Permit CITY TIGARD PLUMBING PERMIT
A . �� DEVELOPMENT SERVICES PERMIT #: PLM2000 -00357
��'I� 13125 SW Hall Blvd:, T i gard, OR 97223 (503) 639 -4171 DATE ISSUED: 09/22/2000
SITE ADDRESS: 12252 SW QUAIL CREEK LN PARCEL: 2S103C6 -10000
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 058 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: Installation of residential backflow prevention device.
FEES
Owner:
Type By Date Amount Receipt
DON MORISSETTE HOMES INC PRMT CTR 09/22/200C $36.25 27200000000
4230 GALEWOOD ST #100 SPOT CTR 09/22/200C $2.90 27200000000
LAKE OSWEGO, OR 97035
Total $39.15
•
Phone 1: 387 -7538
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
Phone 1: 682 -6076 RP /Backflow Preventer
Reg #: LIC 6136 Final Inspection
PLM 11558
•
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: P ermittee Signature: /ja G iC'4 T10 /
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
09/14/00 THU 12:47 FAX 503 596 1960 CITY OF TIGARD wj""
Plumbing Permit Appli�tUiVED Plan Check#
;IfTY OF"TIGARD 9 y �'9A' /�
B
13125 SW HALL BLVD. Commercial and Residential Recd Recd 9,2,E __
rIGARD, OR 97223 SEP 21 2000 / Date to P.E. _
:503) 639 -4171 ( I l Date to DST _-
• COMMUNITY DEVELOPMt,. Permit # PLI1 - (JD 35 7
• Print or Type Related SWR #_
Incomplete or illegible applications will not be accepted Caned
Name of Development/Project Q • FIKTURES „(individual) , 4.:,.
(.f-bl / V w s-O Sink 16.60
Job l � Q.LL !V o lsso
treet Addres Su Lavatory
Address / 1O �,l Qd -, 16.60
Tub or Tub/Shower Com
Bldg # C4/ Stale , , Z� I Snower Only r 16.60
I I �Tl1 �(,t 0 ��� Water Closet ! 16.60
N �f Ann TT f 16.60
Owner Mailing Address Suite �� Dishwasher 16.60
`1�30 6 w (7lil6u�o Garbage Disposal 16.60
C tyl 0 CP O C "4h 9 3 / - Laundry Tray _ 16.60 I t
Name 16.60
Washing Machine 16.00
Floor Drain/Floor Sink T
Occupant
Ma ' •g Address I Suite 3' 16.60
a• 10.60
CIry1S +a Zip Phone • Water Healer 0 conversion 0 like kind 16.60
Gas piping requires a separate mechanical permit.
rime Meiling Address ude MFG Home New Water Service 46.40
t � e MFG Home New San /Storm Sewer 46.40 I
Contractor <9.-99s 14ASTY o/l• kb Hose Bibs 16.60
Prior to permit City Stare Zi a Roof Drains 16.6? _
issuance, a copy City/ Slate OR + ip p
�()1 7070 6 47'7 DAnk!ng F ountain 16.60
of all licenses are Oregon. Cons( " Cont. Board Lic.# Ex to f Other Fixtures (Specify) 21.75
required If (DI
expired in COT Plumbing Lic. # Exp. Date
. database .
Name
S ewer 1st 100' • I 55.00
Architect
or Mailing Address Suite Sewer - each additional 100' i 45.40
_ Water Service - 1st 100' i 55.00
Engineer City /State Zip Phone Water Service - each addlional 200' I 45.40
De cbe Storm & Rain Drain 1st 106' 55.00
ri_ work to be done:
New Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain. Drain - each additional 100' 43.40
'
Residan , I O Commercial 0 Commercial Back Flow Prevention Devise 46.40 •
Ad rtianal descTiptlon of work: Residential Backtlow Prevention Device' r 2 7 55 a� $
� �1() 1() Cwt t� i 6ie � Catch Basin 18.60 •
Are you capping, moving or replacing any fixtures? insp. of Existing Flumbing or Specially ! 72.50 1 ally Requested perrhr
Yes 0 No 0 Inspections
•
If yes, see back of form to indicate work performed by R ain Drain, single family dwelling 65.25 1E 60
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps •
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
I hereby acknowledge that I have read this apps cation, that the i nformation isometric or rise diagram is required it Quantity Totals > 9
given 's correct, that I am the owner or authorized agent cf the owner, and `SUBTOTAL
! that plans submitted are in compliance with Oregon State Laws. _ al40- ;
Slgpature of Ow nt - Tat` /9 - O0 8% I
`1 ct Per Na e� �vrrr , n8 �7�0 • -P LAEW 25% OF SUBTOTAL i
en /�I I Utz _ -�p1j7 Re an y ! ru Aure REVI qty. to1a� Is > 9
'.`t° : • I _. O USE'S
24920 ;' u --� j -. 3 s 4 - t " �l . T OTAL ' .q • i
9 OUSE 5399.00. .:.• "?•3r N :7 - r , ; --,.*,., . ,,. r
:ai, fee•inel •.1er. D tun • ure$ nh dweldn . trn • a K e t h. 'Minimum permit fee is 812.304 8% surcharge, except ReslderOW 6acdlow Prevention
.t o , san
OfY "so saws �" we st • rime =,e. n•w se °p : •• = ;Y r<1urt� Device. i 75 a B°e su ar6e'-
'•AII New Commercial BJ n s V I plans with isometric Or rise d'a9am enc plan rev +e,v
NauVermApiumapF rer.doe 9/8/00
CITY OF TIGARD BUILDING INSPECTION DIVISION MST .7.e>4-1/ 7,
• 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / ` 6 AM PM BLD
Location / Z Z-> 2- .54/ 41.6 (/ r Suite MEC
Contact Person Ph 2o 3 7 PLM x23 S
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
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
LUMBI
Post & Beam
Under Slab �
Top Out
k
Water Service
Sanitary Sewer AT
Rain Drains t•�/
jr PART FAIL
' HANICAL
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 [ I 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
Approach /Sidewalk
Other Date I U1) Inspector rrn Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.