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Permit ,, CITY TIGARD PLUMBING PERMIT i � DEVELOPMENT SERVICES PERMIT #: PLM2003 -00610 1 DATE ISSUED: 12/9/03 ° � . 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 1 SITE ADDRESS: 12330 SW KELLY LN PARCEL: 2S103CC 08300 SUBDIVISION: WHISTLER'S WALK ZONING: R - 4.5 BLOCK: LOT: 030 JURISDICTION: TIG 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 Remarks: Install irrigation backflow preventer. FEES Owner: Description Date Amount DON MORRISETTE HOMES 5000 SW MEADOWS RD [PLUMB] Permit Fee 12/9/03 $36.25 SUITE 151 [TAX] 8% State 12/9/03 $2.90 LAKE OSWEGO, OR 97035 Total $39.15 Phone : Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD. TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone RP /Backflow Preventer hone : 503 692 5945 Final Inspection Reg #: LIC LCB: 7804 PLM ALL PHASES - PLL 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. Issued By: S , / / ' / N • Permittee Signature: QL Z Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business (� ss day . De(f ,G•4 03 1 1 : 07a dan edmonds 503 -692 -0768 p. 1 • • . FOR OFFICE USE ONLY . Plumbin'�Permut A.pplicatiIV -Ow. ,rvy ' � �� Plumbing -oa��V CI of , ar P lanning AppcOval a Sewer l g LL t e/By: Permit No.: 13125 SW Hall Blvd_ 5 2UC "t Review Other Tigard, Oregon 97223 Date/By:. Permit No.: Phone: 503 -639 -4171 Fax: 503 -598 -1960 �, F T IGARID Post - Review land Use , Tl�}v`(I DIVISI('` �ate/ey: Case No.: Internet: www.ci.tigard.or.us . . e•J Contact El See Page 2 for 24 -hour Inspection Re quest: 503- 639 -4175 "`-" Name/Met Q Supplemental Information. . '' :. FEE *. SCHEDULE (for special information use hecldlsi)" ; }.New construction (] Demolition Description [ Qty. I Fec(ea_) 1 Total Addition/alteration/replacement ❑ Other: ,:-..,; . New . 1.; & 2- family:dwelling •: : •f. _' fL for each utility :connection) : : '.. CATEGORY OF. CONSTRUCTION .:.:.:: - :.:;` -= ".' :, SFR (1)bath 249.20 & 2- Family dwelling ❑ Commercial/Industrial SFR (2) bath 350.00 ❑Accessory Building , Q Multi- Family SFR (3) bath 399.00 ] Master Builder LI Other: Each additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCATION . Fire sprinkler - sq. ft.: Page 2 Job site address: % , 33 0 S-w kP 1. (1-( U..Yi x _ ` > • • • __ '•`: "::'` • :: - • .:.'Site Utitiiics; . _ ' . ; Suite #: I Bldg. /Apt. Catch basin/area drain 16.60 Project Name: C tiGU sht.r t t, GU-ic. 12)r a) DrywelUleach line/trench drain 16.60 Footing drain (no. linear ft.) Page 2 Cross street/Directions to job site: Manufactured home utilities 110.00 c S t- . 7 L ! .)- / �, Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.) Page 2 Subdivision: LUtn.t jler ,• W a k. - Lot #: 3( Storm sewer (no. linear ft.) Page 2 Tax map /parcel #: (,o 5 S 3 Water service (no. linear ft) Page 2 ': :':DESCRIPTION OF WORK re o m . :r -:: ;:; _ Fiztri i-Ite ,,:....;:; Absorption valve 16.60 I Li.ndSC:ap t.. T 2. C -lChC► G( Ice) Backflow preventer / Page 2 ,2'7_ sS Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 • Drinking fountain 16.60 N ii31.3)120PER2'C'Y:OWNER. 1: 0 :TENANT -; -:•:'.'. Ejectors/sump 16.60 Name: Dirt flr)M - k- l-- kyyl <•S Expansion tank 16.60 Address:4 . BO 'SW .zi- 4.42-4..A-ro0 CO • Fixture/sewer cap 16.60 City /State /Zip: i.li --k_e_ CAS -Lut 6 C/ -70.. Floor drain/floor sink/hub • 16.60 Garbage disposal _ 16.60 Phone: Fax: Hose bib 16.60 :APPLICANT :. laCONTACT•PERSON Ice maker 16.60 Name: el I Cr) Spo- rYlrLO Interceptor /grease trap 16.60 Address: I D-.1O O S.t.3 1'YI ty9 RID Medical gas - value: $ Page 2 City /StateJZip: - r'4A_0. edri ti., 0 ie._ 9 - 70 (p D..., Primer 16.60 Roof drain (commercial) 16.60 Phone'So3 locia -. - Sc/ uS I Fax: 52 l a- 076 g Sink/basin/lavatory 16.60 E -mail: Tub/shower /shower pan 16.60 • -. CONTRACTOR . _Urinal 16.60 Business Name: LU-rcLSCa-p Q Mol -r.."--1(, Water close[ 16.60 Address: L a a-OO '1 Water heater 16.60 rl1 t , ,{$s �fMy An • Other. City /State /Zip:-w.,� J 6 A_ qo J(o Other. PhoneS63 EL' a -- SI Y S FaxS33 4, - 0 a Pltinibirtg Perritit Fees- : : . 2'7..SS- ,.. CCB Lie_ #: `78U' f Plumb. LiC. #: Subtotal S Minimum Permit Fee 572.50 S Authorized e 1 / ,, F Residential Backflow Minimum Fee $36.25 3(m ' °ZS Signatu Date:. G /S-j Plan Review (25% of Permit Fee) $ L 1 / dY) \c ar r State Surcharge (8% of Permit Fee) $ e2 . 96 / (Please print name) TOTAL PERMIT FEE $ .39, / S Notice: This permit application expires if a permit is not obtained within _ All new commercial buildings require 2 sets of plans with isometric or 180 days after it has been accepted as complete. riser diagram for plan review. *Fee methodology set by Tri- County Building Industry Service Board. CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP i z, 2-2- /a/2 --03 Received Z Z Date Requested p AM PM BUP Location 1 3 .� / C /� 4-\ _ Suite MEC Contact Person � - el'..P ( J Ph ( 5O3 & - 'z__. - 5 3 O© 6 cc.) Contractor e.„..,, d Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall 1 Fire Sprinkler Fire Alarm ()-1. Susp'd Ceiling Roof ' Other: Final I PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain PART FAIL I MBCHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL, ' Service Rough -In UG/Slab Low Voltage Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ° Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line 7 ADA l /d3/I 3 Approach /Sidewalk D a t e I nspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL