Permit CITY TIGARD PLUMBING PERMIT
�, r� DEVELOPMENT SERVICES PERMIT #: PLM2000 -00092
'�I � 13125 SW Ha Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/21/00
SITE ADDRESS: 12186 SW QUAIL CREEK LN PARCEL: 2S103CB -10500
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 063 JURISDICTION: URB
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: Installing residential backflow prevention device.
FEES
Owner:
• Type By Date Amount Receipt
DON MORISSETTE HOMES PRM4 BON 3/21/00 $25.00 0000831
4230 GALEWOOD STREET 5PC2 BON 3/21/00 $2.00 0000831
SUITE 100
LAKE OSWEGO, OR 97035 Total $27.00
Phone 1: 274 -5223
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
Phone 1: 682 -6076 RP /Backflow Preventer
Reg #: LIC 00006136 Final Inspection
PLM 11558
ORIGINAL
•
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: 6. (VI} iJL4wk i Permittee Signature: ( 644 —
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next siness day
•
06/06/99 TUE 10:57 FAX 503 598 1960 CITY OF TIGARD R) O02 •
CITY OF TIGARD Plumbing Permit Application Plan c,;e
13425 SW HALL BLVD. Commercial and Residential Ret'dBy
TIGARD, OR 97223 Da:e Reo'd 3 24-
(503) 639 -4171 Da :e to P. E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit .11U -
) 2_
Related SWR X "f5
Called
Name of Deveio enUPro•ec: F
pm 1 � � D •1X' f .URES;;1hd dual
lVlj 1.: - .,� .....
-r� �... , Q'EY�i ?PRICE-, =igMT;S •
Job a,t t- rz,c�l- ollzAk1 Sink 11.50
Address Street dress I Suite Lavatory 11.50
• IZI' - -SW 4Il Cate Lane Tub orTub/ShowerComb. ` 11.5C
•
• • ' Bldg # • • City/State Zip • • • . -- - -' Shower Only 11.50
Name I Ti a� d X773 Water Closet I 11.50
Dan Ma'Yi %�+4e.. 1�a»1t.S Clshvasher l 11.50
Owner Malfng Address Suite Garbage Disposal 11.50
wa 3C) sw GalewoC)d. Washing Machine 11.50
atylS.ate Zip Phone Floor Crain/Floor Sark 2° 11.50
• Lake bSwcgo O k, 790- tic So
• Narre 3° 11.50 •
4° 11.50
Occupant Mailing . ss Suite Water Heater 0 conversion 0 Ike kind 11.53
Gas piping requires a separate mechanical permit. •
City /State Zip Phone Laundry Room Tray 11.50 I
_ ` Urinal 11.53
tarti S -
me Grasp La-44 SG [> Other Fixhues (Specify) 15.00
Contractor Mailing Address Suite
1 9 . 8 PI S 94) ki n s: marl°
Prier to permit Gty/State Zip Phone b >? - Sewer - i st 100' 38.00
issuance. a copy _WO O S ULIk 0297070 &4974, an S ewer -each additional 100 32.00
of all licenses are Orego Conat. Cont. Board tic.* Exp. Date
required if a9)3(p St 3/1 aac.)0 Water Service -1st 100' 38.00
expired In COT Plumbing Lie. C Exp. Date. Water Service -each additional 200' • 32.00
database I Storm & Rain Drain - 1st 100' 38.00 .
Name . Storm & Rain Drain - each additional 100' 32.00 I
Architect Mobile Home Space 32.00
or - Mailing Address Suite Commercial Back Flow Prevention Device or Antl- 32.00
• • Pollution Device
Engineer Ctty/State Zip Phone Residential Bacuflow Prevention Device' i 19.00 .5 eti `
• (Irrigatior: timing devices require a separate
Describe work to be dcne: restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes 0 No O Arty Trap or Waste Not Connected to a Fixture 11.50
Residential 0 Commercial 0 Catch Basin 11.50 f
Additional description of work: .
Insp. of Existing Plumbing 50.00 •
per/hr I
you capping, rnOYln Or r@ replacing any fixtures? Specially Requested Inspections
Are per /I
Y p 9 Y - perl�r
'Yes 0 No 0 Rain Drain, single family dwelling 45.00
If yes, see back of form to indicate work performed by Grease Traps 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES. - QUANTITY TOTAL" I
I hereby acknowledge that I have read this application, tha: the information IsoerIC cr riser diagram Is required I Qum* Taal is > 9 1 ' :.' � ='
m
given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL ;, , - •:
that plans submitted are in compliance with Cregon State Laws. _ - :- ;:
etQrv - etsw ' ent Date V9, E54, SURCHARGE _ _ --
Contact Person Phoni "PLAN REVIEW 25% OF SUBTOTAL -
•
Requi:ec orgy It fixture qty. total Is > 9
i :�__:_,.��T�_.: sr : _ y *r = == TOTAL
;tBIK{kt#�r?iJSit81a- _:_ _ -_:_ zaaen.. >• - -
r t} 1 r Wi °X - �- k_ r:,,: _�_ : .,° 2 Mi nimum permit fee i s $50 + 5% surcharge, except Res Backflow
5� "' - `""'• `� Y "`: - ";""{ or ftr - -- -, Prevention Device. which is 525 + 5% surcharge
J All New Commercial Buildings require plans with isometric or riser diagram
:y1 0tr�aP>gant� iseHe 8to�rY5i6wer_ati'd:_� t x:;3
,, ,_ ,_ - .- K '`-= and plan review
CWs:s ;`xmsloiurnapo.dceSh'S3 f � �] ��
•
•
03/31/2000 Activities for Case #: PLM2000 -00092
1:59:46 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA003 Application received 03/21/2000 BON DONE No Hold BON 03/21/2000
PLMA005 Create Permit 03/21/2000 BON DONE No Hold BON 03/21/2000
PLMA750 RP /Backflow Preventer No Hold BON 03/21/2000
PLMA799 Final Inspection 03/24/2000 MRS PASS No Hold AKJ 03/26/2000
PLMA050 (F) Issue permit 03/21/2000 BON DONE No Hold BON 03/21/2000
PLMA800 Case Finaled 03/26/2000 AKJ DONE No Hold AKJ 03/26/2000
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION 044
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST C/� _
g2- /, BUP
Date Requested `1 AM PM BLD
Location 12) O 14 A I Suite MEC
Contact Person Dam Ph VI- qg 3 / .irP 2, tco - apbc(3-
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ..aillr , ,`,
Fire Alarm
/ AID /��'� MI
Susp'd Ceiling :'
Roof
Misc: Final (:c./______
P RT FAIL
/
UMB
Post & Beam
Under Slab
Top Out
Water Service
l; Sanitary Sewer
T Rain Drains
)7%2
• 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
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA / rn Other Approach /Sidewalk Date v Inspector Ext .7 Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.