Permit C ITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2004 -00268
11, DEVE H BMEN9 Tigard, ) 639 -4171 DATE ISSUED: 6/16/2004
SITE ADDRESS: 12068 SW WHISTLER'S LP PARCEL: 2S103CC -12800
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 075 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 install.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES INC [PLUMB] Permit Fee 6/16/2004 $36.25
4230 SW GALEWOOD ST 100
LAKE OSWEGO, OR 97034 [TAX] 8% State Surcharl 6/16/2004 $2.90
Total $39.15
Phone:
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: ' ed / � Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Jun 14 04 09: 19a
_ dan edmonds 5 0 3 - 6 9 2 - 0 7 6 8 p . 2
'''' ::; .':'. ' .- '...' ' " ....-. ''': F 6 ' Z 1:11.F.FIcXJ-ISE.:-QN1,,...'.:-;:4.2,,._:-::::-:-.:i]..:.:-..,..:::i•. ,,,
Phrnilig Permi
irt: P pcm.`"""ilt.:?4-//70 7 00y- 00 ola
City of RECEN D Planning
Date/By: Sewer
Permit No.:
13125 SW Hall Blvd. . Plan Review ma
Tigard, Oregon 97223 41111116 usteith : •
Post-Review PermitNo.:
Use .
Phone 503 Fax:- 503-5913 -1960 i ., . , .,.,
. ,--,. Land
,,, .. 41 .:,:t , -.;■.r‘'.:iii:' Date/By: ' Case Ani No.:
Internet: worw_ci.tigard.or.ur OF T IGIVL :,4,;;: ....,.. Contact . s.: I Kg See Page 2 for
24-hour Inspection Ra 9 - NameiMethod: 1163 I Sueplemental Information.
., . . .
" - ... :; :f ...:.-TYPE:OF- WORK- .-- - -";-..:.-tr-:::::-7. .f.;._ :.... :: -...;FEE*;scHEDRLEttrofjpeefiVitifeiniition:Inile!dildaistf ' ;- _-•
, 0 New construction I 0 Demolition Description 1 Qty. I Feelea.) 1 Total
EI Addition/al teration/replacement ( 0 Other: ::,— ;:-:.-- !:--. , . 1- : .•.. -:;:-Neifizzi:24a
7....";;;A , . - : : - --- , .:-,finchidet100 ILtOse.eneb hilly conneetton):.-
. • .- - 7 ' CATEGORYOF.CONSTRUCTION: , - 2 .::7:: ,. .,-;1 '-.
SFR (1) bath 24920
Accessory
R i& 2-Family dwelling 0 Commercial/Industrial - SFR (2) bath 350.00
Building 0 Multi-Fanuly sit F (3) bath 399.00
[] Master Builder 1:::1 Other: Each additional bath/kitchen 45.00
: - ' • : :30B STECINFORMA.TION and LOCATION ..-:::: .. r Fire sprinkler - sq. ft: Page 2
Job site address: /20
6: -9
t -t-;' iA; Ai ci e-r La(
Suite • ?,;:'.. i=, :::'',. .:'....,:•-•'.;::::7;-::i.-.:::..:;-::::siiettiiiiies:":. ').-.: .'' :..- ' - " •:-.:-,:- • -
Suite #: i Bld.s./Apt#: Catch basin/area drain ' 16.60 _
Drywall/leach line/trench drain 16.60
Project Name: WEI', T-T_ i—C 7 - 7 g Footing drain (no. linear ft.) Page 2
Cross street/Directions to job site: Manufactured home utilities
110.00
Manholes 16.60
S . 1.0 i a i S---T il-t<... Rain chain connector 16.60
_
Sanitary sewer (no. linear IL) Page 2
Subdivision: 4- /..s+-iee (i)a.11:. rz 1 Lot 75 Storm Senter (no. linear ft) Page 2
Water service (no. linear ft.) Page 2
Tax map/parcel #: lib 0 S 8.5 :...: ;..,, :: .. - : ..:: . oilian - ---..
---. : • • • -: IDESCRIEErlION OF WORK :- :.-::::".•'.;--,---.: , : '-- - :i.'... --
Absorption valve - 16.60
1-and Cape- -Rac-lc-riact) citAi ice) Backllow preventer I Page 2 ..,77.- 5S"
Backwater valve 16.60
Clothes washer 16.60
... .
" Dishwasher 16.60 _
Drinking fountain 16.60
13.PROPERTVOWNER" , '.. : .. t 0 TENAPrf: 74 . r s :": . .. : :,.1 .-L '...!." ..7:5- —
Ejectorsisaunp
Name: Defri rleVYY kinirle---C Expansion tank 16.60
Address:4A 30 S.u) &a-t./Liu-340c3 ct) Fixture/sewer cap 16.60
City/State/Zip: 141.4f-t. 4r:34-ts-esys Q-70.35. Floor drain/floor sinkAmb . • 16.60
Garbage disposal - 16.60
Phone: Fax: Hose bib 16.60
E1-APPLICANT .•: - '... ISKONTACT:WIRSON
16.60
Name: 61 Lai .2.parriri-0 Interceptor/grease trap 1
Address: I .:. 0 Cu YY9-c1tivt3 -RD MerUcal gas - vain= S Page 2 ,
. Primer 16.60
City/StatefZip:71.010.1 0 R. 4 470 fa a— _ .
Roof drain (coumwscial) 16.60
PhoneS33 (09a- - SR 45 I Fax Oa.- 0719 g Sinldbasin/lavatoty 16.60
E-mail: , Tub/shower/shower pan 16.60
- _
•-: ,:- - --.... ....:: - .----..• -.:*-...- ,:.'- CONTRACTOR - . : - .- -7;•::•:.:',:::....---'-'1.._.- Urinal 16.60 _
Business Name: f_a_ncifeaprz,_ o I - ran c, Water closet .16.60 -
Water healsv 16.60
Address: 1D-D-00 SLA) On 4 4-4/Virvi ex).
- ,. Other:
City/StateiZip:mitaito "bit- --(4-14fao Other:
PhoneSb3 (cfja- WitiS FaxS)3 (09A - 01710k :!-:: .-,..:Phuiiiiiig:Piiiilit Teliil!' .".',2-'71.S -*:.- ' •
CCB Lic. #: 7 fft)14
Plumb. Lic.#: Subtotal $
MiniMunt Permit Fee ST2.50 1 Date - $
Authorized d zizii Residential BackflowlVratimum Fee S36.25
SignaL __,,-fiZt..4_,I-i-Z4../ k/ 1- 4 6 1
Plan Review (25% of Permit Fee) -- S
el I dr) %Spar inf.) State S — — .., 8% ofFerrnit Fee S -
(Please print name) TOTAL rEamrr FEE , S 39.. / 5
None= This permit appileietionespires if a permit is not obtained within All new counnereaul' buildings require 2 sets of plans widt isomdrie or
180 days after it has been accepted as complete. riser diagram for plan review,-
-
.. 'ice methodology set by Tri-County Building Industry Service Board.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPEZTION DIVISION Business Line: (503) 639 -4171 MST
•
2 BU P
Received Date Requested _ Z AM ` J 1) PM BUP
Location i a C1 g w ��� %�� ,�,• Suite MEC
Contact Person Ph ( � ) 6 9 ? - S 9 (K PLM ,,O0 1/-00 =-(o
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear 7725-kg—a, _
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 (1116:7/..
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Ot
P PART FAIL
C 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 Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA � VI; (7Q
Approach/Sidewalk Date �v2` 0 / Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL