Permit CITY TIGARD PLUMBING PERMIT
PERMIT #: PLM2000 -00061
y4 , DEVELOPMENT SERVICES D ATE ISSUED: 2/29/00
'�" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12398 SW QUAIL CREEK LN PARCEL: 2S103C6 -09300
ZONING: R-4.5
SUBDIVISION: QUAIL HOLLOW - EAST ORIGINAL URISDICTION: URB BLOCK: LOT: 051
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 PRM4 DEB 2/29/00 $25.00 00- 321897
4230 GALEWOOD STREET 5PC2 DEB 2/29/00 $2.00 00- 321897
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
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 ma ' copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issue By: L _ ? � � � / ' i i / , ' . Permittee Si nature: / / , i ,/
Call (50 639 -4175 by 7:00 P.M. for an inspection needed the next business day
FEB -29 -00 02 :53 PM PLSI 15036829876 P -02
06/46/99 TUE 10 :67 FAX 603 S98 1960 CITY OF TIGARD ®002
CITY OF TIGARD Plumbing Permit Application plan Gr
13125 SW HALL BLVD. Commercial and Residential Reed
TIGARD, OR 97223 Da Qeed
(503) 639.4171 Ma to P.E.
Print or Type Oats lc D3'''
In or Illegible applications will not be accepted Permits Pa-M/m:: Q/
Rented MR $
�� yy,,,,,!y�� tt ee Caned ly
Name of Dava:oprnent/Projec •
_ • ltJi illrlWY y6ii':u`r'a1';u'::i i4'��i! ?: 'QYl °' PRICE& .; r' :
Job 01A-41-IL' ' blollcs�l LDT S 1 Ri ti. _
Addr06S net Add mss I Su lavatory - 11
. l 39 r S W QLlar.4., tJtL U1 4 T ever Cemb. 11.5C
Bldg $ ilStato . .. 91.60 t
I T!Q clrlolEl'Z� 3ovar�nty
Name J Water Closet - 11.60 _
Dan rflori .#Pc S Clam Harr' 11.50
Owner Meting Address Suns Garbage deposal • 11.50
Na3o S ty Ga /cr+- 'coca _ Waehinaldaohine 11.60
Otyr9tate Zip Phone F loor Cr9 WFbor Sink et' 11.50
N
aa OS 1,11d90 o 1Q, 790- G y S{o 11.60
4
Name 11 50
.
Occupant Wailing • as Suits Water Heater 0 come 0 like kind 11.16
('s
Gee piping reque a se�arale mechanical month, .
City/Stele 21p Phone ' Laundry Room Tray 11
Lhinal 11.60 ,
'( riQ SCe P o t'arasS [jtiid S G4ao G 'Other Fthdtrss (9pac li) 16.00 -
Contractor Meat Address Saes
a4Pi S .btu 6nfFna t p
Prier :o permit Qtyratete Zip Phone 1d Sewer -1st 100' 30.60
Issuance. a copy Lim 5•0n wilt Old 97070 &Dv all ' -...
sewer - each additional 106' .
of as license& are Oregon t. Cont. Board use 8 E/ • / Da o Water Sondes - lid 960' 36.00
tequlred K J (/ .
expired in COT ' PlumNng Lie t ' Eap. Data Water Sondra • each additional 200' 32
database Storm d Rein brain - let 100' 56.00
Name Storm 4 Rain Drain - eaoh s ididoMl 100' 31.60 • Architect Mobilo Home Spree 32.00
or • Mating Add rsae Suite Cernmer&Yal Back Flora Prevention Device or Ardl• 32.00
Pollution Device
Engineer f c"y/SI Zip Phone ' Residential Bec I
w Prevention Device" ' 19.00 lei am
I tlnloallor: *Nag devices requee a Depends
Describe work to be done: restricted energy permit)
New 0 Repair 0 Replace with like idM: Yes 0 No 0 Any Trap or Wade Not Connected to a Fbdure ii .50
Rsslisnilal 0 Commends! 0 CORM Bealn 11.50
Additional desorption of work: Imo. of Existing pltrnbing 50.00
PeO Or
-
�...._ Specially Raqueated Inspections • 50.00
Are you capping, moving or replacing any natures? perhir
Yee 0 No O ' Rein Orainn, single rental/smoking 46.00
If yea, see back of form to Indicate work performed by �Glvaae Traps 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES, QUANTITY TOTAL, I '
I hereby acknowledge that t have read this eppllcation�r the Information -. Isomeric a bler dpgravw I. rub , ,, �Nn d If quwtIV Ted II ± ! : ; i l1 ' ' 1= �'' � � ' ' '
glvsn is cored, that I em Be atMort�ed agent o the owner, and — 'SUBTOTAL • h e orvnbr or
Pet plane submitted ere In comprlen wit Crown Stat Laws. H ' ' -i r' s * .
. �J J an Date a TA SURCHARGE >'': i
Contact Person Phan: -"PLAN REVIEW 26% OF SUBTOTAL :; . '•; Jt ;:L .
! t�'!� Rweed way N Powre VI. twit le • e , . r .._ ,e.,1•1,.::4';.
J �
"" Fi. !n^ I yi f � ..'' s -. ' ^[a • .. TOTAL ?w,,1-,..,, .^,
c' ;_• r _ I ' '' ' ' .;1 ' ''.41.'"--2.4-0- ` ''' - 'Minimum psrmIt fee le 33'0 * 5% surcharge, except Residential Be -ldlow
9., i.�n1 ]i= t ill � y4 - '_,i - r^ ' , 5
r' V - - • 1'1 L �f I ( '„ 1 4 , M, . 4 tY,. P ravereon tonics, whI3h is B • 5 % surcharge
X, I J ,:4�. 1 : �- r L`:f . .., ; ;; r -%, ax `..t4, All New Commercial Solldinge rsot.lrs plans with Isometric or riser diagram
tit: s .F+' ,�..:i. , ,, JL' S' " �f. ,�9 . 1 and plan review
tkde snrmekpiJm.P0.doo YVP69
•
FEB -29 -00 02:54 PM PLSI 15036829876 P.03
06/08/99 TUE 10:59 FAX 503 588 I CITY OF TIGARD @J009
?LEASE COMPLETE:
�:. ".Ri 0.:^ .:,..q R.. •.•.•. t. rT7 .R',� - .- t• •. -- t '•5: 'r' 4:4^ .��.
•'i; .� re!:T �.. .,.' ,'�' ,�`,_'. •i��l°arit �� r�C:.Pelrr 18 �:... ','.<:,,;.;:�
�.ic� ;.;;.,:1.41�ti:�•�� • ":..f •.i4 �:.�: :�!s' �`� ' •5: .r. .! . , r .. ♦ 7►. �. t.:
`•,i�!.: fA..` 4 ., �i' - '"::f. 'ICi,Y.3: .5:: 1 =::?ta ,. ;':' :. i•, r . .,. :L7. .rt}} �.. _ :y.•. •. � a as p/��.
.f :�.• ~ + "d.R� .Say l +►:n w..d"•:w�g'+. :j; .A •. .,y`.. � e 1 cap .0 1.Ca• t
• �ti'St . ';Y4 ti �:R'• - ?fc ?�. :.. ..� .. �`?�:�:t�:... .. .:.�. .:R.�a,:�9Yrf•. .,:1:�Q7 >. d .....•...p.�.....:;i:,.R��., Y.ad Pp.,...
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal •
Washing Machine •
Floor Drain /Floor Sink 2"
3 .,
•
4" •
Water Heater
Laundry Room Tray
Urinal •
_
Other Fixtures (SpecifyL
altc f*zO Pru , hhovl beuice ,
COMMENTS REGARDING ABOVE:
.mf,qdatf.MD W0.400 VIPS
•
03/21/2000 Activities for Case #: PLM2000 -00061
11:21:53 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA003 Application received 02/29/2000 DEB FAXD No Hold DEB 02/29/2000 Received check without
permits, permit was faxed.
PLMA005 Create Permit .02/29/2000 DEB DONE No Hold DEB 02/29/2000
PLMA750 RP /Backflow Preventer No Hold DEB 02/29/2000
PLMA799 Final Inspection 03/06/2000 MRS PASS No Hold AKJ 03/06/2000
PLMA050 (F) Issue permit 02/29/2000 DEB DONE No Hold DEB 02/29/2000
PLMA800 Case Finaled 03/06/2000 AKJ DONE No Hold AKJ 03/06/2000
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested 3/ L( AM PM BLD
Location Q IA AA / (Au Suite MEC
Contact Person fil Lti/L Ph (P g 2 — ‘0076 PLM 2100 — C OLD I
Contractor Ph k 2/7 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
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final ,i / a�l�I 174"7-
Ma__ PART FAIL
-
(i�UMBIR Th
Post &Beam
Under Slab
Top Out
Water Service d
Sanitary Sewer
Rain Drains
�'.. PART FAIL
r ANICAL
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 Inspector Ext
Final
PASS PART FAIL DO O T REMOVE this inspection record from the job site