Permit r CITY OF TIGARD PLUMBING PERMIT
� DEVELOPMENT SERVICES PERMIT #: PLM2004 -00359
I 13125 SW Hall Blvd., Tigard, O R 97223 (503) 639 -4171 DATE ISSUED: 8/4/2004
SITE ADDRESS: 12075 SW WHISTLER'S LP PARCEL: 2S103CC -14000
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 087 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 GALEWOOD STE #200 [PLUMB] Permit Fee 8/4/2004 $36.25
LAKE OSWEGO, OR 97035 [TAX] 8% State Surchan 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 #: L1C 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: :±2.2_24
Permittee Signature: J p5\f
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
• -
Building Fixtures
NE Plumbing Permit Applica C�� v FOR OFFICE USE ONLY
City of Tigard oO t RCC1Vy 7 ...,t)(/ ) Permit No.: LM 28 f 9
1`�
13125 SW Hall Blvd., Tigard, OR 97223 pl l Plan Review
Phone: 503.639.4171 Fax: 503.598.1.960 ! ; ,, :.;(1;, \ Date/By:
� Other Permit No.:
24- Hour Inspection Line: 503.639.4175 T Y ® , ` ' ''1.L, r _ Date ied /Mc By: `T S See met P cnt al for formotion
t Notified/Method: i Supple to
Internet www -ci.ti ard.or.u B i
o )r • -, -, F' ;;. ,. F EE" 'SC
For special information use checklist.
"New construction El Demolition
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
•CATEGORY'. O., v TRUC•gaON.',: `• , - SFR (1) bath 249.20
1 -and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ building ❑ Multi family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
. ,,,; „ dO8'S1f , INFORM TXO)!4 &) L'UC0Ib1V' ' ,, . - Site utilities
Job sue address: / ao'75 s4,-
t) W hi S f - f i , ( o p Catch basin or area drain 16.60
City/State/ZIP: 7 i 6) -4.CL pit 4 -) a,3 Drywell, leach line, or trench drain 16.60 I
Suite/bldgJapt. no.: Project nam4j•() hi sf(tits W(•e>' ka - rish� l Footin drain (no. linear ft.: ) Page 2
u0r Manufactured home utilities 11000
Cross street/directions to job site:
Manholes 16.60
S Lt.) 1 2. ( 14 Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: - ) Page 2
Subdivision: UJh j •S f - / - 4�5 [,U CUIC. L L 1 Lot no.:F7 Water service (no. linear ft.: • ) Page 2
Tax map /parcel no.: (p S 5 6s Absorption Fixture or ite
Absorption valve 16.60
' • - - '_'DE ggrPON 9? ,**S: - - i:0 • , : , Backflow preventer / Page 2 a
7. SS
Lct-nd s(' a _ p e , i rr/ 1 U M o ' Y ) h( / -ce 2 I AO c -Ie . %/ e.4' , Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
�. .: i z 'k - Drinking fountain 16.60
• -- PR�AERTYr GVPIpg :;. =,,. ,r,°., - ': a • rt` .. 5 =' ' 4..4 ' 16.60
Ejectors/surnp
Name: l !v /li (; ) r / S S t f How) e _s Expansion tank 16.60
Address: 0 ,5 LC! &.f.-<. ( e. CAD 0 oct FixtureJsewer cap 16.60
City/St ate/ZIP:L t - g_L 0 _c Lt.) •Cc%cj QI& e / . 7b3 S Floor drain/floor sink/hub 16.60 _
Phone: ( ) Fax: ( ) Garbage disposal 16.60
xcy: a.i,S.Y *fir z. s� :+•r Hose bib
16.60
- .. :;: XCA ..., `: ;.. (tf1 l rao•i'E'F3RSUi4,4 1, •
r 4: ice maker 16.60
Business name: L ((s C.0 p-% (3/ -•G' ' Cj - n �ir, [nicer eptor /grease trap 16.60
Contact name: .'
G� � ,� z p ( -/'jr , Medical gas (value: S ) Page 2
Address: i 3 - Q ¶.w f)1 S J I v n LI RD Primer 16.60
City/State/ZlP; -p . (Lt � t j 7C; (0 ) Roof drain (commercial) 16.60
Phone: (5e3) (G e'.-2 -5 I Fax: : (,503) & y� - G •„.7& ��i Sink/basin / lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CO N`1i RACE UR y _ , . Water closet 16.60
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Business name: a Seu/ O fo7 G Water heater 16.60
Address: /(�� Other:
�• a:� --tea S �c� rn S - /rim• �
/it� -fin ` `4' 700 Subtotal
City/State/ZIP: 7 (
Minimum permit fee: 572.50
Phone: C54.3) (DQ, S S ' Fax: (503) (9Q - 070 r Residential backflow minimum permit fee: 536.25 3� - as
CCB Lic.: 7 kU Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee) a • 9U
Authorized sign,wet Lz �t 7 TOTAL PERMIT FEE 3 /
Print name'/1 e) -/ /r j`u, Dat :g 3 (C)L-1 This permit application expires if a permit is not obtained :.ithin
180 days after it has been accepted as complete_
*Fee methodology set by Tri -County Building Industry Service Board
a . d d9 :60 .00 CO 2nu
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: p3) 639 -4171 MST
BUP
Received Date Requested s3--- AM PM BUP
,Location .)-0 7 T w Suite MEC
Contact Person Ph ( ) PLM •DD y vd
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC ��
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT Mill
Post & Beam M'.
Shear Anchors i //
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
Catch Basin / Manhole
Storm Drain
Shower Pan 4a p
Other:
gretilk
PART FAIL
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 0 Please call for reinspection RE: D Unable to inspect — no access
Fire Supply Line
ADA ".. N
Approach/Sidewalk Date 1 2 0- Inspector � ' N �� Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL