Permit a , CITY OF T I GA R D PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00382
I IGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/26/2008 PARCEL: 2S109AC -05400
SITE ADDRESS: 13231 SW NICOLE LN ZONING: R -7
SUBDIVISION: WILSON RIDGE NO. 2 LOT: 022 JURISDICTION: TIG
PROJECT: WILSON RIDGE II
Project Description: Install residential 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 Description Date Amount
16869 SW65TH AVE #505
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 9/26/2008 $36.25
[TAX] 12% State Surcha 9/26/2008 $4.35
Phone : 503- 387 -7577 Total $40.60
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
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 : r ! Permittee Signatu .
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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• .
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El‘IED
Plumbing Permit Application 6 2 008
bt? 2
Building Fixtures FOR OFFICE r_lSE ONLY
OF 'MN°
City of Tigard ari wisioN Received ,,, 4 4 , pc ? ,/ Permit No.: S
Reel -cesg •-
. 13125 SW Hall Blvd. Tigaml.ft14110.:NGD
' ' - Phone: 503 Fax: 801:598.1960
11 Date/By: j
Plan Review
Dateilinr. -
Other Permit No.:
inspection Line: 503.639.4175
TIGARD Date Ready/By: 1.41.- 21 See Page 2 for
Internet: www.tigard-or.gov Notified:Method: el i Ce Supplemental Information
. r.-- - ; :: ilii: :WOW' : r ' - '`;. : ::, - 7 : :;,:::. i ; ',T" .- _'t';':, - ,::;;! . ..! .J'zik` ' , '.7 Z.. : .: Dirt;c : 4-1 - ; 7' f4:11. -. ."1: - .1,1 L -
El New construction 0 Demolition For special information use checklist
Description I Qty. ! Ea. I Total
0 Additionlalteration/replacement El Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
" .': e SFR (1) bath . 24920
0 1- and 2-family dwelling 0 Commercial/industrial SFR (2) bath 350.00
0 Accessory building 0 Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
0 Master builder 0 Other:
Fire sprinkler ( sq. ft.) Page 2
'''''. 1 ;.--:'' ;' '' ' idii 'gni iiii6iisfAiiiitme ,-:- . '..". ' '."':,''.!
.•:,,,,-: ;:'. , •-. . . . • _, ' - ''':: -;.;•'---_--' -_: - '- Site utilities
Job site address: (3 3-3i 5.1.0 A) , cole, 1_0-r) e Catch basin or area drain 16.60
City/State/ZIP: 7--/ ci 0 , 4 _0._ cp._ ci - 7 D-p-- Li Drywell, leach line, or trench drain 16.60
Suitefbldg./apt. no.: I Project name: CI) i J5)-) /2,4j./ 9 :2 )-- Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: .
Manholes 16.60
/3 1.-4-4-4.- ) 12_4o Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2_
Storm sewer (no. linear ft.: ___) Page 2
Water service (no. linear ft.: ) Page 2.
Subdivision0..)/ 0 P-c. 4 g e Lot ne.:, >-
Fixture or item
Tax map/parcel no.: Co f". .5 14-6.„..,
., Absorption valve j 16.60
.13 •
i ESCiaiTIOirt5F.iiiiii2IC'r.: - . : " 17'''.; - -11O-
: - V : A .-1 pl. 1,11
,. j.,,.; , i ,:,:.- ..: I ..r.T.',,,z;,•;,:y *.; ,,,__ , ; ... :, tii ." -;:-.; ".! ,..-1.:!/;'_ . .-.. ; r7.. .r.-.. OW preven(e x Page 2 1
Landscape Irrigation Bacidlow Device Backwater alve 16.60
Clothes washer 16.60
Dishwasher 16.60
16.60
,, .,.: ,-. -:, :,.. 0 ,pROpERTY: L: ,..y, ..s. .-.< , .7.1- , . -. t'.,- : DI 'LTEN'ANT _•_ Ejcctors/sump 16.60
Name: Stone Bridge Homes LLC 1 Expansion tank 16.60 •
Address: 16869 SW 65 Ave 4505 Fixture/sewer cap 16.60
City:State/ZIP: Lake Oswego, OR 97035 Floor drain/floor sink/hub 16.60
Garbage disposal 16.60
Phone: ( ) Fax: ( )
. - • - ' ' - • • Hose bib 16.60
: • :::.:i.'," 7 '1 : :: n:::,Lioi,xcoi :..*----..:...-:...,--6-titi±cti...i.ici.*--:.:',.;:i: Ice maker
16.60
Business name: Landscape Oregon, Inc
Interceptor/grease trap 16.60
Contact name: Ellen Sparrow Medical gas (value: S _ ) Page 2
Address: 12200 SW Myslony Road Primer 16.60
City/State/ZIP: Tualatin, OR 97062 Roof drain (commercial) 16.60
1 Sink/basinnavatozy 16.60
Phone: (503) 692-5945 Fax: : (503-) 692-0769
Tub/showev'shower, pan 16.60
E-mail: ellenSlandscapeoregon.com
Urinal I 16.60
- ... ; • ;?_ 1, ..: _ .,,:2.-..".. -L''-= ' "' ' -,--,-' • ,, ..`,1.,:■ 1 , , -1 :-:;;:: ' ■ C: ' , ,::..-,-: -.1:: i,, •, !
,ii7--.- -,- ? : ; - e,:..,,7, :....-,,,,, CONTRACTOR • -.-..-- --- •..-- • - .. , i •• ' ' .." ' ' • Water closet I
16.60
Business name: Landscaper Oregon, Inc Water heater 16.60
Address: 12200 SW Myslony Road Other:
Subtotal
City!StateJZIP: Tualatin, OR 97062
Minimum permit fee: S72.50
36.25
Phone: (503) 692-5945 Fax: (503-) 692-5945 Residential backflow minimum permit fee: 536.25
CCB Lie.: 7804 Plumbing Lie. no.: Plan review (25% of permit fee)
State surcharge (12% of permit fee) 435
Authorized signature:,./7_410‘4,....yds_10-C.0 . TOTAL PERMIT FEE I
Print name: Ellen Sparrow Date: 9 ( ?-6.." Oi ... This penult application ex.pires if a permit Is not obtained 180 within
days after It has been accepted as complete.
*Fee methodology set by Tri-County Building industry Service Board.
IABrildingTerciriPLIAF-PemtitApp.doc 12/27/05 440-4616T( I CVO:ICC/A/WEB)
L.d E9LO uen3 90:0L 80 9Z des
CITY OF TIGARD
BUILDING DIVISION r PERMIT #: PLM2008 -0038
13125 SW Hall Blvd., Tigard, Old 97223 DATE ISSUED: 9126/2008
Phone: (503) 639 -4171 /�n�,9y {
Inspection Requests (24 Hrs.): (503) 639 -4175 ''II�
INSPECTION WORKSHEET FOR DATE: 11/13/2008 TIME: 7:00AM PAGE: 19
SITE ADDRESS: 13231 SW NICOLE IN CLASS OF WORK:
SUBDIVISION: WILSON RIDGE NO. 2 LOT #: 022 TYPE OF USE:
PROJECT NAME: WLSON RIDGE II
DESCRIPTION: Install residents F or irrigation.
OWNER: STONE BRIDGE HOMES NW LLC, PHONE #: x50 387 -7577
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-69/5945
Inspection Request Scheduled For: Date: 11/13/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 078033 -01 503 -692 -5945 N
Corrections /Comments /Instructions:
T l■-.‘ 4 \--RIA 6J-- i 4" , . •N . . - ( . ( J
T - No o - 6/t/TL-----
, 1 _ •
i ,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
:1 VIVO 2 Inspector: � Date. Phone #: (503) 718- 2if