Permit . - a .1,
C ITY OF TIGARD PLUMBING PERMIT
� � DEVELOPMENT SERVICES PERMIT #: PLM2004 -00240
. .� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/27/2004
SITE ADDRESS: 13620 SW PIPER TERR PARCEL: 2S103CD -WW271
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 071 JURISDICTION: TIG
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
Remarks: Installation of residential backflow prevention device for irrigation.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES INC [PLUMB] Permit Fee 5/27/2004 $36.25
4230 SW GALEWOOD ST 100
LAKE OSWEGO, OR 97034 [TAX] 8% State Surchari 5/27/2004 $2.90
Total $39.15
Phone:
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)
246-669
Issued y: /i! ; / • Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
May 26 04 12:22p dan edmonds 5 0 3 - 6 9 2 - 0 7 6 8 P - 2
••::'..:::', ...‘: •., ::,;-..: ....,... FOR OFFICE I.J.SE:ONLY:
P1
urn ne Perrault Applicatiftp
Plumbing
IIRWONAIIII PermitHoz 1 11 5111 r. •• AM 0 )
City of Tigard ■›),,,,z,,,, Wilijiall11.1111 Permit No.:
13125 SW Han Blvd. .
Other
<1(> 'V . <z i ..., ILIWilifilliM peroui• No..:
Tigard, Oregon 97223
Land Use
Phone: 503-639-4171 Fax: 503-59 ,..... . -!, 47 Pc6t-Review
' '"- ': Date/ft '
1, '•. . • Case No.:
Internet www.citigard.orms 4 i):4 . i ;, .! ' Contact . Axis.: Eii.11
24-hour Inspection Request 503-634 .V " ---- -;:." Name/Method:
N A
C.)
. -- .:i : .' ., ": ..... 1 : ' ' 1 •. : 1....>:'7 . ' :. TYPE :OF WORK' : ' ..-:- '. -.' :-.::,..' ".::::i.?.?...."•:::::::::•,:.. • • 7,-- ::: , :frEESCIFIIED:ULE -- (fOr iiiiiiitir LittiffirlatiOniiiie•iiliiteldlitr"
New construction • De' , lition Description I Qty. - I Fee(ea) I Total
a Addition/alteration/replacement • Other: . _:::::::: i;;•.i ' ...-•'. ,:- : : -. .
. .CONSTR -L--- 4iiiiiiii14 - 180ICiiiii'ilitli ' iineetitaiij ' '''• - -':' ' :
C:ATE.GORY0/ s).: "-',..; ::.... ...., ...; , ty co
1 & 2-Family dwelling DPIII Commercial/Industrial
Accessory Building . ae Multi
bath
Master Builder • [i Other: . SFR (1) bath
SFR (3)
Each adtritional bath/kitchen 249.20
350.00
399.00
45.00
JOB SlTRINFORMATION:sint LOCATIOPr-:Fire sprirAder - sq. fl: Page 2 _
Job site address: i3(o c.a sip elb p Ee --ri /Ai_ c_t_ :: :: - . ::y f. : :-:•: • " : - ::::::•-:: .
Suite ii: _lEJAptit: Catch bXsiniaren drain 16.60
Drywelnleach linefftench drain 16.60
Project Name: u; 1.:.1 z.r Lor r71 pes.A.k.e4--
Fooling drain (no. linear ft.) Page 2
Cross sireet/Directions to job site:
bAanufactured home utilities 110.00
S 1 D i S4 Ali-e._ Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: Li-N ■A.M.1-1 trs l.LC.) i 1-12-t C. .r.2.. I Lot #: 7i storm sewer (no. linear 11-) Page 2
Tax map/parcel #: (4) 13z Water service (no. linear 4,-) Page 2
-. '-'• " -- ::, :•.: . ' 7 i' ' . ei'lltein : "• " : ". ,•-•: :' • ' .."'• '
": •• • •' - • .' ' :: " • DESCRIPTIONOF=WORK:: '.: :".- ' 'F..:::. - ''.. ' - ' • ' - - • ' - ." - • - • '
Absorpticut valve 16.60
Lands c a-p 4- Vtar-tc-Floui LLGIJICC..) Baddlow preventer i Page 2 cari 4"5"
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16_60
• Drinking fountain 16.60
..193'ROPERTTOWNER 7 l' LTIMNANT.:. ',•i,-,---•:::;'...:•;:.::..:!,•1 Ejectors/sump , 16.60
Name: bon 1 laY tinrY1C---S Expansion tank 16.60
Address:4-a 30 Su) &a-Co-u-300 CL) Fixturefsewer cap 16.60
City/State/Zip: t_o-ie... 0.C-u-tesic, g'70.35' Floor drain/floor sink/hub • 16.60
Garbage disposal - 16.60
Phone: Fax:
Hose bib 16.60
JELAPPLICANT : ': • :.:- :;,.:•-•-', '!F' J'ETCONTACriPERSO,PU - i ma
16.60
Name: El Icri .Sparra-LO Intereeptodgrease trap 16.60
Address: / •...1.0 0 C..2.4.3 jry R ' Medical gas- yak= S Page 2
Printer
City/State/Zip: % n_. 0 te.. 9/0 C a_. .
ga Root (cowmelaI) 16.60
' 16.60
PhoneS03 to - 9? LLS I Fax toqa. 0762 Sirdc/trashifl n:
avatory 16.60
E . Tubfshower/shower pan 16.60
. 7. ,:, ••••••••. '.••• :•. :'. , I': ::. - CONTRACTOR : S . : ..;:: :';-:-,,•'-:•-.::-V.:::::ii ... Urinal 16.60
. 1 6
Business Name: t_o_rdscapt 0 r can .c -rile., Water closet 1 6.60
Water heater • 16.60
Address: l 00 D E.1-13 ry) i ,i.g ter.. Other:
City/State/Zip:mAtutat- +g - 'qnoloa..... odic=
PhoneSh3 (d - Siivs 1 FaxgrS Gagal - 61 lo k .- --- .:::::?1 , ::' ,. :: -- :::ti;:::':::;-Pliiiiiblug're:iiiiitiVeiisk-,..; :.' '::.•:: •'
' CCB Lic. #: - 7epti I Plumb. Lic.#: Subtotal S
Minimum Perna Fee $7250 S 7 ,
Authorized -
Residential Baddlow Mininann Fee S36.25 •-• (0 ' " •
S' ./Z"..")._>,140a4..4-124_, Date,51-0-1
Plan Review (25% cif Pernut Fee) S
Eli en \Spar rat() State S r -. , 1 8% ofPennit Fee $ _
(Masa print name) TOTAL PERMIT PEE S aci. / S
N" This Pernik 21*ra:dim expires ifs permit is out obtained within All new commercial borlikilugs require 2 sets organs witb isometric or
180 dans after It bas been accepted as complete. ris' er Annum for pbm review.
-. -
•Fee metbodcdogy set by Tra-' Calmly Building Industry Service Board.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Reques d AM PM BUP
Location / - 3 400 0 SI.) - Suite MEC
D
Contact Person ZAP Ph ( ) a-194 4 PLM
Contractor Ph ( ) 7 SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
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
Fire Alarm
Susp'd Ceiling 1/1/1
Roof
Other:
Final
RT FAIL
PLUMBING'
am
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower P
• per:
. 1: 1 4)
Ca) PART FAIL
ANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA Inspector , "v Ext
Approach/Sidewalk Dat ` p
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL