Permit CITY TIGARD PLUMBING PERMIT
r DEVELOPMENT SERVICES PERMIT #: PLM2004 -00057
' 13 125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/10/04
SITE ADDRESS: 13705 SW HATHAWAY TERR PARCEL: 2S103CC -07900
SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5
BLOCK: LOT: 026 JURISDICTION: TIG
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
Remarks: Install irrigation backflow preventer
FEES
Owner:
Description Date Amount .
DON MORISSETTE HOMES
4230 GALEWOOD ST [PLUMB] Permit Fee 2/10/04 $36.25
STE 100 [TAX] 8% State 2/10/04 $2.90
LAKE OSWEGO, OR 97035 Total $39.15
Phone : 503 387 - 7538
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : 503 692 -5945 RP /Backflow Preventer
Final Inspection
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.
Issued By: �/' / - Permittee Signature: / • C.,7
r/1�
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Felt, 09 04 11:55a dan edmonds / 503 - 692 -0768 p.2
Plumbing Pe Y ioII .,.FORQFZ?ICE ; tiSE :0 - _
1'LY
\ - - Received n Plumbing
\ Date/By :a' /U £ r Permit Vli 10D L / -ooU S7
City of Tigard FEB 9 2U0 Planning Approval Sewer
'J g Oatel8y: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF TIGARD DateBy.- Permit No.: •
Phone: 503- 639 -4171 Fi asomPi DW Post- Review Land Use
aS' . liti i i . Case No.:
Datc/B
Internet: www.ci.ti ard.or_us L v { y
g
24 -hour Inspection Request: 503 - 639 -4175 '."`"';" 'c��! Contact furls.: Supplemental See Page 2 for
4 Name/Methad: ,Supplemental information.
:; .. TYPE: OF'.WORIC- : ' .,.. .;.' i;g: 'r,-''':•:-'.'": '.-,' ::. . '-.; " :: FEE *` SCHEDULE (for .ipec1 finforiiiation iiSe checklist): -':
New construction [� Demolition Description Qty. I Fee(ea) I Total
Addition/alteration/replacement ❑Other: .New i &2= fatiiily : dwellings '
:::CATEGORY CONSTRUCTION:. :. . ' - ;;' : : :; ` `. ' ' : :.. :' .. ; (includes. 100 ft. for each 'uttiity :' ;..': , .-
N 1 & 2- Family dwelling 0 Comercial/Industrial SFR (1) bath 249.20
m
SFR (2) bath 350.00
❑Accessory Building _ Multi- Family SFR (3) bath 399.00
0 Master Builder Other. Each additional bath/kitchen 45.00
• :JOB SITE INFORMATION'ind "LOCATION Fire sprinkler - sq. It: , Page 2
Job site address: /3 •7C S ,...c Ha-ill , i-e.r voct.- . :. ,; : _ : : := � : : :'f :. ' .Siti.X. ilities : :. > : :`. '_` : ...
Suite #: 1 Bldg. /Apt. #: Catch basin/area drain 16.60
Project Name: LL hrS1 /t:s s" 1...0a-Le L LET -,-(e, �Yt felUleacl' line/trench drain 16.60
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job site: Manufactured home utilities -
Manholes 16.60
1 - .-1z', Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision:Wk1;. - /'i1S tc)a.ac. 1 Lot #: .2-1,e, Storm sewer (no. linear ft.) _ Page 2
Tax map /parcel #: , ...5- 6g Water service (no. linear ft.) Page 2
:DESCRIPTION'.OF. WORK % -;` =,.- tnreor;It :..,
Absorption valve 16.60
LLU'1JJ Cap •gi_C
e_ ichot .) CIO-) f Ce) Backflow preventer / Page 2 ' _ 5"
Cap Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
13- PROPERTY.OWNER: ,,' �L N TENANT: s; = , i; : a .r.:= :: .. : :. Ejectors/sump • 16.60
Name: Dar, tY) - iS.SJt412- H Expansion tank 16.60
Address: 21-. 36 -St.) Get.- E.0..I O 0 01? Fixturelsewer cap 16.60
City/State/Zip: 14.3-it. 0S -ure_6 Q70.3.c Floor drain/floor sink/hub 16.60
Garbage disposal _ 16.60
Phone: Fax:
Hose bib 16.60
:: PPLICANT :' `a CONTACTiPERSON:''-:: Ice maker
Name: E11cn Spar - re -7-L� _ 16.60
Interceptor /grease trap 16.60
Address: t -O 0 S.) Y1"1 /1A 247 Medical gas - value: S Page 2
City / State /Zip: "}l t_CL1.it
a - 1 t , 0 R. 6 /10 ( Prime 16.60
Roof drain (commercial) 16.60
PhoneSD3 to cia. - 99 451 Fax :3 log a..- 076 Q' Sink/basin/lavatory 16.60
E-mail: . Tub /shower /shower pan 16.60
:-'_' .. . .'CONTRACi'OR. :.. .,. ` Urinal 16.60
Business Name: LO_na.S CapiL Q -- r-fl 1 C"> _Water closet 16.60
Address: ED-D-00 Water heater 16.60
�•il h1 i �kyv 1�- Other:
City /State/Zip: ►ti. � j R. - 4 - 76(0a - other: - ,
Phone:543 &IQ - Sll &1 S , FaxSD (p9.1 - Q`I( - , .. - - ::Pltiiubing:PeiintFees • ,' i7;;55
CCB Lic- #: - 78Yt.J Plumb. Lic. #: Subtotal $
Authoriz Minimum Permit Fee S72.50 S 3 (D -)
�LL _) O- 1 . - G Y J ce / r / f ` Residential Bacicttow Minimum Fee S36 25
Signature Dat d Plan Review (25% of Permit Fee) $
Ell eri kc Joa Sta te Surcharge (8% of Per Fee) $ e2 CI
(Please print name) TOTAL PERMIT FEE $ ,39. / S
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or
180 days after it has been accepted as complete. riser diagram for plan review.
- *Fee methodology set by Tri- County Building Industry Service Board.
CITY OF TIGARD 24 -Hour
BUILDING I Inspection .Line:, (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ BUP
Received �1 & : �S Date Requested 34 9AM PM BUP
Location /Suite MEC
Contact Person Ph (L__i_ • _ ` erfi /d" a<5
Contractor dares _.[e Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler e
Fire Alarm
Susp'd Ceiling I/
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower P n
• her:
1 S PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date-3 / Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL