Permit -A • CITY OF TIGARD PLUMBING PERMIT
0I n DEVELOPMENT SERVICES PERMIT #: PLM2000 -00181
��I II 13125 SW Hall Blvd., T O 97223 (503) 639 -4171 DATE ISSUED: 6/5/00
SITE ADDRESS: 12284 SW QUAIL CREEK LN PARCEL: 2S103CB -09800
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 056 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 INC PRMT DEB 6/5/00 $25.00 0002703
4230 SW GALEWOOD SPOT DEB 6/5/00 $2.00 0002703
LAKE OSWEGO, OR 97035
Total $27.00
Phone 1: 790 -6456
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
1tV
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 • stain copies of these rules or direct questions to OUNC by calli • (503) 246 -1987.
Issue By: : 0 Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
06/08/99 TUE 10:57 FAX 503 598 1960 CITY OF TIGARD 0002
CITY OF TIGARD Plumbing Permit Application Plan Crack
13125 SW HALL BLVD. RECEIVED Commercial and Residential ReedBy
TIGARD, OR 97223 Dare Reed (p -a-v
(503) 639 -4171 JUN 0 2 2000 Daze to P.` _
• Print or Type Date tc c
CDPAR PARSPEOTllegible applications will not be accepted Permit ' - e/04/
Related S/JR ft
Called
Name of DaveopmentIProjec: Fl)('CURES ( ndjv ldui l :; {:• ° = ; '.QTra. ;PRICE_ .00TH=
Job al & � 6:AL () LOT Sl S1nk 11.50
Address Atrqet Address ' I Suite Lavatory 11.50
I 01 v_i S Ci2.1.1c1A-LI Crt GIC Lan& Tub or Tub/Shower Comb. 11.5C
Bldg* .. .- • City /State • - • Zip -- - - - -- --
Tlicvca oo • `7 Shower Only 11.50
I .
• Name 1 Water Closet ( 11.50
T3 Cm inerriS 5e- ilarricS Clstwasher 11.50 •
Owner y Maiing Address Suite Garbage Disposal 11.50
L1a30 FLU 641e - wOac1 Washing Machine 11.50
Clty/S�ate Zip Phone Floor Crain/Floor Sink 2° 11.50
• (Alec vSCUCya oR. 790 Gy S(o
Nazre 3° 11.50
4° 11 50
Occupant Mating Ad . Ss Suite Water Heater 0 conversion 0 Ike kind 11.50
Gas piping requires a separate mechanical permit •
City /State Zip Phone Laundry Room Tray 11.50
Urinal 11.50
t
►Masco r
-
b
.0 • Grass Lstild sc O ther Fixtures (Specify) 15.00 G I
Contractor Mating Address S uite •
agFi go Klnsmat.
Prier to permit City/State Zip Phone be? - Sewer -1st 100' 38.00
Issuance, a copy WI' 1 S-- 1 ()ilk OR 97010 Go74p - - 21 - 1" - Sewer - each additional 100' 32.00
of ell licenses are Orego Cenat. Cont. Board Lie.* Fes. Date • •
required if CO/3-(00 • 813/),)00c) _ Water Service -1st 100' 38.00
expired In COT Plumbing tic. C Fes. 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 •
Architect Mobile Home Space . 32.00
or • Mailing Address Suite Commercial Back Flow Prevention Device or Aral- 32.00
• • Pollution Device
Engineer I Clty/State Zip Phone Residential Bacldlow Prevention Device' ' 19.00 rap an
(Irrigator. timing devices require a separate
Describe work to be done: . restricted energy permit.)
New 0 Repair 0 Repiaca with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 11.50
Residential 0 Commercial 0 Catch Basin 11.50 •
Additional description of work: .
Insp. of 6rising Plumbing 50.00
perRtr I
Are you capping, moving or replacing any fixtures? Specially Requested Inspections per / i i
er /�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 _t�25: t:: , : ,
I hereby acknowledge that i have read this app5cabon, tha: the information Isomeric a riser diagram Is required If Quan: t Taal is s 9 _ : - 9 " [ J_
given Is correct, that I am the owner or authorized agent of the owner, and 'SUBTOTAL is
flat plans submitted are In compilance with Cregon State Laws.
=ref . _ca._ sTa, (P 1 �S`9, E°A, SURCHARGE :`i :=
Contact Person Phone "PLAN REVIEW 25% OF SUBTOTAL ;f':,:f=
Requimd only ir fbcure qty. total Is > 9 . i;i: ; :: Ti
1, a
1 r��y -- = r'_z_; - -- -,i..,.: E TOTAL _ - 7 I
I �� k1s?- �8,�1�ra_ - _ : __ ._. _ _ 1 = 72aL� 3 n .:Y `=`=- -' ... ±. �� "- _ ,
h°? + except Residential Baaktlow
yy 77}}yy►r�� + �(/� � f; - �,_E �• = : rs., =w r :���:y 'Minimum p ermit fee is $53 5% surcha rapt .
I eF'7 �7. s� �"�5T57s:a'"�'�o ewe o ans� > , "r.. w -: - rn,iur . !�?to; _ _ '
t . --• . _. r . 1 ! 111 h 0101 •-__� fi s� & T Y Neven' Dp,:do_. whi: h is a 5% surcharge
' 'L -= • arr r i A•"" ` `' p ? � a "'All New Commercial Buildings require plans with isometric or riser diagram
Ole'- e811rtH88HeFSlafitrl `seire�alld: tyf . �_�s: ;,
- _ -` -- ��`�"'"
and plan review
I:ldetsl'xmslplumepe.dec 5/2/99
•
06/08/2000 Activities for Case #: PLM2000 -00181
3:41:48 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA003 Application received 06/02/2000 GEO MAIL No Hold DEB 06/05/2000
PLMA005 Create Permit • 06/05/2000 DEB DONE No Hold DEB 06/05/2000
PLMA750 RP /Backflow Preventer No Hold DEB 06/05/2000
PLMA799 Final Inspection 06/06/2000 TLP PASS No Hold AKJ 06/06/2000
PLMA050 (F) Issue permit 06/05/2000 DEB DONE No Hold DEB 06/05/2000
PLMA800 Case Finaled 06/06/2000 AKJ DONE No Hold AKJ 06/06/2000
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 'L030
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested /�P /OO �� A , PM ,�( BLD
Location 12 2� (,Let.(< CJ�_QJCZSuite MEC
Contact Person f1 i1A Ph '1.03' 1 PLM woo- a? fS
Contractor Ph SWR
ILDING 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 OW C4 crF 04/ f C y �_e 7-te
Fire Alarm
Susp'd Ceiling ?P /` [ C f
Roof
Misc:
_ART FAIL
:-`17171 - N)
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
ASS PART FAIL
CHANICTAP
Post & Beam
Rough In
Gas Line
Smoke Dampers
WO PART FAIL
-- ICAL
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 Date ‘76 7(1 6" Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.