Permit N
•
r CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2004 -00211
' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/13/2004
SITE ADDRESS: 12066 SW WHISTLER'S LP PARCEL: 2S103CC -WW274
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 074 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 device.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES
4230 GALEWOOD ST [PLUMB] Permit Fee 5/13/2004 $36.25
STE 100 [TAX] 8% State Surchari 5/13/2004 $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 - 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.
P ermittee Si nature: //77
Issued By: ^ �- 4 9 �'1 � O..-0
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
May 11 04 02:04p dan edmonds 503 - 692 -0768 p.2
Plumbing Permit Application
FO OF FICE USE ONLY
' Received PlumbingTh
City mt' Tigard
R E C E � � E % /'3 � 6 Permit N e i( �l /�®U�l/
13125 SW Hall Blvd. Permit No.:
Tigard, Oregon 97223 r _ W .: 200k Plan Review other
Da0
Phone: 503 - 639 - 4171 Fax �y' Permit No_:
Post - Review Land Use
7� La
Internet www_ci_tigazd or Fax-
i- TI RD ''''''.'1') ti I'` Davy: Case No.:
24 -hour Inspection Reques������� t =�=�° ° � � Conrad J - -
Name/Method: rr See Page for
� C.�� � Supplemental Information
. • • - r" ' - TYPE OF WORK - ' -,' _ ' . , : - 'FEE* SCHEDULE (tor spedai riation
►1 New construction [] Demolition
D
Addition/alteration/replacement ❑ Other i ma f Fee(ea ) Total
: . '.:,New I - &° family - dwellings"" •
CATEGORYOF CONSTRUCTION -- :'.'._: ;., " -:.:: -•' = ; v • .- :: (ineludes:100'/L for each a'triity'eonneetlon) .: .
il
III I & 2- Family dwelling ❑ Commercial/Industrial SFR (t) bast' 249.20
Accessory Building SFR (2) bath
Multi- Family SFR (3) bath 350.00
R Master Builder El Other_ 399
• :. JOB SITE :and LOCATION' - Each additional q. ft: Page 2
Job site address: / O & ( W h i �,� Fire sprinkler - , ft- Page 2
Suite #: - - • :......, _- ;. °• Sire- Utilities. : , " ... "
BIdgJApt. #: Catch basin/area drain 16.60
t,isr- /U�� /Vatic- Ph [- r -741 Drn ll/teaclt line/trench drain 16.60
Pr:feet Name: 6vi
Cross street/Directions to job site: Footing drain (no. linear R) Page 2
/� f �7 � U Manufactured home utilities 110.00
J /7 �. Manholes 16.60
Rain drain connector 16.60
Subdivision%U 11 i S >< /cis 1! Sanitary sewer (no. linear ft_) Page 2
I.I •e3 /� I Lot #:7'/ Storm sewer (no_ linear ft-) Page 2
Tax ma . . arcel #: La S S Water service (no_ linear R) Page z
• --- .DESCRIPTION OF WORK.. S
��j . Fixture
J'lQSC { -�CUr1) !.clef-) [t p� Absorption va 16.60
La
Backflow preventer i f Page 2 �f7- 5
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
� • I'D TENANT. Drinking fountain 16.60
Name: p, IS Ejectors/sump 16.60
RA Expansion tank 16.60
Address:41 -A 30 SW G4- ('0--E,-)OO CV Fixture/sewer ca.
Ci /State/Zi .: i.1s `►� O.�tve- 16.60
-
6 C171L3� Floor drain/floor sink/hub • 16.60
Phone: Fax: Garber: a di ... _ 16.60
'�APPLLCANT _ Hose bib
Name: j S a- '� CONTACT PERSON " `:;' 16.60
YJi-Q lee maker 16.60
Address: I � i O 0 Ci c3 !� In Interceptor/grease trap 16.60
U Medical gas - value: S Page 2
City /State/zip- - 1 r O � Jc )70( o a-... Printer
16.60
PhoneSa3 (o �Z - SQ Fax Iona_ �7� Q Roof drain (aomtnerciat) 16.60
E -mail: Sink/basin/lavatory 16.60
. Tub/shower/shower pan 16.60
• ' CONTRACTOR •- _. Urinal
Business Name: L4 v)ctS Qty
Water closet
16.60
16.60
Address: a-a Qo �,V � �V �� C Water heater 16.60 len. Ci /State/Zi . :-P A O nf- O t t q -loao
Phone :543 Ra Other: Other: �a - Sil 4 S• I F ax 503 Ce - e wok ' " : Plurnbin : Permit Fees *: - - a: :. ..$'5
•
CCB Lic. #: '7 )r./ J f Plumb. Licit: Subtotal a
Authorized n �" Minimum Permit Fee $72.50 S
Si ��LLt J1 � - j r&) Date! /j 1 / Residential Backflow Minimum Fee $3625 31,0 -. •
G� F dIell t�/) Plan Review 25% of Permit Fee $
�" (Please grin[ name) State Surcharge (ft%of Fe_e) 3 9/11 , G
Notice: This permit application expires if a permit is not obtained within TOTAL PERMIT FEE 3 9 /
180 days after it has been accepted as complete All new buildings require 2 sets of plans with isometric or
riser diagram for plan review.
*FOe methodology set by Tri- County Building Industry Service Board.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
• INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received 36 Date Requested 2 M PM BUP
Location f 2 L fi_ Atrz. r (- ME
Contact Person Ph ( ) Z' PLM O20 — 6Z /
Contractor Gi%r 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 1
Catch Basin / Manhole
Storm Drain
Showe an
Ojher:
i a1;
S PART FAIL
MECHANICAL
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 . S- I - o i o y Inspector ( Th �*'w I No ; Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site. •
PASS PART FAIL