Permit _ t
C ITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00019
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/24/2007
PARCEL: 1S134DB-10300
SITE ADDRESS: 11345 SW MEGAN TERR ZONING: R - 4.5
SUBDIVISION: DAKOTA GLEN LOT: 005 JURISDICTION: TIG
Project Description: Install residential backflow prevention device 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 HOMES, INC. Description Date Amount
4230 GALEWOOD ST #100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 1/24/2007 $36.25
[TAX] 8% State Surchari 1/24/2007 $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 OU NC by calling 503.246.6699 or 1.800.332.2344.
•
Issued By: ! • ,a _/ 4„, Permittee Signature:( roy
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.
. - • - • Plumbing Permit Ap; , Iitatiftn ! ,) FOR OFFICE USE ONLY
City of 'I'iglllyd Received / ® Q 7 P ermil No.: , C-(N 7_ea° C 9 . _. _.
13125 SW Hall Blvd., Tigard, OR 97223 Dante .
Tigard, Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ppl r t . it ti, M.. , I t DMA) Uthcr ['emit No.:
24- Hour Inspection Line: 503.639.4175 i ��J�• Data llcedy'By: Q1 See Pace 2 for
Internet: www.ci.tigard.or.us Notified. /Method: 01 Supplemental Information
TYPE; O' ) 'II R ` .T ION FEE* SCHEDULE
For special information use checklist
® New construction 71r - +, 'r 1 hill Demolition
Dcscri.tion EME Ea. Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for rash utility connection)
.. CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
® 1- and 2- family dwelling ❑ Commercial /industrial 5FR (2) bath 350,00
❑ Accessory building ID Multi-family SFR (3) bath 399.00 Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. 11) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
lob site address: 11345 SW Megan Terrace Catch basin or area drain 16.60
City/ State/ZIP: Tigard, OR 97224 Dry well, leach line, or trench drain 16.60 •
Suite/bldg. /apt. no.: Project name: Dakota Glen 05 Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW North Dakota Street
Manholes 16.60
Rain drain connector 1 6.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear n.: ) Page 2
Subdivision: Dakota Glen Lot no.: 05 Water service (no. linear R.: ) Page 2
. Fixture or item
Tax map /parcel no.: 655 C 2
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Landscape Backflow Device Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER Drinking fountain 16.60
❑ TENANT
Ejectors/sump 16.60
Name: Don Morissettc Homes Expansion tank 16.60
Address: 4230 SW Galewood Fixture /sewer cap 16.60
City /State /ZIP: Lake Oswego, OR 97034 Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
® APPLICANT ® CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Landscape Oregon, Inc. lnterceptodgreaseIrap 16.60
Contact name: Ellen Sparrow Medical gas (value: S ) Page 2
Address: 12200 SW Myslony Street Primer 16.60
City /State/ZIP: Tualatin, OR 97062 Roof drain (commercial) 16.60
Phone: (503) 692 -5945 Fax: : (503) 692 -0768 SinWbasin lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: 1 Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Landscape Oregon, Inc. Water heater 16.60
Address: 12200 SW Myslony Street Other.
City /State /ZIP' Tualatin, OR 97062 Subtotal
_. Minimum permit fee: $72.50
Phone: (503 -) 692 -5945 Fax: (503) 692 -0768 ' Residential backflow minimum permit fee: $36.25
CCB Lie.: 7804 Plumbing Liu. rto.: Plan review (25% of permit foe)
/ �
/7 State surcharge (8% ol'penuit Fee)
Authorized signaturg,✓ .-Ze77 4 ' � ) TOTAL PERMIT FEE
Print name: Ellen Sparrow Date: 01/23/07 This permit application expires if a permit is not obtained within
180 days aft er it has been accepted as complete.
"Fee methodology set by Tri- County Building Industry Service lioord.
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CITY OF TIGARD
BUILDINGDIVISION PERMIT #: PLM2007-00019
13125 SW Hall Blvd., Tigard, OR 97223 1 IA DATE ISSUED: 1/24/2007
Phone: (503) 639-4171 Aow IN4t I fl` --- -
Inspection Requests (24 Hrs.): (503) 639-4175 „,--14.V Ai!.
INSPECTION WORKSHEET FOR DATE: 2/13/2007 TIME: 7:03AM PAGE: 29
SITE ADDRESS: 11345 SW MEG' AN TERR CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 005 TYPE OF USE:
PROJECT NAME: DAKOTA GLEN
DESCRIPTION: Install residential bacIdlow prevention device for irrigation, ,
OWNER: DON MORISSEITE HOMES, INC., PHONE #: 503-387-7535
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-0092-5945 ;‘
Inspection Request Scheduled For: Date: 2f5/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 043103-01 503-692-5945 N
Corrections/Comments/Instr ctions: •
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07'
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PASS 0 PARTIAL APPROVAL El CANCEL I NO ACCESS
I FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: • /(A” Date: 71k79 Phone #: (503) 718-