Permit A. CITY OF TIGARD ORIGINAL
PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2000 -00202 •
` I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/14/00
SITE ADDRESS: 12404 SW QUAIL CREEK LN PARCEL: 2S103CB -09200
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 050 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 device.
FEES
Owner:
Type By Date Amount Receipt
DON MORISSETTE HOMES INC PRMT DLH 6/13/00 $25.00 0002930
4230 GALEWOOD ST #100 SPOT DLH 6/13/00 $2.00 0002930
LAKE OSWEGO, OR 97035
Total $27.00
Phone 1:
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
Phone 1: 682 -6076 RP /Backflow Preventer
Reg #: LIC 00006136
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: Permittee Signature: ,(
Ca I (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
06/06/99 TUE 10:57 FAX 503 598 1960 • CITY OF TIGARO
CITY OF TIGARD P.ECEniEnPlumbing Permit Application Plan Creck I -
13125,SW HALL BLVD. - Commercial and Residential . Redd By
TIGARD, OR 97223 . ... Date Reed
(503) 639.4171 JUN 0 7 2000
.• • • - , Date to P.E. - s,
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Date to DST - -.. ..
COMmuNiry Print or Type . • .
incomAFAMIngible applications will not be accepted Permit 4 P‘°V-2 °° ° - 461,20 . 2 '
Related SUR 5 - . "
" . Called - -
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Name of Davaiopment/Projec a ADORS41 i' L •02 . - .
44. )
Job . 0-t-A- RollatO . sink 11.50 -
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§treet Addres„,s t 1 Suite Lavatory . . 11.50 • . .
• Address 1 Q ttl) au-ix-t- cre-t4c ta_ne, • 7 Tub or Tub/Shower Comb. 11.5C
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• - • -• • ---- - - -.- •Bidg il • I City/State •••• - - - Zip • -- - - ----- 7 - sh ower o
I Ti ciaAa Ok. 1113:14 .._ . 11.50
. ' .. .11:
••• Water Closet
Name . , . 1 / 4 / . . ,..... • . ..
Berri fretYi SS CNC, .iffrrne..5 • Clshwasher .
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• Owner Haling Address ' • . SuRe . '. Garbage Disposal • " 11.50
L/30 5I) GAIewoothL Washing Machhe . 11.50
City/State Zip . Phone
La iec oSivey6 ore., 790- 6'150 Floor Crain/Floor Sink 2 . 11.50
• Name\ . . 3° • 11.50 , • -
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4' - 11 50
Occupant wallingm • ss Suite . Water Heater 0 emersion 0 lice kind , . 11.50
G as .
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%As piping requires 8 separate mechanical permit. • - - " •
City/State Zip Phone - Laundry Room Tray . 11.53
Urinal - r 11.53
Name .. • - - -- . - •
. • - ro&rass Litidsze_. . .. : Other Ftdures (Specify) 1600
• . 15.
Contractor Maiing Address .. Suite . . ,_ • I • -
al F1 5" go Kt nOrfut. ' -
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Pricr to permit City Zip Phone LP - 38.00
- _:__, Sewer - 1St 100' •
- a opPy 1,1)1 I Sin 0 ilk OR.47070 (.D74, -7a.r) ,.. - . .. Sewer - each additional 100' 32.00 • • •
-
of licenses are " Oregoo Conat. Cont. Board Lk.* ., Exp. Date • - -• --
required if • • • CO)34, .- : gh/iCie,) p • . : Water Service -1st 100' . : . _ 38.00 • .•.
, ---•"-„, •
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expired In COT Plumbing Lie. 0 . r Exp. Date , -• Water Service - each additional 200
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. •database Storm & Rain Drain - 1st 100' '.. • -
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Name Storrn & Rain Drain each additional 103' ,32.00 .
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Architect . . •-• Mobile Hans Space . •:. •-. - 32,00 : -- '• : ,
or . Mailing Address Suite • Commercial Back Flow Prevention Device or Anil- 32.00 • .-'
• - Pollution Device . •
- Engineer City/State Zip Phone Residential Beediow Prevention Device' , i 19.00 rya . - . .
(InIgatior timing devices require a separate •
Describe work to be dcne: .
• •
Replace with like kind: Yes 0 No 0
\ Repair 0 si restdcted energy permit.)
New
Any Trap or Waste Not Connected to a Flidure ' 11.50
Residen 0 Commercial 0 Catch Bashi 11.50 :
Additional description of work: . •
Insp. of Existing Plumbing 50.00
• . per/hr
Specially Requested Inspections • 50.00
Are you capping, moving or replacing any fixtures? per/nr •
Yes 0 No 0 Rain Drain. single family dweliing 45.00
If yes, see back of form to indicate work performed by Grease Traps I 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
I hereby acknowledge that i have read this application, that the Information Isomeric or rises diagram Is required If Clusreity Total Is s.. 9 i 1 :141 - .41. 4 * ',"2
given Is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL
• that plans submitted are in compliance with Cregen State Laws. i-7.=
_
ref,,Svrtgent . V3106 ic9, IS% SURCHARGE 2. :.'4.'ii 2.::-::
142:
.. .*:- .. . ...
Contact Person Need Phonii "PLAN REVIEW 25% OF SUBTOTAL TI
Requi:ed flly If tan qty. total Is . 9 ..:::".= "&",jii . ' '
L ., .IttTS.MCM r r ETABO.1.1 TOTAL
RrtNtjkINg_krSEXIOP:g",ik-."PAA--t=>--a--.-V-4T_LVISfg.l:-4S.V,:;:_.ifrltlf-kz - • _.,,, 7::' 'r-S.M!,77:77 ,
PAM_ tigkintl#40.93:ZiF961.4.4111-Pdp.."4-!.;414ii5;;;X:WErsilte3140
Minimum permit fee is $50 + 5% surcharge, except Residential Backll ow
ctimEsgeArtogio-motimmogefolipaOg-wtobighau,-._ft,---atj-- -->. Preve De_____t • - cign_____etit,..01;b.11/35 -, 5% surcharge
F:t,..1...Cier* tagi.51PIRIAMt"---Kira "All New Commercial Buildings regLire plans with isometric or riser dtagrain
and plan review
imes..fonnstaiumapp.dcs 912/S
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06/08/99 TU.E 10:59 FAX 503 598 1960 CITY OF TILiAny .,...__
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PLEASE COMPLETE: . " • • •
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4r.:' ;:'i..11iNeW;:i5* kil Afc:100 ;. 1;• :t cAzigitid - -
......• ,... • . .... .• ,....„......
Sink . . . •
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Lavatory • - . . . .
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Tub or Tub/Shower Combination - - - .
Shower Only
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•- Water clo ''.. • ".•••• .- - •••• • . ..,. „ .• • ...... ...
Dishwasher • . . V • ,
Garbage Disposal • • - V • ' . V
Washing Machine - . _. • _ • • . - --..• .-• ...• .
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. Floor Drain/Floor Sink 2" _ . .
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4" ----.
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Water Heater . . . •
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. . Laundry Room Tray . - • • - . . - • .
.Urinal ' .. . . - . • •
Other Fixtures (Specify) . . - , - -• -
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..:_ B ifj-ck ft ' Perzem7.€7a4 .br.c;ic . • - •
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COMMENTS REGARDING ABOVE: - . •
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1:Witvlarrnsip.unt app. dem 6/2/6
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CITY OF TIGARD BUILDING INSPECTION DIVISION 0 , 9 , 4 ,
ST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
l,L / UP
Date Requested �/� a AM PM /Y /X/---I3
/ BLD
Location 4,2 0 Q / / Suite MEC
Contact Person Ph 2.4 0E09 0 1 00 0- ov v
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR v
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: X _ oo'4 b SGN
'E Z
Slab �V SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler
Fire Alarm
Ceiling •//
Roof
Misc:
Final
• RT FAIL
PosT& Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drain %
• SS vART FAIL
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 Ext —
Other Date 17, Inspector
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
• ' 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
r
/"!7r � P Date Requested D o� » AM PM BLD
Location /c2- yi V � 1 l1 4? i?//Q' Li^ Suite MEC
Contact Person f ay, Ph 6g2 6D76'-W7PLM 4 9A4
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: 6 rl SGN
Slab 1/ 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
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
it
PART FAIL
ECHANICAL
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 Y�
Other oach /Sidewalk Date �l/ 7 Inspector 0�� ( Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.