Permit ■ `
'CITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00373
TIGARD
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/20/2007
PARCEL: 2S109AC -05800
SITE ADDRESS: 13154 SW NICOLE LN ZONING: R -7
SUBDIVISION: WILSON RIDGE NO. 2 LOT: 026 JURISDICTION: TIG
PROJECT: WILSON RIDGE NO. 2
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
STONE BRIDGE HOMES NW LLC
16869 SW 65TH AVE #505 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 8/20/2007 $36.25
[TAX] 8% State Surcha 8/20/2007 $2.90
Phone : 503- 387 -7577 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
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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: Permittee Signature: %�
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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Plumbing Permit A t .- 't • `,7
City of Tigard . i •1�U n ey: il?o/o ;3 P. -0032$5
13125 SW Hall Blvd., Tigard, OR 97223 G 1 Plan R
P 503.639.4171 Fax: 503.598.1960p` u I1 II DaNJBr . Other l'crmitNo.:
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24- Hour Inspection Line: 503.639.4175 t i VI .� : j „ � ,• ! See Page 2 for
, V __ Date R eady/By: hers:
Internet www.ci.tigard.or.us �`� C!`�L� Notified/Method: Supplemental Information
TYPE�F WORK FEE' SCHEDULE
® New construction ❑ Demolition For special infonnador use dteeklirt
Description
p Addition/alteration/replacement ❑ Other New t I Qty. f or each I Total
ti
New 11- 2- family dwellings (includes 10011. for dt utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 249.20
® 1- and 2- family dwelling 0 CommerciaVindustrial SFR (2) bath 350.00
El building ❑ Multi- family
SFR (3) bath 399.00 '
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
JOB SITE INFORMATION AND LOCATION Fire sprinkler �_ sq. ft) Page 2
Site utih'Ges
Job site address: 13154 Nicole Lane Catch basin or arca drain 16.60
City /State/ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60
Suite/bldg,./apt. no.: I Project name: Wilson Ridge Phase 2 Lot 26 1 Footing drain (no. linear It: ____ j Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW 133'" Ave •
Manholes 16.60 .
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft: ) Page 2
Subdivision: Wilson Ridge Phase 2 Lot 26 I Lot no.: 26 Water service (no. linear 11.: ) e Page 2
Fixture or item
Tax map/parcel no.: 655 A6 Absorption valve 16.60
DESCRIPTION OF WORK •
Badcfow preventer / Page 2 ..7 . S5
Landscape Backiow Device Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
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® PROPERTY OWNER I El TENANT Drinking fountain 16.60 j
Ejectors/sump 16.60
• Name: Don Morissette Homes Expansion tank 16.60
Address: 4230 SW Galewood Fixture/sewer cap 16.60
City /StatLT: Lake Oswego, OR 97034 Floor drainifloor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
® APPLICANT ®- CONTACT PERSON
ice maker 16.60
Business name: Landscape Oregon, Inc. Inte /greaseP 16.60
Contact name: Ellen Sparrow
Medical gas (value: $ ) 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 I Fax: : (503) 692 -0768 • Sinldbasin/tavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Busing name: Landscape Oregon, Inc. Water hcaler 16.60 ,
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Address: 12200 SW Myslony Street Other: I .
City/State/: Tualatin, OR 97062 Subtotal
Minimum permit fcc: $72.50 _,
Phone: (503 -) 692 -5945 Fax: (503) 692 -0768 Residential hack flow minimum permit fee: 536.25 .. . �S
CCB Lic.: 7804 Plumbing Lic. no.: Plan review (25 %ofpermit fcc)
�� raj;' ���� ��� State surcharge (8% %o of permit fcc) c . y 0
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Authorized signature: ' �/2 i.A. J TOTAL PERMIT FEE ' 3 /S
Print name: Ellen Sparrow II I Date: 08/17/07 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete_
*Fee methodology set by Tri -County Building Industry Service Board_
1 tuddtoe mania- Panitwpp.dcc 4.16.1 440-46ItiR1oavcoatwau)
Z ' d 89LO - €O9 U a 65:80 LO L I. 6nb'
CITY OF TIGARD
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BUILDING DIVISION PERMIT #: PLM2007- 00:73
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 81201200i
Phone: (503) 639 -4171 Aa°
Inspection Requests (24 Hrs.): (503) 639 -4175 `'� I..
INSPECTION WORKSHEET FOR DATE: 8/21/2007 TIME: 7:00AM PAGE: 69
SITE ADDRESS: 13154 SW NICOLE LN CLASS OF WORK:
SUBDIVISION: WILSON RIDGE NO. 2 LOT #: 026 TYPE OF USE:
PROJECT NAME: WILSON RIDGE NO. 2
DESCRIPTION: Backflow preventer for irrigation.
OWNER: STONE BRIDGE HOMES NW LLC, - PHONE #: 503 -3t7 -7577
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503 - 692-5945
Inspection Request Scheduled For: Date: 8/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 054350 -01 503- 692 -5945 N
Corrections/Comments/Instructions: r
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: 0 r - P 0 k 5 ' s ❑ PARTIAL APPROVAL • ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V4\21? Date: / 2c ' /— / Phone #: (503) 718 - 2 '
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