1 : :V"ri. C'. _ i.'ZikA., W' . -
.
�, .rxh. -r , .. t;- r ,;:4,;,�.;,.r:�,.,,..'..:;..�r, Ice maker � 16.60
Business name: .,y ; ( e•
_: 0y _ r0 .. e - ` ,y - ! r - 27-- 7 d) /
l . P fr: • Interceptor /grease trap 16.60
Contact name: r� / ,'_i1 `1 ,� ,._y _, i'i t� Medical gas (value: $ ) Page 2
Address: / •
_.- 3 - 0 S C.LJ -- £ all,/ . / tVl-) t,1 (Zt Primer 1 6.60
City/State /ZIP:111 (, 4 ( h _ 0 l � _ .. '- ' L Roof drain (commercial) 16.60
t ' I " � C c `1& Sink/basin /lavatory 16.60 I
Phone: (SO 3) 4e) /ral /'L/ ) Fax:: (..-5.3) `/ - 6' S'
E -mail:
Tub /shower /shower pan 16.60
, ;, - - , wF: r" r : a ,. P. Urinal 16.
y i;q t :4, :;'ati , L? , �hj: ,r.E' C°0 .•ic : Fx'.. " ; ;;; ?'` i ia : , 's;.' . Ik ?''
..� i , 1;t ,r't '.:s :' .:Y^.:r,1.�F•nn: • -•t,..,.g.,. ', o- n • p`•f{ ?:r :. j`1�f, '
,.,, ,, ,. .:: � + .� < ri4 .- ,. .a:a;.:i;� }� ,:4,:.. Water closet 1 6.60
Business name / /
LL C./)L { -S( eip , t . ?' %0� �I) G { Water heater -- -- 16.60
Address: / -.D- -(O : r i_
) /Y (.S / fi\ I Other: -
''.iy /: _...e/ZIP: - Iii ` ' ..` I F 1, '' 0 / eo - = ..'fi' _ !
Minimum pemtit tee: S72 ,0
Phone: (56.3) & Q _s Fax: 5 9e _ D 7 (o g. Residential backflow minimum permit fee: 536.25 3(..,0 • - S
CCB Lie.: 7 . (.� Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized sigtta State surcharge (8% of permit fee) • G l D
I
TOTAL PERMIT FEE ; ,35, l S
Print name / �,n
„ - = �,' "' - � DaD .1, This permit application permit is not obtained " ithin
expires if a
Lr l - v.. ` - ' = J -..._ . 3l(�� I i P PP P P
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board
i : \nuilding\Pccmits\Pt- htr -Pcrrni V:pp.d„r. Oil' :140- 45l6T(I O /02 /COM/WH5)
a'd 99L0 -a69 -COS ua1T3 eLT :OI 90 Ea gad
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: ,20/6 -0070 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 4 � �� °0104 f1hl
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION. WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: a rje ASS OF WORK:
SUBDIVISION: 40 LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspec on D scription Confirm # Contact # Message
� N v Flo L/
Corrections /Comments /Instructions:
'V 2i r A.�w!1w � Ic,
•
•
NI PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL ❑ 'CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
\ Inspector: <Td Date: 3)/ ?/0 Phone #: (503) 718-