Permit C ITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2006 -00326
111 DEVELOPMENT SERVICES DATE ISSUED: 6/30/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DB - 04400
SITE ADDRESS: 13097 SW SUMMIT RIDGE ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT: 123 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
4230 GALEWOOD ST #100 Description Date Amount
•
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 6/30/2006 $36.25
[TAX] 8% State Surcha 6/30/2006 $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: Permittee Signature: _yQ,<../ ,c,e
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
Plumbing Permit Application RECEIVE
FOR OFFICE USE ONLY
•
City of Tigard Receives , y � E ;
13125 SW Hall Blvd., Tigard, OR 97223 JU 006 Date/By t , 3 f � VU Permit No \V\ 016 - 3 . 7!
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review t U �C6
24- Hour Inspection Line: 503.639.4175 CJ I , � / i
a_ 1jp i ' '1 I'j Date/ •
Date Other Permit Na.:
Internet: www,ci.tigard.or.us I � !7� c D . Ready/By: 1"4/ :
Si See Pap or
Notfied /M e tl rod•
., , .. : : 17iiig. :Q • WORK ,; `'I. "j; , Supplemental Information
New construction • ., :�-.���, .� >! , :.;, ^. : ,''L�E1� SCS.EDULE� °.` :�•
❑ Demolition For special information use checklist,
❑ Addition/alteration/replacement Description
New am dwellings J Qty. 1 Ea. I Total
•... ,r. : : :O. Y g (includes R. for each utility c
Ne 2- 2-family d n s in 100
• :... , .�,.CONSlRflC1` ION,;; ; ; _.,..; : : :; : ? : : ; . � :.• `� .:.;4. SFR (I) bath
1 onttrction)
:...
1- and 2- family dwelling ( 249.20
❑ Commercial/industrial SFR (2) bath I 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑Other:
r:t.
... Fires sprinkler
';. : ' .�; . ., JOB 'S IT I r 'WI r Q 1 tl 14 'IpOPI ; AND LQ [ �.: ' P ( sq. ft.) Page 2
/ 3�� 7 r,f � � ��� : S(te utilities t
Job site address: ! � l�v � �(� • , � '/
' '"L 'i't i�-C K. y� Catch b or area dra in 1 16.60
City /State/ZIP: �goArt. • c'R y - 1
ZZ Drywell, leach line, or 7erlch drain I 1 6.60
k CY-. , `
Suite/bldg. /apt, no.: ) Pro. f , 3 Footing drain (no. linear' ft.:
/K-CJC L 1 Fti ) Page 2
Cross street/directions to job site: Manufactured home utilities 110.00
Manholes 16.60
� ��- Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2 I I
Subdivisiot L, Mini. /Q s �-G :. I Lot �3 Water service (no. linear ti.:
s `�`'a�! n� l ) Page 2
Tax map /parcel no.: (0 ,.,c Fixture or Item
.ESCR)fI'3TON: QgTC Absorption valve I 60
'
:QF .W ;i .,
16.
/......(.:e. I l/ v(. (../.7-, Backflow preventer Pao
v'. - ( :. / .' 7- .: i; i , •r " ..././}..: J. Page 2 a7 , SS
: , Back water valve 16.60
Clothes washer 16.60
Dishwasher 16.60
' :.. •/'ROPER1 f•.! 0**• . � ' Drinking fountain
.,:i ` , .., a Q °,`t.�►NT . 16.60
Name: b r :, ( f � / ; i'r . . _ .;. : .: `'; Ejectors /sump 16.60
•
., C 'YnmiLl,10 -E.S L.L anion tank
Address: `.-- •` .-; (-, ` r L r_ •, (c' .• t t c L 16.60 i
Fixture/sewer cap 16.60
City/State/ZIP:L /". Al L • t-' \ t Ci t:' t; . ( (_. ; `.'... Floor drain/floor sink/hub
16.60
Phone:
r disposal
Fax: ) Garbage
( di o 16.60 I
.:; ' .. 'ti:: : ::. APPI XC!' 'r'. ; .'y :.,
C'Gl1`TACF :PRSUA>. 16.60
r i ' :. � :; , ' . ... , . ... . , . . ...
_ l ./; ('� /•,../_,.....-. C; ri/, :3 `.: Ice maker 16.60
-- / T.,' .
Business name: Interce for /cease trap
-'•;,,) ......p � , .
Contact name: p o P 1 6.60
( -, ' ' y�•• Medical gas (value: $ ) Page
Address: / ' .J t C.- , I g 2
ty (.( / hlr;..s / l i'i cj (l.0 Primer 16.60
Ci /State/ZIP: r (� f a ji1 C,!1. J - ?' • Roof drain (commercial) •
Phone: '- , �) -: . v.. 16.60 .
(` c ;• ' -' -..', - I Fax ., :• ' - :
Sink/basin/lavatory I
(._. �) � -. ,.: ;l - : .. : 16.60
E -mail: Tub /shower /shower pan 16.60
• Urinal
4...?.. ,., ..... -... . CONTRA ," Water closet
16.
�J I 16.60
Address: p t J or b , !_ W ater heater I
Ott j ,0443/0;164 ' i X_/ + 1
Business name : � Subtotal i v- Other: I I
i
City/State/ZIP: '1 7
taz �i"L � � P7G .•, Subtotal I
jt ,� ) ,4 J •��� Fax: �L ) / 9 /� Minimum permit fee: $72.50
Phone: ( ?�
3 Cc 7� '' 0 70 g Residential backflow minimum permit fee: $36.25 ao•• I
CCB Lic.: 7 y(0 1 Plumbing Lic, no.: Plan review (25% of permit fee)
Authorized sign ! C �n ....... State surcharge (8% of permit fee) . go
Print name , / TOTAL PERMIT FEE I ,39'
1f `S- �'tz,, - -k z.�� I D C of 'Y , I This permit application expires if a permit is not obtained ithin I
� 180 days after it has been accepted as complete.
:\ B uildiattmPermhs \ 12/03 *Fee methodology set by Tri- County Building Industry Service Board.
440.4616r( I a/0JCOM/WEB)
uaii e6,► =90 90 62 ��C
2'd 89L0- 269 -E0S
1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006.00326
13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 6/30 /2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 . -1.--.
INSPECTION WORKSHEET FOR DATE: 7/27/2006 TIME: 7:03AM PAGE: 104
SITE ADDRESS: 13097 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT #: 123 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 3
DESCRIPTION: Backflow pre/enter for irrigation.
OWNER: DON MORISSEITE COMMUNITIES LLC, PHONE #: 603 -3U7 -7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503.692 -5945
Inspection Request Scheduled For: Date: 7/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 033796 -01 503692 -5945 N
Corrections /Comments /Instructions:
/ .i
/ /,f' O '
- 7/ 1 y --- 4 X -----
\66Ass ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
r
Ins
a /�
Inspector: k - T --- Dat n v ? Phone #: (503) ✓
P I ( ) 71 8- �