Permit C ITY OF TIGARD PLUMBING PERMIT
,A DEVELOPMENT SERVICES
PERMIT #: PLM2004 -00280
`- .,1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/21/2004
SITE ADDRESS: 12071 SW WHISTLER'S LP PARCEL: 2S103CC -14200
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 089 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 [PLUMB] Permit Fee 6/21/2004 $36.25
4230 GALEWOOD STE #100
LAKE OSWEGO, OR 97035 [TAX] 8% State Surcharp 6/21/2004 $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: 444-4, i <�=7 �A Permittee Signature: /)i (I� Ly I
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Jun 17 04 03:41p dare Vmonds 503 -692 -0768 p.1
Plumbing l Ter • A p p • Calf• - - < FOR OFFICE., L SE, O:lLY = fn
fiffriera O (<- j L\� s
City of Tigard �`� c�® .. • Permit
13 125 SW Hall Blvd- 't V . - AV Other
rtiVo.:
T Oregon 97223 O 0\ ,:,
Phone: 503- 639 -4171 Fax: 5Q ( 960
Post-Review
• vmew la use
Internet www.citigard or ns 3 , •3 \\ ci �f . i' (� No.: _,
'✓L1
24 - hour Inspection Request 503' - 6394175 'C raai. Name/Method:
• ..Y •: - "TYPE :OF WORK '4. , - :.. •.` FEE' •SCEF -41. L''ES(t'or sliecial fo'timatloo:ase ctieeldistj ' • • •
1I New construction I 0 Demolition Description I Qty. I Fee(ea) { Total
0 Addition/alteration/replacement I ❑ Other. •: �:.t� r•i &2- fainity :dwellings - : • >
• CATECORYOFCONSrRI1C1ON::::: _.: ;r :_: (roan. 10011. - � ycona«6a)..:,
& 2- Family dwelling Commercial/Industrial SFR (I) bath 249.24
SFR) bath I 3
Hi 00 Building Multi-Family SFR (3) bath 39900
Master Builder • ❑ Other: Each additional bath/kitchen 45.00
: : JOB SITE' INFORMATION ^andLOCATION•'::::::` Fire sprinkler - sq.ft: Paget
Job site address: f ;C)•7I Le `ti st1 i i Lane,
Suite #: I B1dgJAEt: #: Catch trasin/area drain 16.60
• Project Name: LC Lc; , r 27. rte;% • y9 j-k'cc ell
Footing drain t ae/tre arairmm 16 -60
Footing drain (no. linear R) Page 2 •
Cross street/Directions to job site: Manufactured borne uh7itia 110.00
Manholes 16.60
i 2 9 - A-o c Rain drain connector 16.60
Sanitary sewer (no. linear IL) Page 2
Subdivision: 1-01-0 T i . I Lot #: g9 Storm sewer (no. linear 11:) Page 2
Tax map /parcel #: (� S $ S Water service (no- linear ft.) Page 2
' -• . " ..(:.DESCRIPTION OF WORK • : ` = :- = . - : "Fi�temt re oi
A
Lands CCa() e- Va.C.iCii B valve 16.60
ci.t) CIO- L Ce) aokflow preeventer 1 Page 2 ..X7- SS
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
�- Drinking fountain 16.60
`A.PROPERT.Y: WNEIr:. : 4 °TENANT• '.-:::;-.-::'-"-",.1.,:'.4.' f Ejectors/sump 16.60
Name: Dpy, m O - Ui'Yr1C Expansion tank 16.60
Address:g z 30 Six) &c.1-1..€2.u.300 Cl., Fier cap 16.60
City /State/Zip: t..0-4e_ -e 6 C17LL3 z Floor drain/aoorsnk/hub • 16.60
Garbage disposal _ 16.60
Rase brim 16.60
? 0. ' P1 CANT :........ i<4 :CONTACTPE1tSOld F .; ;`: lee maker 16.60
Name: el ! cri •}4rfd - r..O Interceptor/grease nap 16.60
Address: I ,,:)..00 CL Irin9s4.0Ytt.1 12D Medical gas - value: S Page 2
City /StateJZp: a r - 0 1q' 4 )24 (n Roof cram (commercial) I6 6 0
PhoneS03 (o ga. - 9145 I Fax5S3 Via.- owl S Sirddhasinnavatory 16.60
E-mail: . Tub/shower /shower pan 16.60
�:' '• CONTRACTOR .. Urinal 16.60
Business Name: trI LSCa pt_ O Midin - - r-in c, Water heater • 16 .60
Address: [? -a-OO Sail {'Y1 1 t ' 1ex . Other:
City /StateJZip: --t R..... gZate�- Other
-
PhoneSba3 (t1 - ON 5 FaxS)3 WA - a?(o E , ..'.':'` ,.-_ <<, , . P1 emit l :Pei iiit- Feee''. ` . ? •
• CCB Lie. #: '7&1'-I Plumb. Lic. #: Subtotal S
Minimum Permit Fee $72_50 $ 3 • Authorized . d ine -C
S t n p In . 1 , Dated:. j 1•7 10-I Residential Baddlow Minimum Fee $36.25 �S •
Eli �`- Plan Review (25% of Permit Fee) $
E 1 &) St ate S - .: 8% afPemrk Fee $ - ,
(Please print name) TOTAL PERMIT FEE S , :9_ / S
Nati= Thb permit appGmrion expires if a permit is not obtained withht - All new commercial buildings require 2 sets of pilaus with isometric or
i8p daps after it has been accepted as complete- riser dip' gram for plan review.
-- 'Fee methodology set by Tri .Connty 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 Date Requested AM PM BUP
Location /-16 �
/ �( J eA Suite MEC
Contact Person Ph ( ) s c1 '1'5 ?e)
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
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
re
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan • p
Ott r• tre
•A • PART FAIL
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 Approach/Sidewalk Date —
• Inspector Ext
Other:
Final DO N s T REMOVE this Inspection record from the Job site.
PASS PART FAIL