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Permit • • 4 CITY OF TIGARD PLUMBING PERMIT l4, DEVELOPMENT SERVICES PERMIT #: PLM2005 -00629 1 I° 13125 SW Hall Blvd., Tigard, O R 97223 503 - 639 -4171 DATE ISSUED: 005 2510 PARCEL: 2S 109DA -10800 SITE ADDRESS: 12898 SW PINE VIEW ST ZONING: R -7 SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 097 JURISDICTION: TIG Project Description: 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 DON MORISSETTE COMMUNITIES, LLC Description Date Amount 4230 GALEWOOD ST #100 LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 11/8/2005 $36.25 [TAX] 8% State Surcharp 11/8/2005 $2.90 Phone : 503 387 - 7538 Total $39.15 Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD. REQUIRED ITEMS AND REPORTS TUALATIN, OR 97062 Phone : 503 692 - 5945 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 -6 9 o 1- 800 - 332 -2344. Issued By: Permittee Signature: 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. Building Fixtures 9 O S - 00 1 10 a . ' y- _uaa�bi,mg Permit Applica, R • FOR OFFICE USE ONLY City of Tigard b.� Received / f (r J e 13125 SW Hall Blvd., Tigard, OR 97223 [ Da tdB y: d U� Permit N. 21r /t 0a / - 9 Phone: 503.639.4171 Fax: 503.598.1960 2 005 Plan Review 24- Hour Inspection Line: 503.639.4175 � s '1� 5Ei 1'I� + � Date/By: Other Permit No.: Internet: www.ci.tigard.or.us -- ire .. Date Read /B y y ' ® See Page 2 for �iOARD Noti ied/Metbod: Supplemental Information • TYPB LDIN Y AIV t hwisIO N ‘N iSlew construction g U1 FEE* S :1-IED LE \ \\ ❑ Demolition For special information use checklist ❑ Addition/alteration/replacement Description Qt Ea. T otal ❑ Oth New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 1 - and 2- family dwelling 1 249.00 ❑ Comunercial/industtial SFR (2) bath I 350.00 ❑ Accessory building ❑ Multi - fam ily SFR (3) bath 399.00 ❑ Master builder ❑Other: Each additional bath/kitchen 45.00 • JOB. SITE In FORMATION AND N LOCATION Fire sprinkler ( sq. ft..) Page 2 Job site address: Site utliities r " �/ _c Ll ' ) p/ae V/ • V .'f Catch basin or area drain • 16.60 City/State/ZIP: •r L U/- 9 7 .3-c9Lz Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Pro'ect na J �Gt- //� �� � Fo drain (no. linear ft.: _� Page 2 Cross street/directions to job site: `� Manufactured home utilities 1 10.00 Stu bCL- cud /24C) Rain 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision :SL•L/Y1/n e_ f Lot no.:4y 7 Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: �,, A Fixture or item Absorption valve • I DESCRIPTI N OF WORK 16.60 I Backflow preventer f Pa 7 5' G 0_1.:(--, f ri / q y .7CL. F. ) f ti ,; /e,G i e i . B ackwater valve 16.60 ^ y(t ' 1 . Clothes washer 16.60 Dishwasher 16.60 Q PROPERTY. OWNER I Drinking fountain 16.60 ❑ TENANT Name: D f /1(� S 6 cf../ / ,TV. Ejectors/sump 16.60 Expansion tank Address: L 7' 3 L' S !Jo plc (C .c....0 U occ Fixture/sewer cap 16.60 Ci 16.60 ty lState/ZIP: �" K C. G . S • i_.f_j' c % - C) y • 7 L.3 5 Floor drain /floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60. . `APPLICANT .Q. CONTACT PERSON Hose bib 16.60 r ,. Ice maker �.fc./ .; ez .,3..c; OlrC'_Cj[} ).n L /' . 16.60 Business name: Contact name: J 1 , - . ..r !! / Interceptor /grease trap �/f �• :D !�o' � ( �L: 16.60 Medical gas (value: $ ) Page 2 a Address: l a -00- ( -!,,1) fl/ c I i ) �. / Li � � Primer 16.60 City/State%ZIP:_ _ �ua=l. ik 1'l o p q ]C• (c. ,` Rbof drain (commercial) 16.60 ' Phone: (5G & 9,4 -S U I - - ' . ' Tub /shower /showe Sink/basin/lavato / S Fax: c 'Y� - �'i� � Sink/basin/lavatory 16.60 E -mail: r, 16.60 pan Urinal 16.60 CONTRACTOli Water closet l 6.G0 Business name: J� , / �, 9 It Ji 1 �'� ` Water heater 16.60 Address: /' `S / tJ • . C L, pj Other: J I • ` U .i /� ! • - -��� +V� 7U� :::a.....: Subtotal City/State/ZIP: Phone: �j(,3) (�q S C Fax: O3) /�� Minimum permit fee: 572.50 (.0 9c;? 0 7 (0 g Residential backflow mini permit fee: 536.25 ,3( CCB Lic.: 7 FU ` Plumbing Lic. no.: Plan review (25% of permit fee) Authorized signa �� State surcharge (8% of permit fee) e l . Print name TOTAL PERMIT FEE ,39. /S a -c.,a, rt�r'J I Dal t._ f. 47 -© This permit application expires if a permit is not obtained s% ithin I 180 days after it has been accepted as complete. t ''+ ildinalPerntiWPtlrtF- Pera+itApp.doc 12/03 "Fee methodology set by Tri -County Building Industry Service Board. 440- 4616 T(10 /02/COM/WEB) T'd 8960- 269 -EOS uaii eEb =60 SO 60 n oN CITY OF TIGARD `- BUILDING DIVISION PERMIT #: PLM 0 0G29 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/9/2005 Phone: (503) 639 -4171 AN ttjll1 , Inspection Requests (24 Hrs.): (503) 639 -4175 "__.. INSPECTION WORKSHEET FOR DATE: 11/10/2005 TIME: 7:02AM PAGE: 80 SITE ADDRESS: 12898 SW PINE VIEW ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 097 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: Bacl4l preventer for irrigation. OWNER: DON MORISSETTE COMMUNITIES, LLC, PHONE #: 503 - 387 - 7538 CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503.692 -5945 Inspection Request Scheduled For: Date: 11/10/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 020935 -02 503692 -5945 N Corrections /Comments/ Instructions: C a J 6 0 &-r- lt_oil, X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: w AA - Date: / ///p / i Phone #: (503) 718- CITY OF TIGARD � BUILDING DIVISION PERMIT #: pLM2005- '� 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2005 Phone: (503) 639 -4171e i Inspection Requests (24 Hrs.): (503) 639 -4175 I —. INSPECTION WORKSHEET FOR DATE: 11/10/2005 TIME: 7:02AM PAGE: 81 SITE ADDRESS: 12898 SW PINE VIEW ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 097 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: Backflow preventer for irrigation. OWNER: DON MORISSETTE COMMUNITIES, LLC, PHONE #: 503.387 -7538 CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503 - 692 -5945 Inspection Request Scheduled For: Date: 11/10/2005 Pour Time: 4 Code # Inspection Description - Confirm # • Contact # Message • 325 RP /backflow preventer 020935 -01 503-692 -5945 N Corrections /Comments /Instructions: [X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CR) IcYn.Aw i l U'-' -- Date: I 1 I Io/ OK- . Phone #: (503) 718-