Permit J, CITY. OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00184
TIGARD 13125 SW.Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/9/2007
PARCEL: 2S109AC
SITE ADDRESS: 13231 SW NICOLE LN ZONING: R -
SUBDIVISION: WILSON RIDGE NO. 2 LOT: 022 JURISDICTION: TIG
PROJECT: WILSON RIDGE PHASE 2
Project Description: Landscape backflow device located at water meter in back of lot 22.
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: 0
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
DON MORISSETTE HOMES
4230 SW GALEWOOD Description Date Amount
LAKE OSWEGO, OR 97034 [PLUMB] Permit Fee 5/9/2007 $36.25
[TAX] 8% State Surcha 5/9/2007 $2.90
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Phone : Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
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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 OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ,1/ i � j j / // Permittee Signature: 1 .e . f fipplir
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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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V Plnmbin, Permit . tierbEivE ). FOR OI F1(T USE O \L1
City of Tigard
F` t Raccnul f . meal :
13125 SW Hall Blvd., Tigard, OR 97223 8 Pte, Review
Phone: 503.639.4171 Fax 503.598.1960 �vll C' 20'�`I!IJI j" Dote/By: tOtlter Permit No.:
24- Hour Inspection Line: 503.639.4175 ,1.1 Date Ready /By: runty El See Pete 2 for
Internee www.ct.dgard.or.us Notified/Method: So pldementallafnrn,atton
T g Y yv I1U i
FEE* SCHEDULE
El New construction B 1 �-1 =1 l �n�
For , der! ' , ornrrraion use checklist.
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Description Qtv. Ea Total
❑ Addition /alteration /replacement ❑ Other New 1-2-family dwellings (iacludcs 100 ft for cacti utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath i 249.20 1
® 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath ; 350.00
❑ Accessory building ❑ Aiu]ti- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION , f Site utilities
Job site address 13 231 SL) N 1 , le.in. Catch basin or area drain 16.60 ,
City/State/ZIP: Tigard, OR 97224 L Drywell, leach line, or trench drain 16.60
Suite/bldgJapt. no.: 1 Project name: Wilson Ridge Phase 2 Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: SWBuII Mtn & SW 133' Street Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.611
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Wilson Ridge Phase 2 Lot no.: Water service (no. linear ft.: ) Page 2
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Fixture or item
Tax map /parcel no.: 655 A6 -
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer / Page 2 , 7 . � _
Landscape Backflow Device - Sec attached Map Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
' Ejectors/sump 16.60
Name: Don Morissette 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
0 APPLICANT ® CONTACT PERSON
Hose bib i 16.60
Ice maker 16.60
Business name: Landscape Oregon, Inc.
. Interceptor /grease trap. 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
Sink/basin/lavatory 16.60
Tub/shower /shower pan 16.60
E -mail: 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: $3625 3 (. s • a
CCB Lic.: 7804 Plumbing Lie. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee) .2 . qqj
Authorized si
gnat /f VLfut r TOTAL PERMIT FEB ,3 v- IS
I Print name: Ellen Sparrow I Date: 05/07/07 I This permit application expires if a permit is nut obtained within
180 days after ii has been accepted as complete.
*Fee methodology see by Tri- Courtly Building Industry Service Board.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM 2007 -00184
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/9/2007
Phone: (503) 639 -4171 At
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Inspection Requests (24 Hrs.): (503) 639 -4175 ._-__ IL
INSPECTION WORKSHEET FOR DATE: 5/14/2007 TIME: 7:01AM PAGE: 1
SITE ADDRESS: 13231 SW NICOLE LN CLASS OF WORK:
SUBDIVISION: WILSON RIDGE NO. 2 LOT #: 022 TYPE OF USE:
PROJECT NAME: WILSON RIDGE PHASE 2
DESCRIPTION: Landscape backflow device located at water meter in back of lot 22.
OWNER: DON MORISSETTE HOMES, PHONE #:
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503- 692 -5945
Inspection Request Scheduled For: Date: 5/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 048229 -01 503- 692 -5945 N
Corrections/Comments/Instructions:
/3 71/
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P SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V A< Date: (_ Phone #: (503) 718 - ‘fi,))