Permit .•
A CITY OF TIGARD PLUMBING PERMIT
r DEVELOPMENT SERVICES
PERMIT #: PL /16 /00 -00385
if; I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/16/00
SITE ADDRESS: 12287 SW QUAIL CREEK LN PARCEL: 2S103C6 -07900
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 028 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
FEES
Owner:
Type By Date Amount Receipt
DON MORISSETTE HOMES PRMT CTR 10/16/00 $36.25 27200000000
4230 GALEWOOD STREET 5PCT CTR 10/16/00 $2.90 27200000000
SUITE 100
LAKE OSWEGO, OR 97035 Total $39.15
Phone 1: 274 -5223
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
Phone 1: 682 -6076 RP /Backflow Preventer
Reg #: LIC 6136 Final Inspection
PLM 11558
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued = : - , ��. / Permittee Signature:a/iJJ, .
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busi ess day
D9 /1.1 /uv •"` • - PlanGhec�>:
Recd ne
^,ITY OF `1-!GARD Plumbing Permit Application Date Reed /D --
Commercial and Residential Date to P.E. _ -
TIGARD, D, HALL BLVD. r 03) 639-4171 OR 97223 Date to D T - G /
Perna! D 8J
503) 639 -4171 O CT 1 0 2000 Re rmit S�tiR ._�- --
• • Print or Type Pted C alled
• •
Incomplete or illegible applicatigrpl���V��oE�g
._ Qty . Prlc? : Total
FIXTURES (individual) - 16.c
Name of Development/Project - ' _ �--:
t i /11, GOT ae Sink. 16.60
Job �a'�' � ! ""' Lavatory - 16.80 !
r Suite
Street Address n , , C Lc / J !
Address � (�(.(�l I 1s.so
` ..D-E 7 Shnrzr Only , -- i , • 6�? j
� Waver C!cset - 16.60 ( I
l e -j�-m c S m 0�I S$e ffe 15.60 I
Suite
1 113 OWnEr Addre:s �� �� Garba3eD :sposa' - 16 c0 I
) 64L&'4 vc Fnone Laundry Tray 16.60
I
IStat Z'°
71C ec/teb .01 V' 16.60 �� NFloor Sink Name Floor Drai 10.60
I Suite 1:.60 Mal
��dress 4•
Occupant 16.60
•
•
Zip Phone Water Heaver O ronw.rs :cn 0 lice Vale I Clty`S s!e ? Gas p:0 re uires a separate mechanical perrn;t. 46.4)
- MFG Herne New Water Service 1 00.40 I
ht.. ante /- SS M S L V MFG Horne Ne.v SanlStorm Sewer 16.80 i
� V ° r I 111111 Rlzili 19 Add R O Hose Sibs 15.6?
Contractor .. � � y s Di Kc n �� Roof Drains 16.60 111111 Zip - vho (LD`7
e 7 07 lu a r Dtink!n Fount +,
Plumbing
FriortoFe'm' U2 _. Lion
issuance. a copy C- to
OGtie: Fixtures (SxGh
•
of au licenses are Ore3of. Cy st. Cont. Board Licit p. �DU�
required a llvv ll Mill
expired in COT Plum IIIIIIIIIIIIIII
database 55.00 N a e Sewer -1st 1J0' - � 45.40
Architect Sewer - each - 1stonal IOC'
or
Ma'ling.' dress Water Service -1st 100 ® ,
Water Servich - eacz add Bonet 200' 55.00 . NM C i : vfState Z '� •
Engineer Storm & Rain Drair.- 1st 166' 45.40
Ne 0' wR ai be done: Storm & Rain: Drain - each additional 100' 111111 45.40
New f e�air 0 Replzce with tike kind: Yes O No O Commercial Back Flow Prevantlor DevI .e ( .4
Res'idantiat�0 Commercial 0 18.80
) L ion of „orfc: Residential Back'kw Prevention Deuce -
A „{Bonet desc L R 1 de i--) ` r C e.) Residential
Basin : 72.50 I
'`,�� � I l/ Insp. of Existing Fl ynGtr•9 or Speci'oif,+ P.e4'iPSt °d peuhr
•
• i moving o replacing any fixtures Insp of'ar�s 5550
Are you caF? ' Yes 0 No 0 Rain Drain, singse is nily d'.velling 16.60
performed by i Ra O mit. single
If yes, see ba of form to indicate work P QUANTi i TOTAL ' �r]..
fixture. F:.ILURE TO ACC IRATELY REPORT FIXTURE
IIIII
I hereby COULD g RESULT IN read this INCREASED a t FEES. a :;cr ! scene: ^c or rise•cia;ra:nisr.�:irra neu l A ..
rnt cf the o.vner, and 3�' ° Z
1 heresy o n ct. that I t - , r tne °e or authorized ag- _
I gi�e� coned, lien a Hitt Oreco, State Laws. bo RC I �;��
t .dt Oars s :br* t•:d are is c =m: 0- t C
:rfA em to 1 �'
r S;r❑ u e of O 7-Lk.) CI-
'
i L.� • h nr "' REVIEW 2 OF SUBTOTAL T -
C �j G I y qty. trial is > 9 7 i
ctperont - !ha 1 �? rGT u..er only /riStA °a. TOTAL ` I
^2 2. .0 �r� rif � � V: 3. - .'q rte w Pre�emicn
. O� F USE' 535 0 0
CQ,` i 5 �` y ° 7t �'` r '� t �� ` y y :e $52
.>...�. _ • i •� s- ,t� •Mlnlraorn ',emit r .50 r 6% cJrr 3
n d th firs 4 '., su c' arCc. r 3t° , � I an rc�'r^
S'FS.4Tr1 OU3S 5399.00 "Am ti N C C is Sr p5 sons a: ri3r .3'S am ere F
1 t " Th tie Icm 6ln 'ntEu or- a: dwe Itnfl' co ,..„ . -74.:.;.,,,...,.,..:„ -�
� �� $ g � i4 f rti Watoreory ^^ ^pll t�e•n Ccrrne+ - :a: t= a:idlr;s r:{u ra p 31 , •
7 6 , "'� �0 11a
KzU\ham `cr...-acF_rre.dNSR.C:
gITY-OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /2,— I I AM PM BLD
Location / 2 2 ri 5 w � tef uG c (! /G Suite MEC
Contact Person /-14 g s Ph G /Z 7 G PLM Z,w(4.. v
Contractor Ph J( 2- 1 7 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 / `. / / Afg _ _
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
LUMBI
ost & Beam
Under Slab
Top Out
Water Service LG c /�
Sanitary Sewer p
Rain Drains
Fi
ASS 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 [ ] 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 l l 1 `I�J'
Inspector /,/ !/ / • Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.