Permit •
CITY TIGARD PLUMBING PERMIT
PERMIT #: PLM2006 -00155
lh DEVELOPMENT SERVICES DATE ISSUED: 4/25/2006
'= --- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109DB -04300
SITE ADDRESS: 13063 SW SUMMIT RIDGE ST ZONING: R -
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT: 122 JURISDICTION: TIG
Project Description: Backflow preventer for irrigation.
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
Owner: FEES
DON MORISSETTE COMMUNITIES LLC Description Date Amount
4230 GALEWOOD ST STE #100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 4/25/2006 $36.25
[TAX] 8% State Surcha 4/25/2006 $2.90
Phone : 503- 387 -7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 692 -5945
FAX 503- 692 -0768
Reg #: LIC 7804
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 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: p �'��1� Permittee Signature: _'e Os
�7 p
� 1 `
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
,Building Fixtures - i
Plumbing Permit A t� FOR OFFICE USE ONLY ..
City of and Ti %1 Received . ',j Permit `V '�! 00 //5-.5-- 131 5 SW Hall Blvd., Tigard, OR 97223 t 1� DatetBy: '� (/O P `" l� O /
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960Pp� ' %- ` F• li\ Date/gy; Other PermitNo.:
24- Hour Inspection Line: 503.639.4175 �� ";1�� mss �� �� Date Notified/Met y: ? ° I1 See Page 2 l'or
Internet: www.ci.tigard.or.us r (`., Notified/Mcthod: U Supplemental Information
t- FrF. $G/FIEDUL
■ New construction N.," ❑ Demolition For special information use checklist.
Description ) Qty
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
: :;:`.. `' : •••,),;;;.-, a
�.� .. . .: . ...:.. ... . - .. i• .: SFR (1) bath 249.20
, •..;.'�,:.. ':':.:.:;:.::,,,,. ;:: GA7!EGOI2Y; NS"F ), +.:; . � :.::
1 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JU S ITE'1!N'PORM:4Ti0 ,/S,t4D:L : ':'t;"-''''.......•-:
'� � t: ' {ti:'C$�.. . $`':-'-- • --- �` ''
._... , , ... ,.�,.. ' Site utilities I
Job site address: / 3 O 403 S L.L) S Z..!./17' ./3A.•(.0 /eat e_ f_ Catch basin or area drain ' 1 6.60
City/ State/ZIP: 71 q CL A.c4.. 0 02-„ q 7 a') -y Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: project na L' Vt
L w_t- ! /et a9.O 1 ,,,,, 1 ,,,,,,... ,., Footing drain (no. linear ft.: ) Page 2
/ Manufactured home utilities 110.00
' Cross street/directions to job site: Manholes 1 6.60
. C--L 6 e2-F 1 /CZ Rain drain connector 16.60
Sanitary sewer (no. linear ft.: - ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision•SU.OYI /'l l. L.1' R.44-9 I Lot no.1 -a-
Water service (no. linear ft.: ) Page 2
5 Fixture or item
Tax map /parcel no.: (, /�
Absorption valve 16.60
..
- ..:.. DESCR[P. a . . ',QF-: ; : VV9 . . ?:: Backflow preventer / Page 2 a' 7 , SS
J _Cc. T e : /%. '.;7- ,.-.i: , - //f r.,/ ' .. -a. >f; : r Backwater valve 16.60
Clothes washer 16.60
Dishwasher 1 6.60
Drinking fountain 16.60
)�REIF.*: U WN ER 't .-r! - ..: : ?ENF."7
,� • ;; �'_�' . P t" - .,, . ;. t.. Ejectors/sump 16.60
Name: j) r ;1 1/y) / . r i i s- C' '_ L 1 _� e- MY) MIL fl, t7 Ea .I..C.fixpansion tank 16.60
Address: =-7' •_• S !.v f-1":""= ( r= _' 0 i'4 ( Fixture/sewer cap 16.60
/ � - : / 2 : r . Floor drain/floor sink/hub 16.60
City/5ta[eJZ1P:(,.C'+. / <: K. C - = � L C , ( %� ; ( " ;/L. t / �- _; - r-- -. ,.
�
Phone: ( ) Fax: ( ) Garbage disposal 16.60
.
:.. -.. ....:, ::. ,::.. •. : ..:: - '� ...... .... Hose bib
lee maker 16.60
Business name: I 6 : %'1t f: • / -% ,`Li!;' ?'\ 7-:i'`• Interceptor /grease trap I 16.60
Contact name: ; ±�) .... !;/ ; ;,L; Medical gas (value: S ) Page 2
Address: j . L C .S U.) r j t,! S t 151:i (1.[) Primer 16.60
Ci / State/ZIP: J r ' . ` Roof drain (commercial) 16.60
ty �� u. t'i� _.- t Sink/basin/lavatory 16.60
Phone: (jt:'_3) i_;..; c %_-. - _.>' / Fax :: (.. :•)) i• - : c .
Tub /shower /shower pan 16.60
E -mail: Urinal ! 6.60
wt 1 1660
Business name: lli i_s e s if).( !; 2?'% / '�_./; r- Water heater 16.60
.?- •Q T l r / •'• i/ - Other:
Address:
a L� / r! . •a t f •� Subtotal
City/State/ZIP: 7UZL r[,L /1 `'O z•/ o& .J- Minimum permit fee: 572.50
Phone: (e .3 ) (0QQ ..S Fax: (50.3) ( '. - 0 70 &' Residential backflow minimum permit fee: $36.25 3 a• aS
CCB Lie.: 7 yC,) if Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee) .Z , Li U
Authorized signal ' G L z i .. 4./ Z. 4 t ? TOTAL PERMIT FEE 3' . / * j
Print name :71/ eil ...ctcG,--)-z.l•tc) Daq r as- /D� This permit application expires if a permit is not obtained •• +thin
11 180 days sifter it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
i,\ Building •:PertnitsrPLMF- PermitApp. 12/03 440- 4616T(10 /02/COM/WEB)
S' 89L0- 269 -E0S u a113 eST =LO 90 S2 Jdd
CITY OF TIGARD oe
BU DING DIVISION PERMIT #: PI_p1 N)t : ;;d}�4i f
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: '1i7S'7 00
Phone: (5'D3) 639 -4171 � .� ,�I�
Inspection Requests (24 Hrs.): (503) 639 -4175 .: .
INSPECTION WORKSHEET FOR DATE: E l l 5/200€. TIME: 1.04AM PAGE: 109
c3o6
SITE ADDRESS: "';'., SW SUMMI 1 F Si CLASS OF WORK:
SUBDIVISION: SUMMIT FRIDGE NO. 3 LOT #: 121 TYPE OF USE:
PROJECT NAME: SUMMIT RIF)OE NO. 3
DESCRIPTION: L3 .ktIow preventer for irri j tion.
OWNER: DON MORI'61 R °OMMUNITIES LLC, PHONE #: a03- 307 - 1530
CONTRACTOR: LANDSCAPL OREGON, INC. PHONE #: °i0:1 -594
Inspection Request Scheduled For: Date: 5/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
39'4 Plumbing final 029823 -01 503 - 692- 694f, N
Corrections /Comments/ Instructions:
.
7 7 5k
(1)
•
i
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 5 , C/ Phone #: (503) 718- 2i'