Permit i a CITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00341
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/19/2008
PARCEL: 2 S 109AC -05700
• SITE ADDRESS: 13177 SW NICOLE LN ZONING: R -7
SUBDIVISION: WILSON RIDGE NO. 2 LOT: 025 JURISDICTION: TIG
PROJECT: WILSON RIDGE NO. 2
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: ALT 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 8/20/2008 $36.25
[TAX] 12% State Surch 8/20/2008 $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 # : PR] 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 ` �� ; /�- % Permiftee Signature: /�i /?�A75�s✓
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.
Plumbing Permit Application
Building Fixtures RECEIVED FO OFFICE USE ONLY
_
City of Tigard Permit :p
a
q 13125 SW Hall Blvd., Tigard, OR 972Th G 19 2003 D w ► 11 S, CJv'
Phone: 503.639.4171 Fax: 503.598, Other Permit No.:
Dare/By:
TIGARD Inspection Line: 503,639,4175 r nF Dat mv: 0 See Page 2for
Internet: w•ww- tigard- or.gov �, ^^11 QQ pR [ �I NoG6edMett ro d: Supplemental Information
_- 0 v . -_ _ - -- :ii:-
F S • D ZE
�, ' ` ' � TYPE OF r s - _ _ . , E CHE L _. CO New construction ❑ Demolition 1 Forspeciaf Information use checklist
Description I Qtv. ( Ea 1 Total
❑ Addition/alteration /replacement ❑ Other: New I.2- family dwellings (includes 100 ft. for each utility connection)
'' CATEGORY:•,OF- - CONSTRUCTION ' - : 1 SFR (1) bath 24920
ISQ- and 2- family dwelling ❑ Commercial /industrial • SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
' Fire sprinkler ( sq. ft.) Page 2
` =:. ., :;:: - • JOB' .INFORMATION AND=LOCATION : _ - : ; - ,7,1 Site utilities
Job site address: 1 :3)-1-1 N i 6 U k.. 1 Catch basin or area drain 16.60
City /State/ZIP: Ti Gf ci -1,I:a 6Q- 9 7 d• -r)•ci ! Drywell, leach line, or trench drain 16.60
Suite/bldgJapt. no.: Project name:( !Stir) ��( 9 L o2s Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
t� L, t Manholes 16.60
6 -i-ti 6-t r i v 12 0 '� 5 1 3 L a d d, • ! A-LIC . - Rain drain connector 16.60
L'e 1 t" /32/1 t- % •3 .3 4 vt. _ Sanitary sewer (no. linear ft.: _J Page 2
I Storm sewer (no. linear ft.: Page 2
Subdivision L) i) S On R.t. a C e-- jr L Lot no.: Q-5 Water service (no. linear ft.: Page 2
Tax map /parcel no.: (O 5 s A- i Absorption o item
... -. . ... . .... .. ::I Ab arption al 1
::. •.:..,-, ,: -: , : - _ : .... - -- -- - -_ ;'?:::,•,..,!: - 3.;:,::. Backilow preventer x Page 2 1
O� OF�R'ORK ;; ;
1 Landscape Irrigation Backflow Device Backwater valve 16.60
Clothes washer 16.60
1 Dishwasher 16.60
i -
4 T _ _ Drinking fountain 16.60
PROPERTY O. - 1 'R :::r ,:_! ;: 4'. I 118: E-!L1 \T r . - : .- .
_- . Ejectors /slurp 16.60
Name: Stone Bridge Homes LLC Expansion tank 16.60
Address: 16869 SW 65 Ave 11505 Fixulreisewer cap 16.60
City/State/ZIP: Lake Oswego, OR 97035 Floor drain/floor sink/bub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60 • •
= : ` ; ; - . ❑ - 4 • _ _ _ =- ❑ PERSON =, Hose 1
m
Ho bib �• la maker 16.60
Business name: Landscape Oregon, Inc Interceptor/grease trap ! 16.60 i
Contact name: Ellen Sparrow Medical gas (value: $ ) Page 2
Address: 12200 SW Myslony Road - Primer 16.60
CityiState/ZIP: Tualatin, OR 97062 Roof drain (commercial) 16.60
Phone: (503) 692 -5945 I Fax: : (503 -) 692 -0768 51nk basln/lavetory 16.60
Tub/showerishower pan 16.60
E-mail: ellen@landscapeoregon.com Urinal 16.60
- ,u = i n _ _ ONTRA :.i . _ : °,4` ;i`_
- - - - _ C, Ci'OR`. - - - -- . - _._,_.� Water closet 16.60
Business name: Landscaper Oregon, Inc Water heater 16.60
Address: 12200 SW Myslony Road Other:
Subtotal
City /State/ZIP: Tualatin, OR 97062
Minimum permit fee: $72.50
Phone: (503) 692 -5945 Fax: (503 -) 692 -5945 Residential backflow minimum permit fee: $36.25 36.25
CCB Lic.: 7804 Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (12% of permit fee) 4.35
Authorized sig ature: J ) TOTAL PERMIT FEE 40.60
Print name: Ellen Sparrow Date: c� J j 4 )/ ( This permit application expires if a permit Is not obtained within
i t 1 180 days after it has been accepted as complete.
*Fee methodology set by Tri .County Building Industry Service Board.
1: 1Building %Peraite1P) Pe:mitApp.doc 12/21/05 44Q 616T(i(e2'COMWEB)
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CITY OF TIGARD . .
BUILDING DIVISION PERMIT #: PLM2008 -00341
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/19/20013
Phone: (503) 639 -4171 a )?'
Inspection Requests (24 Hrs.): (503) 639 -4175 I �l
INSPECTION WORKSHEET FOR DATE: 8/2512008 TIME: 7:00AM PAGE: 20
SITE ADDRESS: 13177 SW NICOLE LW CLASS OF WORK:
SUBDIVISION: WILSON RIDGE NO. 2 LOT #: 025 TYPE OF USE:
PROJECT NAME: WILSON RIDGE NO. 2
DESCRIPTION: Bacltflow preventer for irrigation.
OWNER: STONE BRIDGE HOMES NW LLC, PHONE #: 503 - 387 -7577
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503692 -6945
Inspection Request Scheduled For: Date: 8/25/2008 Pour Time:
Code # Inspection Description Confirm # • Contact # Message
399 Plumbing final 074599-01 503692 -5945 N
Corrections /Comments /Instructions:
Q_ lc 1 4
Cait '1 t-c- ;CI
.;)& PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CrOVY►.it.I +vVti"-- Date: I2S1 Or) Phone #: (503) 718-