Permit _ "w
CITY TIGARD PLUMBING PERMIT
0,A PE SERVICES PERMIT
#: PLM2004 -00358
.,��i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/4/2004
SITE ADDRESS: 12072 SW WHISTLER'S LP PARCEL: 2S103CC -13000
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 077 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
4230 SW GALEWOOD ST 100 [PLUMB] Permit Fee 8/4/2004 $36.25
LAKE OSWEGO, OR 97034 [TAX] 8% State Surchan 8/4/2004 $2.90
Total $39.15
Phone:
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : 503 RP /Backflow Preventer
Final Inspection
Reg #: LIC 7804
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR
952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)
246 -6699.
Issued By: . .7 'Sf/c, Permittee Signature: r,.{_ p
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Building Fixtures p,Uli v S
Plumbing Permit Application jr ��p� @ L e l. FOR OFFICE USE ONLY
�1� �� @t�
City Of Tigard e Raeee�(�� 3 � iv v Pemti,140.:?l��0"Qy e6 3 y
13125 SW Hall Blvd., Tigard, OR 97223 1latC Jt
Plan Review Other Permit No.:
Phone: 503.639.4171 Fax: 503.598.1960 4 �•: - ,.�,;; i ,' N Date/By:
24- Hour Inspection Line: 503.639.4175 ' Date Ready/By: �' " See Page 2 for
Internet: www.ci.tigard.or.us J Notified/Method: ) I ( Supplemental Information
- - ° -- _ mfilisHbv "%t'.•, - - ~ T",:-: .� ( •FEE• `SCIi$DiLJI:,E'
Ig
New construction El
Demolition For special information use checklist
Description 1 Qty Ea. 1 Total
Addition/alteration/replacement ❑Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
- .. , . CATEG_OR Y:- OF.0.; RUC*)N., . , r SFR (1) bath 249.20
IFLI- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 4500
❑ Master builder ❑ Other: :
_ Fire sprinkler ( sq. ft.) Page 2
r , - _JOS S1�,F},I FORiV iiiiOIt; ;LCOATION, :, : r
. , .
- ., _ _ Site u tili t i es
Job site address: /,D.070 SQ.) CL) iii S - (GAS I-00 e- Catch basin or area drain 16.60
City/State/ZIP: - I/ /Ct/t. ( Q R c 7 0-,?...3 Drywell, leach line, or trench drain 16.60 I
Suite/bldg. /apt. no.: I l Project name h ISt (!'S Wct(f Z>_ - Pet VW, Footing drain (no. linear R.: Page 2
Manufactured home utilities 11000
Cross street/directions to job site:
Manholes 16 60
ll.) I Z i Sir {r1) L Rain drain connector 1660
Sanitary sewer (no. linear ft.: Page 2
Storm sewer (no. linear ft.: Page 2
Subdivision: LC) h i S / J L Lot no.: 77 Water service (no. linear R.: ) Page 2
Tax map /parcel no.: () SS ('S S -
bsor
A t or item
Absorption valve 1660
. . - - ,'`DECRIPT'ICON OB',WQMS • •'a ;): • • '- , .. Backflow preventer / Page 2 D7 . SS
/fin S(' a_ rr • C u 07) • U -# /..44) de )i 1 Backwater valve 16.60
Clothes washer 1660
Dishwasher 16 60
_ Drinking fountain 16.60
. - X - _ �. y am - • -- PRb PERTY:- OVV.IVER•: -.; � _:1., " .: i •y .. :'{ ' PFT ::t....;„..-;,::: Ejectors/sutr� 16.60
Name: 7) t +' / / ni , - / S S f f How) t' J Expansion tank 16.60
Address: fa 3 L) ,S UJ & <-( CAL NO oct Fixture/sewer cap 16.60
City /State/ZIP:[_(.`i g C, C) S r_U cc7C j O/2_ y 7 C 3 5 Floor drain/floor sink/hub 16.60
Phone: ( ) f Fax: ( ) Garbage disposal 16.60
' ".,Tf > , ry,izt,. i c
y,i.7 ,;,.,b m , _,x v • ,;(: Hose bib 16.60
• P LiCPi'IT • - ...- >� r :` •' G(I1 CT " YP SO G:
�
•_ ..::: �' •.•,: � . s -,: • . � , , ; - Ice maker 16.60
Business name: LtiJ(j ; e!1/ o_ or ' _L� Interceptor /geese trap 16.60
7 V i
Contact name: r.--=';./' n y Medical gas (value: $ ) Page 2
Address: j D-00 S, LU miiS-I ern j PI) � Primer 16.60
City/State/ZIP:-tu / n_ , 00.... , j 6' (c c; Roof drain (commercial) 16.60
Phone: (5e3) (G e/; ---.5- 5 I Fax: : (,..5 & y.:_q _ 0 767.S. Sink/basin / lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
• ,'- dol*It'Re C�101i ^. : ' Water closet 16.60
Business name:Lr /SeL t i Orr - I /Uri �— G Water heater 16.60
Address: /� Other
a - .� - oo S ID rn y.�lr � Oth
City/State/ZIP: 7/„Le ,[f -,r "0Q ` 7L3� sobtntal
Minimum permit fee: 572.50
Phone: esu,3) (pl/� s•77 Fax: (-G3) �9a - 076, g Residential backilow minimum permit fee: $36.25 3 1.o' ° 5
CCB Lie.: 7 i3 U Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized signs j�i1 State surcharge of PERMIT fee) /0 p
TOTAL AL PERMIT FEE 3, IS
Print name `I eil I Dat• 3/01 This permit application expires if a permit is not obtained within
f' } 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
Z'd - -- - dzz :ED trD CD 2nd
CITY OF TIGARD 24 -Hour -
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested s -zd AM PM BUP
Location / .2-0 7 of uti Gujei±gez Suite MEC
Contact Person Ph ( ) PLM ,Roo 3,Se?
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing . ELC �_
Foundation Access: /
Ftg Drain E L - /
Crawl Drain Inspection Notes: S
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation (1 „ -�'
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 n
Other:
_i:. c 1
___
PART FAIL •
ME 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 20 0 Approach/Sidewalk Date � lJ Inspector f: Ext
Other:
Final DO NOT REMOVE this Inspection re rd from the Job site.
PASS PART FAIL