Permit C ITY OF TIGARD •PLUMBING PERMIT
4 DEVELOPMENT SERVICES PERMIT #: P 31/200 -00397
A .� � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/31/2004
SITE ADDRESS: 12055 SW WHISTLER'S LP PARCEL: 2S103CC -14400
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 091 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: Backflow preventer.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES [PLUMB] Permit Fee 8/31/2004 $36.25
4230 GALEWOOD ST., #100
LAKE OSWEGO, OR 97035 [TAX] 8% State Surcharp 8/31/2004 $2.90
Total $39.15
Phone : 503 387 - 7538
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : 503 - 692 - 5945 RP /Backflow Preventer
Final Inspection
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.
Issued By: Permittee Signature: d27 ``� c, ��'�
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
A B .. rig fixtures RECEIVED
Piu, i ng Permit Applicant ' c� f 200p FOR OFFICE USE ONLY
City of Tigard Received
Date/By:
13125 SW Hall Blvd., Tigard, OR 97 Received 9' ye) ` Permit No.• 4/y/ �� a�39 7
Phone: 503.639.4171 Fax: 503.598.1960 CITY OF �I�' , , "? : ,; Plan Ravi Other Permit No :
24- Hour Inspection Line: 503.639.4175 BUILDING DIVI' _t I' t�l 1 Dat Ready/By:
, Date l ®See 2 for
Internet: www.Ci.tlgard.Or.us Notifed/Method: 416, Suppl Information
. TYPE O,WORK . E
FEE* SCHDULE
\New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. [ Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
,':CATEGORY; OF . '• • SFR (1) bath 249.20
M l - and 2 -family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building El Multi SFR (3) bath 399.00
CI Master builder ❑ Other Each additional bath kitchen 45.00
Fire sprinkler ( sq. ft) Page 2
. , - • ,..- i . :J Og' ST, i' E INFORMAT 'IO�!U;ANDr'"GOC,AT[ON` �,.
, '• �� � � Site utilities
Job site address: / Xo SS RA) Li..) hi 9f-(-e -s ti Catch basin or area drain 16.60
City /State/ZIP: -r; � i� 0 97 1 Drywell, leach line, or trench drain 16.60
�/ �� 9/ Footing drain (no. linear ft • Page 2
SuitePoldgJapt no.: Project name: W (,(� Z.Z 7
Manufactured home utilities 110.00
Cross street/directions to job site: ,
/ � /4 L .� Manholes 16.60
W /S I it ve Rain drain connector 16.60
Sanitary sewer (no. linear ft: _) Page 2
Storm sewer (no. linear ft: ) Page 2
Subdivision: u ;l srt-1 -er ` S (�Q� ph Z I Lot no.: �/i Water service (no. linear f .: ) Page 2
Tax map /parcel no.: to S < B s Fixture or item
Absorption valve 16.60
DFSCRIPTIO \
N OF VORI • • : -.: - Backflow preventer / Page 2 c ,/7. GS
Lzt_rlel Sc afe,, i cri 9 0_7'7 �n «
h e '; 2G 1 51 ez1,•/, Backwater valve 16.60
/ Clothes washer 16.60
Dishwasher 16.60 • - sl PROPER T 1t� oivr.lER -;',.-:-..,,•._ r [ ; t1V � g founta 16.60
,� E 16.60
Name:
z !'. p nf--7�l 5 (7 4. / l'1^ t' ' Expansion tank 16.60
Address: L--t,:a 3c, .. C J ( c.( c° Ck10 O(t Fixture/sewer cap 16.60
City/State/ZIP:[ K U L: 1 LL) C c/ Q 4'.- ' 7 O3 5 Floor drain/floor sink/hub 16 60
Phone: ( ) F ax: ( ) Garbage disposal 16 60
Hose bib 1660
. - APPLICANT' ' ", _ .. , ' CoNri ._PERSON '
/ � Ice maker 16.60
Business name: L. -CEA L( ez .(2,-G Ore L • 071 2 , G Interceptor/grease trap 16.60
Contact name: £ ] z p ar -- 6 Medical gas (value: $ ) Page 2
Address: / a-D-C)C S -W rnOjS_/I i ij go Primer 16.60
City/State/ZIP:I- La,�,� rt. G 1L . J 1 7f (c `L • Roof drain (commercial) 16.60
Sink/basin/lavatory 6.60
Phone : (5c (G•4- — S %Cls I Fax: : (S�j) &5., - C' ', l o.� ry
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR .. . . - Water closet 16.60
Business name:LanCtS fell •e, 077_C/(fri �n C✓ Water heater 16.60
Address: ," 2-a-O& S u) rn �SI_v gin other:
City/ScateJZ>P: eZe. r OR. 17 ' ' �- Subtotal
Minimum permit fee: S72.50
Phone: 64 3) (p;i S Fax: (503) 69a - 07 ( 0 ,q' Residential backflow minimum permit fee: 536.25 3( . DZ
CCB Lic.: 7 eU Plumbing Lic. no.: Plan review (25% of permit fee)
L. aft State surcharge of permit fee) a . /U
Authorized sig t aiZ 0
TOTAL PERMIT FEE 3 /
•Em `� ef) Print name _ yL L, Dat 3) 6 L This permit application expires if a permit is not obtained within
i < ' p•Z, / 180 days after it has been accepted as complete.
'Fee methodology set by Tii -County Building Industry Service Board
i•\ Euitding \Pertmas\PLA1F•PennitApp,doe 12/03 440- 4616T(10102/COM/WFB)
a d
- e9b :60 ir0 TE 2nd
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: \,; • 39 -4175
INSPECTION DIVISION Business Line: ) 639 -4171 MST
Received Date Reques ed AM PM BUP
Location id D .5 5 Suite MEC
Contact Person Ph ( ) PLM BUD ( 7' 1 : 63 9 7
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing -
Foundation ELC .
Access:
Ftg Drain
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear S `c .^- ofj-
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling 4 .
Roof -_- `'
Other: - `'
r
Final �s
PASS PART FAIL r /1. I
PLUMBING � ' i - . .
Post &Beam Ma■MOO111-
Under Slab
Rough -In
Water Service t
Sanitary Sewer
Rain Drains :r
Catch Basin / Manhole i
Storm Drain
Shower Pan / / / / �y. ( �
Other: / .. f./ r
- {'
t F a2d PART FAIL
13 - ` ANICA
L
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line w /' �/ ° ADA � ,i •
Approach/Sidewalk Date Inspe � - " Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL