Permit CITY TIGARD PLUMBING PERMIT
4/A DEVELOPMENT SERVICES PERMIT #: PLM2004 -00317
- 13125 SW Hall Blvd., Tigard, OR 97223 (503)639 -4171 DATE ISSUED: 7/8/2004
SITE ADDRESS: 12064 SW WHISTLER'S LP PARCEL: 2S103CC -12600
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 073 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
4230 GALEWOOD ST CITY OF TIGARD MEr 7/8/2004 $36.25
STE 100 [TAX] 8% State Surchan 7/8/2004 $2.90
LAKE OSWEGO, OR 97035 Total $39.15
Phone : 503 387 - 7538
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : 503 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:_
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Jul 08 04 10:59a dan edmonds 503 - 692 -0768 p.
Build; , Fixtures
Plumbing Permit Application FOR OFFICE USE ONLY
��. Application_ �
City of Tigard iR G , V Received
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: 1,//0 Y Permit No.:1) yl+l 2 per, /(,.-ova /7
Phone: 503.639.4171 Fax: 503.598.1960 .-,..; + ., 11';', Plan Review No.: w7
24- Hour Inspection Line: 503.639.4175 L. 4 '
Other Permit No.:
Internet: www.ei.tigard.or.us y _ DateyBS" linc 0 See Page Z for
:.:s,- ;uv,..- „„ www.ci.tigard.or.us •^ . # +:, Notified/Method: /� Supplemental Information
<.+ gag +'% -.s az,...:5a. -; �. "� . "' "' ''' _ 'S f . ` ;: '°•�- ` k �
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- For special information use checklist I
Description
i ❑ Addition/alteration/replacement ❑ Other: Qty. Ea. Total
_ lter t y / ,_,� -� t � {Y. , « New 1 - 2- family dwellings (includes 100 4t. for each utility connection)
I.iT '" : : �5 -` , i , :." l• .... ,y ,.�fJTt'� ..j X , , :,r - . ,".t;. 9.20
. _ . �-- _ -�.'., �Y-w "r...�::'- :,�• ...." .�..; ;: =: SFR (I) bath 24
1R1- and 2- family dwelling 0 Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath
399.00
Each additional bath/ldtchen 45.00
❑ Master builder ❑ Other:
.
j.Z':%K;';:i 4.+ c a , K e m w y sprinkler
`; r _ :':;'.! ." i •510 ' jl W ( /� -.r�,t .• • ": ':-L= ' . Fire sp ( sq. ft.) Page 2
Ye Y t:s Ys :''t.. - '� y •? (� 9, ` ra.,, ,„ -, O ,• .. - Se •• •i •.: :' 5�
'� ' �•� 1 '� `u ..-c..:- � . Site utilities
Job site address: / �?G,( L/ S,[ x-,17) j / - J Lew, C., Catch basin or area drain
16.60
G,
City/State/ZIP: '77 ate( C i 9 7 ..)...3 Drywell, leach line, or trench drain 16.60
(no. linear ft.: ) Page
Suite /bldg. /apt no.: / Project name: ` C,T 7.3 Footing drain e 2
Lc t.� r
Cross street/directions to job site: Manufactured home utilities 110.00
Manholes 16.60
S LL /D-/ S/ / Rain drain connector
16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear R: ) Page 2
Subdivision: (. U h I ± - -s Lf&tt k L .)✓ Lot no.: � , ; Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: t S C 6 Fixture or item
;x; ,:- ; it = "y �p , r1., � y ��{.. ,r ,. 7 ems.- Absorption valve 16.60
•�,I Y; <' • ^ , : . "15 � ii ii• ll � lcl V - :.Y,i'Vyii 9 +: "fwY n_'`' } ,, 1 .r. -
/ ^ - C} ° - :.•. ,.: F � i � . * •- : ti�:Gf; .f,ems' -.� 'a ,o,
L La �� -.•` -' Backflow preventer / Page 2 a. 7 / - S'�
"n Sc- / rte C. '7 WI 0. f /OL 1 Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
t , f r- s�i " "y zt e .,.: . ;.; s`,� Drinkin fountain
;' � o w• 16.60
^roa e- bt•�g•. � o`e'. :(•�.'e ,fi r, - , .,:.5 . ' F•r.t.•• �''.-e4rn
Name: �h mCYI S S e- f / Ejector tan 16.60
e� Expansion tank 16.60
Address: '.7 3 0 S w Gc�( C....4-a o Or
�. Fixture/sewer cap 16.60
City/State/ZIP :LCA- f.e 0 S. L.0 .t' 7 Qom. 9.7 03 S Floor drain/floor sink/hub 16.60
Phone: ( ) / Fax: ( ) Garbage disposal 16.60
' r[Y 6;' i.i.+ f` :, y.: g ? x r.•:� r, 3 �, i X `;v Hose bib 16.60
' , � , %, ,a . - .r> •, - ` ''. • Ice maker 16.60
Business name: Lam el s eat o-,, Ur • 0- r,....,- G
Interceptor /grease trap 16.60
Contact name: -- ;1 „I S re.rK
Medical gas (value: 5 ) Page 2
Address: 1 0 0 -pt} .-(.0 /Y1VS- 1 /�Ytl./ � Primer 16.60
_
JJ
fty/State/zlP :•^i•1 J // /, off . J . + r x( Roof drain (commercial) 16.60
Phone: (S413) ( �/ - -51(15 I Fax :: (.5 /c Y,� - 0 764°
Sink/basin / lavatory 16.60
E-mail: Tub /showerlshower pan 16.60
•.. :1; * y l u. • ^' Urinal 16.60
"v'.+:r " ..' ; ,�' '•r (3ONT , 5 ,. - �'= :!q:OR:., i.. • ,A ; i ;sr. � ,
� �,1... •? n ... , ., Water closet 16.60
Business name:��Lrse . ( )7 `��/.�m " « "�Q Water heater 16.60
Address: j'?.-,D.-00 S 4,U m `,'( ( ' � Other:
City/State/ZIP: ' " " -f? �/ 7U� Subtotal
Phone: (C3) iQa S-9-1,,S- I Fax: ��a - 076, g minimum permit fee: 0
� Residential backflow minimum permit e: 536.25 3(,„. as'
CCB Lic.: 7 to n Plumbing Lic. no.: Plan review (25% of permit ee)
Authorized signs Y��� State surcharge (8% of permit fee) 9L3 �� �� TOTAL PERMIT FEE 39, / S
Print name`/ f (` Dat. /e/G This permit application expires if a permit is not obtained within
��� / 180 days after it has been accepted as complete.
*Fee methodoloev set by Tri- (:minty Rua/lima tnrtxectry ,(swiss Retard
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line :, ,. (503) 639 -4171 MST
/ t BUP
Received 7 4. / Date Re uest d - AM PM BUP
Location /ca-06 P-1-61-44J Suite � MEC
Contact Person Ph ( )O77-2. — �� PLM a� -��
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR /� ./A
Crawl Drain
Slab Inspection Notes: SI j
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Drywall ll Nailing e/ 00
Dryll N
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
UMBING)
Post & Beam
Under Slab
-
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Showe arT
Other:
Fi •
•ART FAIL
MEC ANICAL
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 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date 21)7 01 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL