Permit CITY TIGARD PLUMBING PERMIT
A
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00641
DATE ISSUED: 11/18/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109DA -11900
SITE ADDRESS: 12922 SW KOSTEL LN ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 108 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. STE 100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 11/18/200f $36.25
[TAX] 8% State Surcha 11/18/200E $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: — Permittee Signature: , 'e ; Q. OTT
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.
tie
,,.,,,wilding Fixtures
Numbing Permftt - : NED FOR OFFICE USE ONLY
City of Tigard Dat eivyd /r- 17 -0 5.� /,A PermitNo.pl \e 9//�' % n 61/
13125 SW Hall Blvd., Tigard, OR 9722 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 17Y OF A �i Other Permit No.:
ur
24- Ho Inspection Line: 503.639.41(�7 TIGARD 4u4t"1I1 I Date D Ready/By:
Internet: www.ci.tigard.or.us `/ �+ �p 67 W ady/By: JJarris: d See Page 2 for
BUILDING DI / ISIV Notitied/Method: �\ ��� Supplemental tnfermanon
TYPE OF WORK FEE* SCHEDULE
a t&I'Iew construction ❑ Demolition For special information rise checklist.
Description I Qty. I 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
- hl - and 2- family dwelling ❑ Commercial/industrial SFR (2) bath - j 350.00
El Accessory building ❑ Multi - family
SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
J013 SITE INFOILMATION AND LOCATION _____ Site utilities
• Job site address/ a 9c::-D- . ' K • GSf je. tun __, Catch basin or area drain 16.60
City/State/ZIP: 7-1 e5j Lt/ -Z Ole- G? 7-J-4-ti Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: ! Project /vat l / l Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site;
l Manufactured home utilities 1 10.00
e � Manholes 16.60
dU) 15C- el 6a 1Q17 Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision:Si�.I'y)ryyt,/- f2 4....9� I Lot no. /0 8 Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: (p S. S A 7 Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK _ -- Bacicflow preventer / Page 2 D 7 . Ss
..f ; J' _( i (7 -, 0 6/_.'h ! ,%v! /, i' J ;/ ' • Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
Q PROPERTY.. OWNER . ❑ TENANT
- - -• Ejectors /sump 16.60
Name: lJ C )n. ril /J 7 S •S ! h -Y‘..1 e Expansion tank 16.60
Address: r--f 3G' ,s u % 6 - I c L z;1 U oc -L Fixture /sewer cap 16.60
City/State/ZIP:L(..4_ «L 0 : �' L _3 C y;.:.) OA. G f . 733 S Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
• APPLICANT Q\ ON"1'ACT PERSON Hose bib 16.60
Ice maker 1 6.60
Business name: L . '% / pi !. , / \ .,!" :�
F Interceptor /grease trap 16.60
Contact name: ! �• q -, 6" 1:' Medical gas (value: S. ) Page 2
Address: J DI) (2) a ' ■ / , ; Primer 16.60 • City/State/ZLP: j �A , .I dbt ;-. e2_ • 47 76,(0 c ) Roof drain (commercial) 16.60
Phone: (SCI -3) CG C/c'� - J57(7Y j Fax: : (L j) G- `r ;i - "://c _ '
Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR _ Water closet 1 6.60
Business name:/ i.2 E` l t.. Y` Water heater 16.60
Address: 7 ?-, - (JO n. li tJ p
OC' J p p . _! / ,n L , i l/ Other:
S
City/State/ZLP: 7j1 .1 Q . 0•4?.. 'L °- Subtotal
��� JL - Minimum permit fee: $72.50
( (i
Phone: Z3) t a s - 94./5 Fax: 6 (43 gyp'' - 070g' Residential backflow minimum permit fee: $36.25 3(o - c)---S
CCB Lie.: 7 fsv � Plumbing Lie. no.: Plan review (25% of permit fee)
/) State surcharge (8% of permit fee) a -ce 0
Authorized signs �, �? . _�;_
�� t ' l ' �- GG ✓ !''- TOTAL PERM 1T - FEE 3? . (s
Print name:`/ e .. a•',tf ; DaVJ- ( -0 S This permit application expires if a permit is not obtained 'a tlii
/ 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
i:\Building/.Pennvs\PL MA- PermitApp.doc 12/03 440- 4016T(10 /02/COWWGt3)
2 d 89L.0- zG9 -EOS u d80 =TO SO ST AoN
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Permit #:05 - 003134 - 00 - PE
C1eanW1ater Services
o„a , c<>,r„ll;,incut is clear. nspecton Request Line: 503- 681 -4444
2550 SW Hillsboro Highway 4 hour notice required for all inspections
Hillsboro, OR 97123 \
Ph: (503) 681 -3600
Project Name: SUMMIT RIDGE, LOT 108
Project Address: 12922 SW KOSTEL LN Issued By: Nichole Vanderzanden
Type: Sani /SWM Connection Issued: Jul 21, 2005
Single Family Expires: Jan 17, 2006
Project Description:
Owner Applicant Contractor
WILLIS, JANET H TR ET AL BY ROBERT CC DON MORISSETTE HOMES NONE
2635 SW MONTGOMERY DR 4230 GALEWOOD ST SUITE 100
PORTLAND 97201 LAKE OSWEGO OR 97035
•
Number of Equivalent Fixture Units (FU) 16 Number of Sq Ft 2640
Treatment Plant Durham Water District Tigard
•
Fee Description Amount
Erosion Control Inspection Fee 88.00
• Erosion Control Plan Check Fee 57.20
Sanitary SDC Fee (Connection) 2,500.00
Water Quality SDC 0.00
Water Quantity SDC • 0.00
Sub Total 2,645.20
TOTAL 2,645.20
•
I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS CORRECT. 7 SIGNATURE: Date: ( 2 Z 5
DON MORISSETTE HOMES
DON ° l0/I ®RISSETTE OBE: 3535
F „,- 4 2 3 G A L E if O O D INCORPORATED STREET LOT: 108 ;
`'4 a , LAKE OSWEGO, • OREGON 97036 DATE: 05/18/2005
- I , (6 03)987 -7538 FAY (603)387 -7615
PROPERTY: SUMMIT -RIDGE
CITY: TIGARD
SCALE: 1 " =20'
12'322 SW `''
®T L LN . O4OO ELEVATION 1
THREE CAR GARAGE
' 456 v1
!
458 _ -..� r,� f � I
Approa ` "V
0.95' gip ;'. R C 11 �i L� (Q 0.
Z EL • 453' 1 451 456' , - \'
• 6' P.U.E — .._: ; " — C ITY Zi
�; a Concrete . \ 45-574: Y 4 \ :Fs; OF TIGARD
W : BU IL DING DIVISION
o Driveway: e �ti�
D - _� III
Z Si 454
y W H •, .. .......451: o ' "i '-5;
CZ H
U_� I I
t,_ X w 651 sq. ft. 1' j, :.,
3 car gar. U
END
W (L V F.F.E. 45'1' e WALL 9:- }'�'
' Q Q d) Ili 5'-0'
WZl3 _ I 8'rp
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W 4,- Q j 45 1 v ,' d" o 452
Q k :_
tY 0 v U ® j 3,425 sq. ft ` ' 4
q Q 4 bd rm .
1 1 2 1/2 bath i -
(D0
i FF.E._45'15' •
z,� I
�CZ F�� I8 1, Q.' „i.....
.....,
Qacn 456 <10 �F.
• 10 ' • - 45 3 i . R
w z :CONG.:, t0 c0 , . --- tr
I .• PATIO 1
O J Q v S t f, < • t ss
wZniZ 1 1 I O
o_.. 3 ... _ ._. !;•', :- 450 ...
ci) D) 1 ! . ' '4,,
,
Z Z (k ! a..: 3. 5
Q 0 z Q 1 i' 0� i .0 _ _Storm 4
W�Z> _ w c �c i ”
J -I J Y 5' W . ! _
` # .yt? ai rra 7 :, I ' 448 1
TW 451 I '. ' 452 ' . <'`, ; :: + ..[. i •.. -
15,W 451 e
, b5:00 . .,
- BUJ 448"' 1f -
LEGEND ........ ....... ... _. ._ . - :.1. r. {
W. t
, / 4 ,,,. ( f , . ~' f F '. f1' �'. � j ., _.._.... +fi -1�f .. i 3
� d — STREET TREES E ; r I
1A5- PfJir"�A 7, , . r i ` . :.L f' : ,,,.1 i . a
,.. — - :fx3. — _
,,� PYRUS GALLERY - - ' •�•
7 'ARISTOCRAT PEAR' • .. , ` ., '?
- - ('N :LOT COYERACsE ..:..If hi
• ' A — STREET TREES LOT AREA &,9e>0 SQ. FT. LOT 11f2)8, ` _,• t ACER TRUNCATUM X BUILDING AREA: 2259 SQ. FT.
6,960 act. ft
'PACIFIC SUNSET MAPLE' PERCENTAGE: 32.5% j
•
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.:V\ 5d }'- ,2O
PLANN?`•!G DIVISION: 1;k- 7
Required 4 -:.erhacks gr Approved ❑ Not Approved
Side s Street Side: lv
Front; Garage. ay Rear: 15-
Visua! Clearance: a Approved ❑ Not Approved
Maximum Building! Height. 35 feet
CWS Service Provider Letter Required: ❑ Yes ArNo
❑ Received
By :- at-• a Date: 7-fl -oS
ENGING DEPARTMENT:
Actual Slope: ` . % ID ❑ Not Approved
Site Plan: grikiiproved ❑ Not Approved
By: Date: -1 - k3—
• Notes: — no paeett di ��
cAocc
•
CITY OF �����������
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BUILDING DIVISION . PERM|T#: �M�O�D0�1
! 13125SVVHaUBkd, Tigard, ORA7223 DATE ISSUED: 11/18/2005
Phone: (503) 639-4171
Inspection Requests (24H:oj:(5U3)G3Q~4175 .J ^ ���
INSPECTION WORKSHEET FOR DATE: 11/21/2005 TIME: 7:18AIVI PAGE: 82
SITE ADDRESS: 12922 SW KOSTEL LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 108 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: �� mrymr�ni
� c -' ^ - )
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503-387-7538
CONTRACTOR: LANDSCAPE OREGON INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 11/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
599 Plumbing final 021987-02 503-692-5945 N
Corrections/Comments/Instructions:
// ,..,,„ v ,,_....6
„I
..,,,........,,,e_______ 1
( .,........„
..
0 ,p,Ass | I PARTIAL APPROVAL 0 CANCEL ACCESS ______
U FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
)4/ �� ~� � / /7
Inspector: � � Date / °~// / ^ Phone #: (603) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005-006411
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/18/2005
Phone: (503) 639-4171
J i t
Inspection Requests (24 Hrs.): (503) 639=4175
INSPECTION WORKSHEET FOR DATE: 11/21/2005 TIME: 7:13AM PAGE: 83
SITE ADDRESS: 12922 SW KOSTEL LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 108 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: tkflObient.er for irrigatiDr1
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503-387-7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 11121/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RP/backflow preventer 021987-01 503-692-5946
Corrections/Comments/Instructions:
•
1 111 PASS n PARTIAL APPROVAL LII CANCEL n NO ACCESS
• FAIL I CALL FOR INSPECTION 11] ADDITIONAL FEES ASSESSED
Inspector:
i\
Date: 1 ) Phone #: (503) 718-