Permit C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00080
TIGARD DATE ISSUED: 3/3/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S109AC - 06200
SITE ADDRESS: 13346 SW NICOLE LN ZONING: R -
SUBDIVISION: WILSON RIDGE NO. 2 LOT: 030 JURISDICTION: TIG
PROJECT: WILSON RIDGE NO. 2
Project Description: Installation of residential 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 Description Date Amount
16869 SW 65TH AVE. #505
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 3/3/2008 $36.25
• [TAX] 12% State Surcha 3/3/2008 $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
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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.
Is ed B ' // Permittee Sin 01
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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.
f _
Plumbing Permit Application
Building Fixtures RELEIVE D Received OFFICE USE ONLY
City of Tigard Date/13y: 4 3 Q g Permit No.: £ e- ea9e./
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• 1 3125 S W Blvd, Tigard, OR 9722 P� Review
10 Phone: 503.639.4171 Fax: 503.5M 0- 3 2008 Date/By: Other Permit Ne.:
T1 GARD Inspection Line: 503.639.4175 Date Ready/By: 0 See Page 2 for
Internet: r
www.tigard- o.gov Notified/Methed: Supplemental fr
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IQN :: °: _ . _: _ ..:::: �� �Cl�vlii;:>` ;, ::- � _ . NGD ® New construction emolition For special information use checklist
Description I Qty. I Ea. I Total
❑ Addition /alterattonireplacement ❑ Other. New 1- 2- family dwellings (includes 100 ft. fox each utility connection)
CATEGORY OF .CONSTRUCTION: - :: - ::: ' , ,; SFR (1) bath 249.20
1 ❑ 1- 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. R) Page 2
JO& SITE Il\FOR.AT1Ois :4ND LOCATION;; . •
_ , - . ..__ Site ut7lties
lob site address: 13346 Nicole Catch basin or area 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 Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW Bull Mountain Road
Manholes 16.60
Subdivsion of Wilson Ridge Phase 2 Rain drain connector 16.60
Corner of SW 133` Ave & Nicole Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Wilson Ridge Phasae 2 Lot no.: 30 Water service (no. linear ft: _) I Page 2
Fixture or item
Tax map /parcel no.: 655 A 6
n ve 16.60
:
. ,. .DESCRIPTION W - Absorption � _ _ Baekil v pre e t
Landscape Irrigation Backflow Device Backwater valve 16.60
Clothes washer 16.60
Dishwasher 1
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tam
__ Drinking fountain 16.60
__ ® PROPERTY -OWNER ❑. TENANT:: :' :
_ Ejectors / sump 16.60
Name: Stone Bridge Homes LLC Expansion tank 16.60
Address: 16869 SW 65 Ave #505 Fixture/sewer cap 16.60
City/State/ZIP: Lake Oswego, OR 97035 Floor drain/ lour sink/hub 16.60
Phone: ( ) Fax: ( ) . Garbage disposal 16.60 bib 16.60
. ❑ APPL `- " : , ❑ CONTACT - He
. _ . . . _ - ]ce mater 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
Sink/basin/lavatory 16.60
Phone: (503) 692 -5945 Fax:: (503 -) 692 -0768 Tub /shower;shower pan 16.60
E -mail: ellen@landscapeoregon.com Urinal 16.60
_ ' - . - CONTRACTOR _ -- ._ 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 '
36.25
Phone: (503) 692 -5945 Fax: (503 -) 692 -5945 Residential backflow minimum permit fee: $36.25
CCB Lic.: 7804 ///30/e8 Plumbing Lic. no.: _ Plan review (250 of permit fee)
State surcharge (12% of permit fee) 4.35
Authorized signature: �GC� - .e j
' _ / 20jt/L/LU J : : TOTAL PERMIT FEB 40.60
Print name: Ellen Sparrow ( Date: 3 /!r //0 r , This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tn- County Building Industry Service Board.
1: 1Buitding `PermnalPLMF- PermitApp.do: 12/27/06 440 tt16r(IO/02/CDMAVFB)
Z 89LO Z69 - £09 Ueiia e£9 :90 90 CO JeW
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: PI..M2008 00080
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 313/2098
Phone: (503) 639 -4171 1 / 1
Inspection Requests (24 Hrs.): (503) 639 -4175 I I..
INSPECTION WORKSHEET FOR DATE: 3/21/2008 TIME: 7:01AM PAGE: 26
SITE ADDRESS: 13346 SW NICOLE LN CLASS OF WORK:
SUBDIVISION: WILSON RIDGE NO. 2 LOT #: 030 TYPE OF USE:
PROJECT NAME: WILSON RIDGE NO. 2
DESCRIPTION: Installation of residential bacldlow preventer for irrigation.
OWNER: STONE BRIDGE HOMES, PHONE #: 503-387 -7577
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 3/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 067126 -01 503-692 -5945 N
Corrections /Comments /Instructions: 1
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A PASS ❑ PARTIAL APPROVAL ❑ CANCEL • El NO ACCESS
❑FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Ayn.A.-I t- _ Date: 317 100 Phone #: (503) 718-