Permit %
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CITY TIGARD PLUMBING PERMIT
AIN DEVELOPMENT SERVICES PERMIT #: PLM2006 -00057
� I DATE ISSUED: 2/3/2006
A.14- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA -07700
SITE ADDRESS: 15018 SW HAZELCREST TERR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 054 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 MORISSETTI COMMUNITIES, LLC.
4230 SW GALEWOOD ST Description Date Amount
LAKE OSWEGO, OR 97035 [TAX] 8% State Surcha 2/3/2006 $2.90
[PLUMB] Permit Fee 2/3/2006 $36.25
Phone : 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.
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Issued By: J) , ,/CZ (�1� % Permittee Signature: 5'p c)I�Q
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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.
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''' Building Fixtures
FEB 0 2 2o6
Plumbing Permit Application
FOR OFFICE USE ONLY • .
City of Tigard
13 SSW Hall C ITY 0' ; ',.G ., ir
C ,,.. Permit No.:
12ll Blvd., Tigard, OR 97223 BIJILD' • I ,3 :Sit te
Phone: 503.639.4171 Fax: 503.598.1960 (iov.himiciti.jV Date/By: Other Permit No.:
24- Hour Inspection Line: 503.639.4175
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Date Ready/13y: h". RI Sc Page 2 for
- Internet: www.ci.tigarcl.or.us
Notified/tv1ethed: ,. /(rSuppieniental Informatio . l
,.ljii.i!.. , l, , Qt , Afi i :ifAZK.::;:;-::-i ' l: l l .: 5 • . '' .. 1',:lj l . , • :: : ,l 7 l..l:l,h1 l 0 :: Y.: *'. . ,..50/Efitii*
' Nlew construction 0 Demolition For special information use checklist.
Description Qty. Ea. i To t a I
0 Addition/alteration/replacement 0 Other:
New 1- 2-family dwellings (includes 100 ft, for each utility connection)
.. 4 .iitiitY :. : 00 :, ; .;', 0014t47 6. *: ..4- ,:- . ...: : :..i:z . :" : - : :!..-::„i ..:,,!.,::.- ,::..: SFR (1) bath 249.20
X- and 2-family dwelling 0 Commercial/industrial SFR (2) bath 350.00
SFR (3) bath 399.00
El Accessory building 0 Multi-family
Each additional bath/kitchen 45.00
0 Master builder El Other:
Fire sprinkler ( _ sq. ft.) Page 2
0!?*;41'46.701-A140.::110.'046ii:1 ''':.'.:.:::. :' 1 ' 'j. ',.i 1' ',.. Site utilities
Job site address: i .SC) / e ..9...i..i i-1&' e cfrc.s-r TEl Catch basin or area drain 16.60
City/State/ZIP: 77 1 et..,Let r 47 - 7 "a- 6/ Drywall, leach line, or trench drain 16.60
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S uite/bIdglapt. no.: 1 Project name_SL Linrn-C-7 tekct 6 6-(1 Footing drain (no. linear ft.: ) Page 2
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Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
.S,:i...i.‘ 8 e 6 1 &.ftek_ 02-0
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision:,g.LM/yk LI' tek_a_ge_.- Lot no.: S Li
Fixture or item
Tax map/parcel no.: (p SI 4 '7
„. , . Absorption valve ' I 6.60
•• "'''''- .. :''' ''';-..:;''.• •:''';'-.-:-6.: in .':'.! :. • i:' - ''....,
J Page 2
,.. /,.-_,../.:, ,,,,,,,,,, 4 .. , Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
: '6iiiis,tkk •:''''••,.•:-.:'1;• 2 • - • :,:, Drinking fountain 16 60
.' - ,.4 P.- , -,=, ' - • .''' '':,','.:' s ' : ' ;; ' ..-.: ' ; ' , M . ''''''' 4 'jt 411 ''''''%-: ..-. :'..' . '. Ejectors/sump 16.60
Name: b e f) 5 ..> 't. 7 - #' - )"r) !' Expansion tank 16.60
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Address: Li) 3 L..' .S L.t._‘ L 1_ c" C_ C. CI (..C'e Fixture/sewer cap 16.60
City/State/ZIP:LC-L k C, 0 Lk) e ? 0 4:.k.. '-i 7 (.3.:: ...--_., Floor drain/floor sinldhub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
, • • • • • : . :.:i ': 4 •? • ; :; .' ' '4:= ' ; ' : - * 7: -‘ • *. i .:11.'•:!'.:-CI: ':''115k.°SIC*;. '...1';•' Ice maker
16.60
16.60
Business na me: LAr a f ,' .c.)K-e;(.)-?-). . Interceptor/grease trap 16.60
Contact name: ;- :','/) LE? ' -7,0 Medical gas (value: $ ) Page 2
Address: i :d .) (...) 0 ...c (1.) filt.iC, 1'm t.I gl) Primer 16.60
City/State/ZEP:--ru to 0..h,. °f a , ---/ - - , ,-,-, ,._- Roof drain (commercial) 1660
_
Sink/basin/lavatory 16.60
Phone: (SCA ) L.: .9_;? --- 55;V 5 I Fax: : (S 3) (..-- ;/ •; - '---' '''- ..c"
Tub/shower/shower pan 16.60
E-mail:
Urinal 16.60
: .,.: .•;: ''
.... . .. ' • .•:!` '•. ,,, . • Water closet 16.60 ..
Business name:La/As( o p . 0(.? „--k._-_-,- Water heater 16.60
Andress: / )--- 6 -:., ,s 0_) RI El 31 (A ti g....e, i Dd.-
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Subtotal
City/State/ZIP: 7it a_ZeLt--)rt '- -e : .--,___ .
Minimum permit fee: $7250 .,.
Phone: t.. te(4.> -53 Fax: 5-0 3) 61 9? - 0 7 E' R ....., esidential backflow minimum permit fee: $36.25 . .- - 4,0 - d---S .
CCB Lic.: 7 gt..) Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized signa 62,7-.1 -1
„.....„411
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i State surcharge (8% of permit fee)
TOTAL PERMIT FEE 1 .. ( S I
Print name// e ,c77->-v- 1 D9 C This permit application expires if a permit is not obtained i• thin
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board
i: \ Bui IdingVertuits 1 PLMF-PcrrnitApp. doc : 2103
440-4616T( I 0/02/COM/WEB)
u a I 1 3 E0:80 30 20 gad
a'd - B9L.0-a69-EOS
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006-00M7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 71312006
Phone: (503) 639-4171 A •
Inspection Requests (24 Hrs.): (503) 639-4175 -AI-
INSPECTION WORKSHEET FOR DATE: 21612006 TIME: 7:02AM PAGE: 6
SITE ADDRESS: . 15018 SW HAZELCREST TERP, CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 054 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Bacirilow preventer for irrigation.
OWNER: DON iVIORISSE.I II COMMUNITIES, LLG., PHONE #:
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-.692-5945
Inspection Request Scheduled For: Date: 2/612006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 026336-01 503
Corrections/Comments/Instructions:
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PARTIAL APPROVAL CANCEL fl NO ACCESS
FAIL CALL FOR INSPECTION I I ADDITIONAL F ES ASSESSED
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Inspector: (.1W Date: • IP Phone #: (503) 718---fA3-