Permit C ITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2005 -00701
; DEVELOPMENT SERVICES DATE ISSUED: 12/30/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109DA -10900
SITE ADDRESS: 12920 SW PINE VIEW ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 098 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
4230 GALEWOOD ST #100 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 12/30/200` $36.25
[TAX] 8% State Surcha 12/30/200E $2.90
Phone : 503- 387 -7538 Total $39.15
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
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: 2 7 v Permittee Signature: -P 7.1
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.
s
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Building Fixtures RECEIVED
Plumbing Permit Application FOR OFFICE USE ONLY
25
City of Tigard Tigard, OR 97223 DEC 30 204 Received Permit
N "
Date/B er Zi h. 242 000 /
131 SW Hall Blvd.,
Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TIG •Ar,,,,,A Plan Review
Date/y: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 BUILDING DI _i_t,E_.'! I f Date Ready/By:
Internet: www.c l.LgaTd.or.us NotinecVmethod: 44104 Top plem Information
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......., - 'n r '''. 9 .*: 17- - , '• • •'; '', •••'.'',; ' ''''''''''''' •16:-. ' : '' ' ''''''' '''' ' ' • " - "
New COnstrUCtiOn El Demolition For special information use checklist.
Description I Qty. I Ea. I Total
Addition/alteration/replacement 0 Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
: '•:::' .....: P*.0 ...',' :;. ;:., '; 1 1 . SFR (I) bath 249.20
1 3A- and 2-family dwelling 0 Commercial/industrial SFR (2) bath 350.00
0 Accessory building 0 Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
I=1 Master builder 0 Other
Fire sprinkler ( sq. ft.) Page 2
.. :, . ,.. . ..., • .,
. . - . ''. - - ' •J ' ' '' •
,...•.::-;1 f 4;.1.4`.`74 • 1 •• -. . 44,.... - N... , ..- . -., 4 ..- • , .., :. •': • -1 Site utilities
Job site address: AP-ei s...u) p , ne , v et....) cr Catch basin or area drain 16.60
City/State/ZIP: 7- cia, OA-- 4' 7 .?--. el Drywell, leach line, or trench drain 16.60
Suite/bldg./apt. no.: I p roject t fri i i- R.4.41.9 e...) 9s ,„ Footing drain (no. linear ft.: _____) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60
B ...e-f ' ELe.J•a__ /247 Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision4W1f) IY) Li- kt.ctet e., 1 Lot no.:q 9 Water service (no. linear ft.: _) Page 2
Fixture or item
Tax map/parcel no.: cps s ,4 7 „, . .. Absorption valve 1 16.60
f. • . .-:•.:-;:,;:: , ..:.!• - ..: , :....,:;:.,, , ::-' ,. ! , :.:iiii,g-6'10:66i,A...t& ikijit :,...::' i,•..":!'i , . : 0
-:,.: :
..-:.r.: • '.- •-..-.. ,...:..i!, ..,-.,....e. - • 1 , i ..., .%11■0.,..4: .. : . ' 1 ' . F' : ''' ii,' Backflow preventer i Page 2 L7 ..\--
Z-Ct 661-Ceapr, i r r / r i at7 , ...) - A ho.eir- f ; ,...-i), tr . Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
.,-. Drinking fountain 16.60
..
'7. Ejectom/sump 16.60
Name: b in'l I C 1 s S -1" ": [7 (...S Expansion tank 16.60
Address: 1 --t c „1 3C' s L 6-:7,-, I 4. - 00 c , e 4 . _ Fixture/sewer cap 16.60
City/State/ZIP:L.11_ K ( C). c / j r' 410 0,0..._ t-I • 7 L - . i 5 7 Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
":.1j,..".,:i...;:1. . ::'";:;;;!.! :Neei:k10 ;-.:!:.i,liz.:■ Hose bib 16.60
? !
i.n.::.,'.: .gris;.,..,, i i 1.:iimr•-44, ;...o.- • I... ,-. 1.. ' ......:: i ma 16.60
Business name: L a f: e. of. „,..:,, or e ei CrY1 Z.%/"'") <Li Interceptor/grease trap 16.60
Contact name: / L oz) „Sp (../.4' CI.,0 Medical gas (value: $ ) Page 2
Address: / 0 D- OC: . to inipc I (nu! 120 Primer 16.60
City/State/ZIP:-ruiLl a. h , cd'e_ . -' / .7((‘'...)-- Roof drain (commercial) 16.60
SinkJbasin/lavatory 16.60
Phone: (Se 3) /..e.; e%.:-.2 -- 9 S I Fax: : (5.: 3 & sr 4 - 4 ::' '76.....r '
Tub/shower/shower pan 16.60
E-mail: Urinal 16.60
....,....,..,, PR ...1,- .:, • :;... •.- •::- t. :;; ., Water closet t 6.60
:.•.
Business nametti)a_Seet 0 , 7 7 . ‘ 7 , ; - , - , /.) C . Water heater 1 16.60
,
..
Address: / ?:_.;--0C, ....., 1 Li / ) i -1.N'i Or #4 • -4- Subtotal
City/State/ZIP: 74-»- t "ate. 706 ::)__
Minimum permit $72.50 ...,
Phone: (503) ifyQQ S WS Fax: 603) 61 9Q - 070 g' Residential backflow minimum perrnit fee: $36.25 .-- eP '
CCB Lic.: 7 C) f Plumbing Lic. no.: Plan review (25% of permit fcc)
r A State surcharge (8% of permit fee)
Authorized signpret e ...4ra.4...4.....,eit...0 TOTAL PERMIT FEE 39 , /
• I Print namee'd e ...ci,„-,0_,--nr-r_u) I Dal i '; /US I This permit application expires if a permit is not obtained , ithin
180 days after it has been accepted as complete.
frFee methodology set by Tri-County Building Industry Service Board
B.13 nildingkeermiu \ PLMF-PermitApp.doc 12/03 4404 6 162110/02/COMIWEB)
a • cl 89/.0-269-EDS u a I 1 3 dSE:TO SO OE oaa
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: PLM2005 -00701
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12130/ 2005
Phone: (503) 639 -41'71 a-dg4 !iii
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/10/2006 TIME: 7:00AM PAGE: 63
SITE ADDRESS: 12920 SW PINE VIEW ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 098 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: Bac:kflow preventer for irrigation.
I
OWNER: DON MORISSETTE COMMUNITIES, LLC, PHONE #: 503 - 7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503 692 - 6945
Inspection Request Scheduled For: Date: 1/10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 024659 -01 503-692 -5545 N
Corrections /Comments/ Instructions:
•
[xz PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: lP 6 l Phone #: (503) 718 -