Permit c
:4 140 CITY OF TIGARD PLUMBING PERMIT
I 4, DEVELOPMENT SERVICES PERMIT #: PLM2004 -00200
��II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4 DATE ISSUED: 5/5/2004
SITE ADDRESS: 12058 SW WHISTLER'S LP PARCEL: 2S103CD -WW270
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 070 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: Irrigation backflow preventer.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES INC
4240 GALEWOOD ST #100 [PLUMB] Permit Fee 5/5/2004 $36.25
LAKE OSWEGO, OR 97035 [TAX] 8% State Surcharl 5/5/2004 $2.90
Total $39.15
Phone : 503 387 - 7538
Contractor:
•
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
P RP /Backflow Preventer
Phone : 503 692 5945
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: 3af...44-1- Permittee Signature: 6)1 c _ i � fr_ '
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
M. ; 04 08:34a dan edmonds 503 - 692 -0768 p.
1 , .I' bmg Peanut Application FOR OFFYCE USE:QtiLY
•
Received /' Ptumbin ,
REC • >b�BY S / 0 9 Permit No. n
;e0 1 cry
(:ity of Tigard PLumingAp vat Sewer SW Hall Blvd_ Penrrit No.:
Tigard, Oregon 97223 Plan Review Other
MAY 4 201 D BY. Permit No.
50 -1960 Pte- Review Land Use I. Phone: 503 -639 -4171 Fax: 503 -59
Internet www.ci.tigard.orms CITY OF TIG ' ' " - 1 , 1-t I '" Date/By:
Case Na:
24 -hour Inspection Request b M DI : - , ° - -
Contact Inds.: ® see Page 2 for
1- El I Supplemental Information.
E'OF -WORK' ::.2:=-.•;;-; y - :FEE or f
_ �. � ]`New construction :TYP ; - � - '" . ,;•.,,,, (f $ Peelal 'ia t�se= d►edclfst �. •
LO Demolition )
❑ Addition/alteration/replacement - _ _ Description 1 Qty. Fee[ea -) 1 Total
replacement I U Other ::Neaili, ,d
• CATECORYOF.CO `:' ` - - " - :Z= fatitily weliings'; ;
NS fRUCTION:• :: ": ;;. :" r' •M: - .' . Q aeGidiiinio - tt.' toy - ia e b'atility' connection)
Q 1 & 2- Family dwelling D Commercial/Industrial SFR (l) bath 249.20
DAccessory Building . 0 Multi - Family SFR (2) bath 350.00
0 Master Builder [] Other. SFR (3) bath Each ' :JOB SITE' INFORMATION 399 -00
Each additional bath/Iri[dren 45
RMATION anilLOCATION
Fire sprinkler address: • - sq. R.
Job site addr /ac ST Leh /cis La-17 e, :.:, > -., .... Pale2
:.. �: _ : ' ";v::,,,..� ra;:,.,.•, ; 'Site<IIbllitics.::� :_ : - ,., ';: - •
Suite #:
Bldg. /Apt. #: Catch basin /area drain
- 16.60
Project Name: M 1 '2 Cs'r `70 Drywel1/leach line/trench drain 16.6 _
Cross street/Directions to job site:
Footing drain (no. 1 ft.) Page 2
S /2- I �T Manuoff actured home utilities 110.00
t, Manholes 16.60
Rain drain connector 16.60
Subdivision :l3! h►stl cra Sanitary sewer (no. linear it.) Page 2
[t � 2 - I L ot #: 70 Storm sewer (no. linear ft.) Page 2
Tax map/parcel #: (p (. $ Water service (no. linear ft_ Page 2
PTIONOFWO `'
DFSCRI WORK I. .. ,- • - . :: r Firtture or-Iteni ,.
LLi visCQ L G� � ) �� tC Absorption valve 16.60 R y
Backtlow preventer / Page 2 .'7_ SS"
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
�.pROPERTY :OWNER ' • Drinking fountain -
[ []-TENANT :.° - '1 = = :r 16.60
Name: per., M Cll�i Ejectors/sump Expansion tan k 16.60
d S Expansion tan 16.60
Address:4,2 30 5.13 Gct a p o ft" Fixture/sewer cap
City /State/Zip: v.3 16.60
C/'7��' Floor drain/floor sink/hub , _
Phone: Fax: Garbage disposal 16.60
Here bib 16.60
APPLICANT '; • CONTACTPI;RR;50N :<
Name: 61 1 al . parrin.m� Ice 16.60
Address: l �v10 O sW In /g _ t gy p 16.60
City/State/Zip: rn � RD gas valor" $ .Page 2
tY P - T1�l0.QLL�l 9 c a:. 16.60
Ci
Phone (ng.2 . - S'fi Fax D3 loaf o1- 076 8 Roof drain (oon nterciap 16.60
E - mail: SmnWbasin/lavatory 16.60
Tu&showedshower pan 16.60
CONTRACTOR = : ':, -' �' �' ' : " - Urinal 16.60
Business Name: La- n�ctre Q � _ • -tin Water closet
Address: I> -po 16.60
` � , 0 l � _j �, Wat er heater 16.60
City/State/Zip: tl, se
p= rte R„ Gj'�U(o�' other.
Phone � 'Z
a - S`�S Fax�3 - .
• CCB Lic. #: //a 71 S / (09d 0 710 , -. , . Ilumtiinl; Pcrmnit Fees; „ • 0'T S5
Plumb. Lic. #: Subtotal $
Authorized n Minimum Permit Fee $7250 S
Signatur - L �� - /} 1 L) Date /'-f1/°11 Resident Backtlow Minimum Fee $3625 3 10 • • • •
E7/ ell c' aa - o Plan Review (75% of Permit Fee) $
State Surcharge (8% of Permit Fee) $ 4 , 9_0
(Please print
IVodce This permit application t name) ermit Lv not obtained within �r�' PERMIT FEE 5 39.
180 days after it has been accepted All new commercial bait plans
rce�pted as compieta dings require 2 sets of m with isometric or
-
riser diagram for plan review.
'Fee methodology set by Tri- County Building Industry Service Board.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received g Date Requested 72 VAM PM BUP
Location / 2 n 2 Col) l?L 3 t Lf Suite L7 76 MEC
Contact Person Qjb1A. Ph (_tom) (P 59�. PLM2 ' C ) 206
Contractor c G 2) E 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
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Otti- : � j0 47,4O/G
(K.-6a •
PART FAIL '
M HANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Q Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA Dt / � Ext
Approach/Sidewalk ae ! `l Inspector
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL