Permit r
C ITY OF T I GA R D PLUMBING PERMIT
PERMIT #: PLM2004 -00360
Ail-. �1�� DEVELOPMENT H BMEN9 Tigard, ) 639 -4171 DATE ISSUED: 8/4/2004
SITE ADDRESS: 12077 SW WHISTLER'S LP PARCEL: 2S103CC -13900
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 086 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
4230 GALEWOOD ST [PLUMB] Permit Fee 8/4/2004 $36.25
STE 100 [TAX] 8% State Surcharl 8/4/2004 $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 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: ..Z LL___ Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busine's day
. .
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Building Fixtures
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Plumbing Permit Apphcatiog r6 , FOR OFFICE USE ONLY
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City of Tigard 4-3.
- l‘ Received mq _ -e , 6
(ft Date/B : , Pennit No.:1 LA h........ p _l b 6 0
13125 SW Hall Blvd., Tigard, OR 97223 0 140. Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 et r-ly :e.:.,••'';ii .'\ Date/By: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 eXIM?A"
__ A i I
Date Ready/By:
... 1 :1 - gr . ) r fifl See Page 2 for .
Internet: www.ci.tigard.or.us NotifietVMethod: j 7- supplemental information
'.,....-::;: . :7 '4 . , - 1:'...:• : `/• ■ .-_,.. ': 4 h e i . ,:i i .0 11 /.Nc . : i i .: ;';;:. " ,.... 4 f . . ■- i . 1 2.:. 7 . .,;:. ....''',..'::.;..: .. • FEE .eFiiiitiiii '''-'• • .
New construction 0 Demolition For special information use checklist
Description I Qty. I En. I Total
0 Addition/alteration/replacement 0 Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
'... '.:-; . :: ,1. - ,:.,!c#1E 941 a 9#404.5T RI.IW • , ..-', .•...,. SFR (1) bath 249.20
6 sk- 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
• . ...- :"7::.:rc . ...--.• - 7 4 '• .': Site utilities .
Job site address: /)07 QA) 1,011,) s fcr Lcz p Catch basin or area drain 16.60 '
City/State/ZIP: - ri qa,1 a o/Q. cf7 D- R-3 Drywell, leach line, or trench drain 16.60
Footing drain (no. linear ft.: ) Page 2
Suite/bldg./apt. no.: Project name:U*11 Stitrs litY,c1) keit IZT" 9ip
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
C LO f 2-i sir A-u <.... 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:U.)1,x', 5 4 - i - c, - !s Oj atiC r r. I Lot no.: go
Fixture or item
Tax map/parcel no.: 6 e lb S . Absorption valve 16.60
: - . 7 . '• •-**'. : : *014 Aii *0)1* ... • - ..: ' .. .. 1.
. „. . • - • - • • •-, . • • -:.; - - - ..- -- • -...- • . ---• :r : ••• ;•:,.. Backflow preventer / Page 2 .27 S...c
Laild se:a_pe, 1 rr 1 gam (...1r1 hack: fitAt:' e ie; Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
-' ' ' ....-'• 1SLPOi ;;;4 . .01
.. -r-, , - .c. •:: -4..... :4,-. .?....... • ,* - -•'. •••••'- • ..-■ •!. ' , --', -- - - " ••••• 4 Ejectors/sump 16.60
Name: Dirt 1?)L- Ss e_ -,1- # /-1. r...s Expansion tank . 16.60
Address: 1 ..--t c ,),30 ...c 1...L.) ii e! 1_4_1 0 oet. Fixture/sewer cap 16.60
City/State/ZIP:Lc& A: c OK Lij <ic, Og_ c i 7 C3 5 Floor drain/floor sink/hub 16 60
Phone: ( ) Fax: ( ) Garbage disposal 16 60
: .,:: ..',,i- Hose bib 16.60
Ice maker 16 60
Business name: Lear a s - eac 0 ,-, 29 0 T: .1.., Interceptor/grease trap 16.60
Contact name: E7i ,..f.,c) zparrerto Medical gas (value: $ ) Page 2
Address: / -)--0 C.) . rr1vS-1 Ayla gi) Primer 16.60
City/State/Z-Mal &tut, , Gk.- • 4 7 7C: (O .c)-- Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: (5 (G' ‘1,..;/ - - 57 *VE I Pax: : (.52'5) 6" 1 .:R - O 164'
Tub/shower/shower pan 16.60
E-mail:
Urinal 16.60
' - '''-: • • -- aoi.itRxc 7 .:. : • . ' . - • .
• Water closet 16.60
Business name:/4 07- gon - c, Water heater , 16.60
Address: f.-,>i& ,..3 to NI LiSloyi, Li Rin, Other:
Subtotal a 7 . Ss
city/state/zip: -- ruiztert-)rt 4 0 R. `
Minimum permit fee: VS Di ....
Phone: (54.. 69Q,;,1 S Fax: (503) (09.Q ..• )749 g Residential backflow minimum permit feer$36.24) ,..5 4o • ,PS
Plan review (25% of permit fee)
1 co:11.Jc.: - 7:C:% Plumbing Lic. no.:
State surcharge (8% of permit fee)
Authorized signa LIA. --t---'-° i PERMIT FEE
Print name ef) „SfiaciIrCk) Dat . 3 64 J 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.
• • • • • - ..- ...---------.
2 .01 dVi:E0 t.o eo 2nu
CITY OF TIGARD 24 -Hour
BUILDING Inspection.-ine: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested —Zd AM PM BUP
Location rl a 0 7 - 7 C-' I &L(dizePA -7 Suite MEC
Contact Person Ph ( ) PLM cd Y -d v 3‘, lj
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC _
Ftg Drain Access: E - /�
Crawl Drain MAW
Slab Inspection Notes: SI
Post & Beam --��
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation I ,
Drywall Nailing Li
s:16
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 / Manhol
Storm a ^
Shower r Pan -
Other: pa, $ r
.aW�Ji
<a> PART FAIL
M ' 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: ❑ Unable to inspect — no access
Fire Supply Line crAR.‘ ( � Q I ADA A pproach/Sidewalk Date ../ U) -- 11 I nspector I O `� Oct
Other:
Final DO NOT REMOVE this inspection re rd from the Job site.
PASS PART FAIL
•