Permit •
4 CITY OF TIGARD PLUMBING PERMIT
I COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00366
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/5/2008
PARCEL: 1 S134DB -12100
SITE ADDRESS: 11012 SW NORTH DAKOTA ST ZONING: R-4.5
SUBDIVISION: DAKOTA GLEN LOT: 023 JURISDICTION: TIG
PROJECT: DAKOTA GLEN
Project Description: Backflow 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
DON MORISSETTE HOMES, INC Description Date Amount
4230 GALEWOOD ST. STE 100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 9/5/2008 $36.25
[TAX] 12% State Surch 9/5/2008 $4.35
Phone : 503- 387 -7538 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.
Issued By: - Permittee Signature: — — / C� A
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.
Or
; 'um bin g Permit A lies CEIVED
uliding Fixtures FOR OFFICE USE ONLY
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City of Tigard S E P - 5 2G. Received , Permit No.: J
+ 13125 SW Hall Blvd., Ti gard, OR �te�`" JI
i� Phone: 503.639.4171 Fax SG3�DOF Plan 'Review Other Permit No.:
Dat Ry.
Inspection Line: 503.639.4175 BUILDING DIVISION e t e 2 or
TIGARD Internet: www.tigard.or.gov NotifiediM j & i Supplemental I nformatioa
'
_.. :::.::: TYPE OF . : RORK :
:.::� ., - -- - FE - . .._
_ ., 1F UL
*New construction I ❑ Demolition For special information use checklist --- I Description I Qty. I Ea. ( Total
❑ Addition/alteration/replacement ❑ Other. New 1- 2- family dwellings (includes 100 f for each utility connection)
P ,.....::..:: . r..;- CATEGORY; OF -__ CONSTRU - : .z SFR (1) bath 249.20
' l- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler L- sq. ft) Page 2
_ JO SITE ; INF'OR11IATIOl\'; AND LOCATION. Site utilities
Job site address: /l (3/ a A.1 CrYY - ' - c • C Catch basin or area drain 16.60
City /State /ZIP: n 'Zl�1.C1__ c , 7 .2.-� 9. Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project namer}a f /�, _� Footing drain (no. linear ft.: 1 Page 2
Cross street/directions to job site: Manufactured home utilities 110.00
Manholes 16.60
S l..- 1.:'0 - Yi Y1 ba- kt!.C; -}Zl_ G 1 t,‘_.. - 1-101,4_,g,?__; Rain drain. connector 16.60
- 1 4 .t.G'� S ,S -f?'Y G Sanitary sewer (no. linear ft.: _ J Page 2
Storm sewer (no. linear ft.: __) Page 2
Water service (no. linear ft.: _ ) Page 2
Subdivision: Da.a ,6 f7.-- i t.el-- I Lot no.: -3 Fixture or item
Tax map/parcel no.: t.p S C.-3
, .:;.: : _: ..,
Absorption olpa on v ve .
= DE C]tIP ION; OF° WO tK ' ' <,_ . - Bacldiow preventer x Page 2 1
- Landscape Irrigation Backflow Device Backwater valve 16.60 ;
n Clothes washer 16.60 ; ,
Dishwasher 16.60 j
.... : -. �- _ _ _ fountain
16.60
.
::. PROPER 'Ty': OWNER• ,:: �:: :.1 _ _ - ®: TE NOT�' `
.. ... ,.. .- ., . .. - - . , : ,. ;. NOT ... : -;;-."--.1,17.- Ejectors/sump 16.60
Name: Stone Bridge Homes LLC
1
Expansion tank 16.60
Address: 16869 SW 65 Ave #505 Fixtureisewer cap 16.60
City / StateZIP: Lake Oswego, OR 97035 Floor drain/floor sinldhab 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
use r
.: .......,:.: �1P_ _ LICAI�'T' s - . _ : ; - CON�'A _ l'ER$aN
.. .. - ,.., ...... - .___ - .. - .. ... , _ . Ice maker 16.60
Business name: Landscape Oregon, Inc
Intercepgegrease trap 16.60
Contact name: Ellen Sparrow _ Medical gas (value: 5 ) Page 2
j Address: 12200 SW Myslony Road 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: elleo @landscapeoregon.com I Urinal 16.60
. r_ - s i r
. ' - . ,..�_ _ _ ; -- - -- - - closet -CO
CONTRACTOR 16.60
__ .. _ ..- .: _ ... ':' "y:: ie ^ - Water c10
Business name: Landscaper Oregon, Inc Water heater 16.60
Address: 12200 SW Myslony Road Other: -
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City/State/ZIP: Tualatin, OR 97062 ! Subtotal
Minimum permit fee: 572.50 36.25
Phone: (503) 692 -5945 Fax: (503 -) 692-5945 Residential badkflow minimum permit fee: $36.25
CCB Lic.: 7804 Plumbing Lic. no.: Plan review (25% of permit fee)'
State surcharge (12% of permit fee) -j!" 4.35
Authorized signature (,�2�(.��� TOTAL PERMIT FEE •"' 0.60
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Print name: Ellen Sparrow Date: gislc1 X 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.
I:1Building\PermicAF.5 - PermaApp.doo 22!1 44046161VCote:CCM'WEB:
l'd 89L 0 - 369 - £09 uell3 e017:60 90 90 deS
CITY OF TIGARD i . -
BUILDING DIVISION PERMIT #: PLM2008.00366
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/5/2006
Phone: (503) 639 -4171 illil
Inspection Requests (24 Hrs.): (503) 639 -4175 F_ ..
INSPECTION WORKSHEET FOR DATE: 10/6/2008 TIME: 7:00AM PAGE 37
SITE ADDRESS: 11012 SW NORTH DAKOTA ST CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 023 TYPE OF USE:
.PROJECT NAME: DAKOTA GLEN
DESCRIPTION: Baekflow for irrigation.
OWNER: DON MORISSEFTE HOMES, INC, PHONE #: 503- 367 -7536
CONTRAC LANDSCAPE OREGON, INC. PHONE #: 503 - 692 - 5945
Inspection Request Scheduled For: Date 10/6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 076309 -01 503 - 692 -5945 N
Corrections /Comments/ Instructions:
p -2 ■Ji Gt. l r-4'c-A.
G6C. u" ei CZ C. - . Lit p,„)
,.
KPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ./ i .l ( h..,...i Date: 10 C (. i? Phone #: (503) 718-