Permit CITY OF. TIGARD PLUMBING PERMIT
f DEVELOPMENT SERVICES PERMIT #: PLM2004 -00357
c� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/4/2004
SITE ADDRESS: 12073 SW WHISTLER'S LP PARCEL: 2S103CC -14100
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 088 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: Landscape irrigation backflow device.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES INC [PLUMB] Permit Fee 8/4/2004 $36.25
4240 GALEWOOD ST #100
LAKE OSWEGO, OR 97035 [TAX] 8% State Surcharp 8/4/2004 $2.90
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
.. ,
. ...
Building Fixtures
‹,.L\t
Plumbing Permit A' , ''-n FOR OFFICE USE ONLY
13125 SW Hall Blvd., Tigard, OR 23 k . ‘. D ae a ceive y .. _ 0 AV II di41/ f
Pennit No73 20,0y-e/t0,5
t. ,.. '13 A.
Plan Review
,.,
Phone: 503.639.4171 Fax: 503.598. 1960K\I , 0 aSe-V `.''_ .. Date/By: Other Perrnit No.: • 24 Hour inspection Line: 503.639.4175 T 4 j% ON° .141, A 1 1 roto
Data Ready/Sy: 0 See Page 2 for
Internet: www-ci.tigard.or.us oN•_*,(2* - Notifiedft4ethod: - Supplemental Information
- • - •. :-.'' L _.. ...,•• ':•:--. ‘:-• • .•:.:' ' iii0. t 7 . ) 4 gic . ..: 7 .'>., 77 ;:j.'_ f.:: ':,;. 'e. ; ' -.. '. n : - ; ,_ ., . . . • EcEEi..s6Htijui:E
New construction • 0 Demolition For special information use checklist.
Description I Qtr. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings (includes 100 ft. for each utility connection)
_ . ...
• " `.;.; . ,' .._. .: 4 _4;CATIEGO* . r...,.(*:10 - 1,54.5 1 :1"010104:,- . i:., .1 ., SFR (1) bath 249.20
and 2-family dwelling 0 Commercial/industrial SFR (2) bath 350.00 •
0 Accessory building 0 Multi SFR (3) bath 399.00
Each additional bath/kitchen 45 00
0 Master builder 0 Other:
Fire sprinkler ( sq. ft.) Page 2
' ?.: : 4 ; ''-7 ' -:" : i .. ‘2. ' e • - ' Site utilities
Yob site address: /OD 73 sw LL) hi i..no Catch basin or area drain 16.60
City/State/ZIP; -Ti q a ok 9 ?-,3,3 Drywell, leach line, or trench drain 16.60
Suite/bIdgJapt. no.: J
I Project name: to h 1 1-tle, s Locui LE Rg. Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110 00
Cross street/directions to job site:
Manholes 16.60
S Lo I 24 ,- tql.) - e_ Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: 1)3 h', si- le...r's Walk- I T j Lot no.: gS7
Fixture or item
Tax map/parcel no.: et) SS 8 G
Absorption valve 16 60
/ Page 2 ,27 S S
La /14 -CC ape', i r r ; ci Cch 0 &Lee' f --- 11:4.0 /; i e e Back valve 16 60
Clothes washer 16 60
Dishwasher 16.60
1 *ta • q" . ,- '-'%' ,,,..,. .- . - Drinking s/sump fountain 16.60
' - ...., f :,..';- .. . 4 .':"..-' , .r.' , ..'; , : '''..','1' I. A5. .,:','".?".- •-
- "' t Ejector 16.60
Name: b CY1 riV5Y7 S S ( -- 7 - # 1-tow) CS Expansion tank 16.60
Address: i cD S LU c..417,...4 cl L&) 0 Clet_ Fixture/server cap 16 60
_ City/State/ZIP:L0- gC 0 -C i_L) -t , i6 c_ ei • 7b3 5 Floor drain/floor sink/hub 16.60
Phone: ( ) j Fax: ( ) Garbage disposal 16.60
''. ..- •-. ''" la ''' '''''' ' ;'-:/'•'''''•
4 ' ' ' '' '' 'PV14 ' 6i4fWei - ii .:‘" if" Hose bib 16 60
Ice maker 16.60
Business name: Let. rid S e.a.f• Oree/CV). l,i C__: interceptor/grease trap 16.60
Contact name: E7) ..24 -Sp cir, Medical gas (value: S ) Page 2
Address: / ...--0C) 1 I N
* I n 1 04 All ti go Primer 16.60
City/State/UP:11M/ ittlfv, , 0 k.- ' q R.: (C c'--•-• Roof drain (commercial) 16.60
Phone: (5413) L',/ ,;? - ..S.3 14 7.5 - Fax: : (.503) & F,,q - 6; 767 S" Sink/basin/lavatory 16.60
Tub/shower/shower pan 16.60
E-mail:
Urinal 16.60
. . .
, . .
. - • , ' • -: • • • •-" - !--• i - , • •• • •. Water closet 16.60
Business name:Lr 0- z.. c Water heater L6.60
Address: / , ? - .D.. - 00 ....3 Li) /y) ti Sibyl Li R.4 Other:
Subtotal
City/State/Z1P: - 7 7, t a z e L _ 7 , - 1 rt Joie_ `
Minimum permit fee: S72.50 , ,
Phone: i3) t 5 Fax: 6 6,9Q - 07 67 g Residential bacicflow minimum permit fee: 536.25 1/45 (AP. -
CCB Lie.: 7
tC.) Plumbing Lic. no.:
Authorized sign .1, „.„,„..
e_..4 Plan review (25% of permit fee)
State surcharge (8% of permit fee) .. .
ta 0
TOTAL PERMIT FEE 3 9 , ( s
Print name// ei _S.', I Dat. R/3/C ) L I ' This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tn-County Building Industry Service Board
- - 2'd d02:60 I'D eo 2n11
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503 63 75
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested - AM \ PM BUP
Location / -v 7 3 Suite MEC
Contact Person Ph ( ) PLM .3 0 'S 7
Contractor 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 -7 /FT y o//
Framing " - "� i 1 ' b
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 0
1 A
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 V /� Approach/Sidewalk Date Inspector `� �./t Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL