Permit 1 4 CITY t"TIGARD
PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00393
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/7/2008
PARCEL: 2 S 102AA -04900
SITE ADDRESS: 12260 SW MAIN ST ZONING: CBD
SUBDIVISION: MORINS ADDITION LOT: JURISDICTION: TIG
PROJECT: FRAME IT
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: B 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
NICOLI PACIFIC LLC
19600 SW CIPOLE RD Description Date Amount
TUALATIN, OR 97062 [PLUMB] Permit Fee 10/7/2008 $72.50
[TAX] 12% State Surch 10/7/2008 $8.70
Phone : Total $81.20
Contractor:
LANDGRAPHICS INC
9005 SE ST HELENS STREET
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 650 -0590
FAX 503- 650 -0468
Reg #: L1C 5037
PLM ALL PHASES +
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
i
Issued B �.� _ Permiftee Signature: _ �� . ,r- , A A
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
A
'�- 10/07/2008 06:27 5036500484 LANDGRAPHICS PAGE 01/03
.+ rPlum III II Permit A lice: 'CUM' RECEIVED
Building Fixtures '
City of Tigard OCT 0 7 2008 Received /J /B
t
D Perm _
p ac y: it NO.: s
13125 SW Hall Blvd., Tigard, OR 97223 Q• ��� I ^�i(��
i 12
r•hone; 503.639.4171 39.4171 Fax: 503.59$.119( r OF TIGARD Date/By: Other Permit No.:
TIGARD Inspection Linc: 503.639 BUILDING DIVISION Date Ready/By: Sec Page 2 for
y „ Internet- www,tigard- or,gov Nonfied/Melbod;
t'� , �er sr t" i a,�� tl 4 ^" ' •17tttir• -.,(w Supplemental leformatten
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:� l� 204 A F 6, ■ . , 04. k , �:u'� C-IRfE °� Y? :- ,'V^ i h '
0 New construction ❑ Demolition For special information tee checklist.
On ;ription I Qty ❑ Addition /alteration/replacement O ther • J Ea i Total
a , J New 1- 2- family dwellings (includes 100 ft. for each utility connection)
i: .'r?K, ±7,d!?� 6F:fCH9 a n+}�n ',� 9 r at .'�ik.�•4Ytii:�D Y
ki : ar ? : t - : s 1'it €i i � y; .! ^;;a l�.... SFR (1) bath 24920
Q 1- and 2- family dwelling E Commercial /industrial SFR (2) bath 350.00
❑ Accessory building CI Multi-family SFR (3) bath 399.00
Each additional Oath/kitchen 45,00
El Master builder 0 Other:
1 ,: y- � ,, .r „ T ° r',. - '. • + '' {h ,N .,r rrp Fire sprinklcr( sq..R) Paget
�tta
l,.P, kc , ; I £5 ,._,,,,...,,,,:,,.;-..r.. ti , x � ,L 5�r rDS , ;r :t "f^§
.. . . ;4....... mgt, J mrt: a, , .. s :� sit, utilities
Job site address: 12241 W Main St ,,. Catch basin or area drain _ 16.60
City /State/ZIP: Tigard, OR 97223 Drywcll, leach line, or trench drain 16.60
-
Suite/bldg. /apt no.: Project name: Frame It Footing drain (no. linear ft.: ___) Page 2
-
Cross street/directions to job site: Manufactured home utilities 1 10,00
-" Mnnhol 16.60
Rain drain connector 16.60
Sanitary sewer (no, linear 11.: _) Pagc 2
Storm sewer (no. linear ft.: ^_) Page 2
Subdivision: Lot no.: Water service (no. linear A.: _) Pagc 2
• Tax map /parcel no.: "" Flxnlre or item
5 '* u P; +.:.: o :w � �. e wr.a rr n.., , Absorption valve 16.60
k. ` 7,,,, , _ ?-?7:0'3."3 - ,..,.: ',.r . (, ;S : 9,,,r F;,:, L+ I; ' r,,;N:3 3 ( iL0. • Backflow prevrmcr i Page 2 & , lid
irrigation I3ackflow Preventer
Backwater valve
16.60
Clothes washer _ 16,(,0
Dishwasher 16.60 •
Y ' .
• '.. .,, f :',7;),,..,,,,, .. .:; W.`,r ,:..- ;wi t�;:+ V< •:.. ,,1,. , Drinking fountain 16,60
P tir. . ,1 :
' .,� - , l@.�:A:(i,K , ��aa � r d�', •� ? ,5 �'� Y,
', .y.fR6'lC+:. a �:° :yJy 1 �, ).: �,i . +. r.' ,c4"±5'. � +• ,'wICL:,ir
Name:
rgcctors/sump 16.00
Expansion tank 16,60
Address:
Fixture/sewer cap 16.60
City/ State/ZIP: Floor drain/lloor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
t t fi �a� i,�c ) rr. , . �t ;" �' "'' ;� *t :r:+ A,. " 4ex ,; Hose utb 16,60
C�, ` ,pelt k�. v., °'' .x ' +r'.,..' t �.' ...,:, ■'u.+r•)l-;
Business name: ice maker 16.60
Interceptor /grease trap 16.60
Contact name:
Medical gas (value: $ ) Page 2
Address: Primer
16.60
City / State/ZIP: Roof drain (commercial) 16,00
Phone: ( ) Fax: : ( ) Sink/basin/lavatory 16.60
E-mail: Tub /shvwcr' /SLuwei p 16.60
ifi Mtl > i d F< , n , ;• it Urinal
1 N 1 Y+,y - , N r. t 4, , Q'tl �Q f i � ,x' 4 1 a,' . 16.16.60 K '(. �,v ,.rr .r „�SuJ:.1ds ' 141M ;k.t:.,,. .lµ .a.. ' d° Je -gym _ s 16.611
r. ,.a, ��.a closet
Business namc: Landgraphics inc. Water heater 16.60
Address: 9005 SE St. Helens St, Other:
City/ State/ZIP: Clackamas, OR 97015 _ . Subtotal
Phone: 503
( ) 650 OS90 - Minimum permit fee: $72.50
Fax: (503) 650-146$ Residential backflow minimum Ecrrrrit fee: $36.25 72.50
CCB Lic.: 5037 - Al1i• .tubing Lic. no.: Plan review (25% of permit fee)
Authorized signature: / , '-� St ate surcharge (12% of permit fcc) r 0.70
�/� TOTAL PERMIT 81.20
Print name: Donald Huber Date: 10/'7/08 This permit application expires if a permit is not obtained ined within n AiErMI 180 days after it has been accepted as complete.
*Fcc mcthodningy err by Tri -f :panty Building h,ductry Service 6aard.
I;1 Pleildingrrermesgn .MRsermenpp.4oe. I 2r27/05 440.46!6T( I0ltt2(COMIWCD)
CITY OF TIGARD ,,_-,.
BUILDING DIVISION PERMIT #: Pl M200B.00393
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/7/20011
Phone: (503) 639- 4171aA „
Inspection Requests (24 Hrs.): (503) 639 -4175 =� ' ` __. .
INSPECTION WORKSHEET FOR DATE: 11/7/2008 IME: 7:02AM PAGE: 11
SITE ADDRESS: i2260 SW MAIN ST CLASS OF WORK:
SUBDIVISION: MORINS ADDITION LOT #: TYPE OF USE:
PROJECT NAME: FRAME IT
DESCRIPTION: Bacldlow preventer for irrigation.
OWNER: NICOU PACIFIC LLC, PHONE #:
CONTRACTOR: LANDGRAPHICS INC PHONE #: 503,65U -05
Inspection Request Scheduled For: Date: 11/712008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 077827 -01 503-969-2366 N
Corrections /Comments /Instructions:
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V PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL VillirtgALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
(1.47----
Inspector: / ,it Date: 1 k/) I' K g #: (503) 718-
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