Permit CITY OF TIGARD
� PLUMBING PERMIT
Vii" DEVELOPMENT SERVICES PERMIT #: PLM2004 -00197
..� �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/3/2004
SITE ADDRESS: 12080 SW WHISTLER'S LP PARCEL: 2S103CC -WW281
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 081 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: Irrigation backflow preventer.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES INC [PLUMB] Permit Fee 5/3/2004 $36.25
4230 SW GALEWOOD ST 100
LAKE OSWEGO, OR 97034 [TAX] 8% State Surcharl 5/3/2004 $2.90
Total $39.15
Phone:
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : 503 - 692 - 5945 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: 1 ' J / ��� f Permittee Signature: e � 7�irY�
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next b siness day
May 03 04 07:12a dan edmonds 503 -692 -0768 p.2
Plumbing Permit Application FOR OFFICE USE ONLY
EnvED Planning 3 i No .Za9.- /- »g ao / 5
City of Tigard REC � Sewer
13125 SW Hall BIvd DetdBy: Permit No..
Tigard, Oregon 97223 MAY 3 20 � ' Plan Pa Other
g e •
Pen No:
Phone: 503 639 - 417] Fax: 503 -
Post-Review Land Use
Internet www.ci_tigard or us CITY OF T1 '° s , i ( '�; Date /By: • No.:
runs.; MI See Page 2 for
24 - hour Inspection Request 503 E tt4G a - ' . �L y e� N N a me/Method: .--p(-7 I Supplemental In ormatton.
••• : " ' ' OF-WORK' • ' •' : ^•: •.,j.r : ` FEE*.SCHEDULE Vet, spbdal'itifiithatfon ftieelieckllst)
N New construction 0 Demolition Description I Qty. 1 Fee(ca.) I Total
Addition/alteration/replacement on/alteration/replacement ❑Other: New '- _&2-fan 1Iy :dwellin • • • l;s
- - : • CATEGORYOF CONSTRUCT ION, -:.t:?: c:::;.:-,.,..Z.,.,- ' ' :': ' ; fiududes loo [dreac�i'a ` conaeetionj::..;
f 1 & Z Family dwelling El Commercial/Industrial • spR (1) bath 249.20
(Accessory Building [] Multi - Family R (2) nth 350.00
SFR (3) bath 399.00
❑ Master Builder • [] Other_ _ Each additional baddltitchen 45.00
:JOB S1TE'INFORMATION'and LOCATION''_z .. Fire sprinkler - s4. R.: • Page 2
Job site address:/.0 S. 4.1..' Loh-is t cr - -. . '
/ � t',41� .:'':'�:::� •: "; ..:r:��•�,: ";' ?�= i..,,��;: . •'fie= DL]11�Lies:.
Suite #: I BidgJApt #: Catch b drain _ 16.60
Project Name: (e.` his s t / WC1�.(r i L [Air 3' / DrywelVlt�ch W . linen h drain 16.60
Cross street/Directions to job site: Footing drain (no. linear R) - page 2
Manufactured home utilities 110.00
c(1,10 2-1 �� •.�,• Manholes 16.60
Rain drain connector 16.60
• Sanitary sewer (no. linear ft.) Page 2
Subdivision: u= T"164 UL is Jr I Lot #: 41 Storm sewer (no. linear R) Page 2
Tax map/parcel #: Cr S S 5 Water service (no. linear R) Page 2 • ' ' • - •':DESCRIPTION OF.WOR1c•: - "'1Tuitarear Item '�... -
L6 d c tpG Vac-1chcr.O cte,iiLC2, • B a Absorption Valve 16.60
ter 1 Page 2 �."2_ ss
Backwater valve
16.60
Qom washer 16.60
Dishwasher 16.60
j [ TENANT - : . D fountain
PROPERTY OWNER''. 2.: • ' 16 60
Ejectors/sump
Name E jectors/sump 16.60
Dan / YM C Expansion tank 16.60
Address:4a30 Su) Ga•Lw -'oo cL, Fixt 16.60
City/State/Zip: LD 0 -56 q Floor drain/Boor sink/hub • 16.60
Phone: Fax: Garbage disposal 16.60
?s.APPLICANT .'.: •....... • . Ice m
. Icai r 16.60
Name: .. 4 ' ` � 16.60
61 ! en ai r i O Imtenceptodgrcase trap
Nam 16.60
Address: i .....Cr O ‘1,43 rnytany .RD Medical gas - values S Page 2 "
City/State/Zip: - A . - t .. O t2 970 ( a.-.. Primer 16.60
Roof drain PhoneSt�3 (nom. - 9345 � Fax 3 toy a- o ?(o g Sink/basin/ commercial)
toty, 16.60
E -mail: . Tub/shower/shower pan 16.60
-•: _ - , , ?:CONTRACTOR: ..'..-'.:•.' .. , �; • 7 "::' ..- 1.1 7 .1:::- "`�-`�s� Uri 16.60
Business Name: L -r CLL pt O l sl � -cart Water closet 16.60
Address: ► a-a-° o FYI ctov �J le-1.3. Other: healer 16.60
Zip: lkat . - � Other
City /Statel
1 �. y $ 70( o �• Other I
Sh3 (SIR - 5i Y s F , :::..1.---:-=;-:,.., T S
(mod � ?1or� ;' ..` ..:' I' lutuitihsg :Peitait.Fars$�'.''••�'�j�$ •
CCB Lic. #: '] -
lrlU t 4 Plu axS03 Plumb. Lic. #: Subtotal S
Authorized Minntm Permit Fee 572.50 S -
ar
Signatu emu 1 ] Ja"1 - t Date : - s /3/ x 1 Residential Badttlow Minimum Fee $36.25 3l 0 • �S •
S al Plan Review (25% of Permit Fee) S
(Please print name) State Surcharge (8% of Permit Fee) S e . , lj
Notice: This ermit s TOTAL PERMIT FEE S a9 / S
permit application e xpires era p is not obtained within All new oommereiai
require 2 sdsof plans with isometric or
280 days after it has been accepted as complete. _ riser dsgram for plan review.
*Pee methodology set by Tri- County 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 1 Z ' Date Requested � `7 / AM PM BUP
Location I ! I O' /L Suite 2 --t MEC
Contact Person ���Q�� Ph (� U — S 9cM�� -PIlJ Viz) / 9 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
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
ShowyPan
el - PART FAIL
CHANICAL
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 /0 / Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL