Permit 4 ® CITY OF T I GA R D PLUMBING PERMIT
100 lt DEVELOPMENT SERVICES PERMIT #: PLM2004 -00087 DATE ISSUED: 2/26/04
- . 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12083 SW WHISTLER'S LP PARCEL: 2S103CC -WW284
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 084 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: Install irrigation backflow preventer.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES
4230 GALEWOOD ST [PLUMB] Permit Fee 2/26/04 $36.25
STE 100 [TAX] 8% State 2/26/04 $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 RP /Backflow Preventer
hone : 503- 692 -5945
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:
/ ,‘1_ . _ g ____
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Feb 25 04 12:46p dan edmonds 5 0 3 - 6 9 2 - 0 7 6 E l p . 1
FOR OFFICE USE ONLY ' . .
i ilotcation
1, v. Received Plumbing
DaldBy: (iis;rovat/ea bi ?emit No.: P<I'l
City of TigarP
7.9ilk Planning
Date/By: Sewer
Permit No.:
13125 SW Hall Blvd. E. c e , A 6 , C Plan Review Other .
Tigard, Oregon 97223 41\1 40 Datell3r•
Post-Review • Penult No.:
Land Use .
Phone: 503 6 No.
Wit-ii Date/By: • Case :
1 El
Internet www.cilig . See Page 2 for
, . i eV. G I I ; 11 Contact .
7, e •
24 Inspection Req t - i . 503 - Name/Method: ) (•,,, Supplemental Information.
•'; I: •.. . .:•••• '•:..f WOR1C • • . ..: '. ' : li=11': ::-..: :','-- TEEe'ISCHEDULEItiir:orkettiant'aibiallotfaieidieddlig" :• ".
New construction
El Demolition
Addition/alteration/reylacement On Other: I - Description j Qty. 1 Fee(ea.) I Total
•'. ',".," .*.• ": ...: •••';•• 4 ';' , Nevi i=li gs' :. • • z• •, -;"' - - -• ' • .
!-. ,...!•, -, • ,.- ;...(ineliklii.100 it..Dir utility ermaccdisn):•'::: : - • - - ,,
• .- • . •';:-. CATEGORY OF CONSTRUCTION!...:::;+.11:;:.:, '.• '-j•-::,. SFR (1) bath 24910
al & 2 dwelling -- Commercial/Indtistrial
sFR (2) bath 350.00 ,
ccessory Building , Multi SFR (1) ' 399.00
bath
0 Master Builder Other: I Each additional bath/kitchen 45.00
'JOB SIT.R INFORMATION iitd-LOCATIOW:::' Fire sprinlder - sq. ft: Page 2
-
Job site address: i a o cs3 ....cw. Whi te; I LD - ? , :.'‘z". ,- -• - • - Y:••• •:.:,...i': ..7,
Suite #: 1. BldgJApt#: I Catch basin/ area drain _ 16.60
Lo
Project Name: L DrywelVleach line/trench drain 16.60
13/11.0 j
(.)a113(..-ii" r e if .
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job site: Manufactured home utilities 110.00
Manholes 16.60
,i..i."). 'at ST . Ai....-c, Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision:a- k■ Sri e(s ii)aii< 71.7 I Lot #:l k'N Storm sewer (no. linear ft) Page 2
map/parcel #: co
Water service (no. linear ft.) Page 2
Tax SS' 13 %.Z. ;: Ffitten'i tiiiiiii • '.--... ' ."'': :::.:• ::. .. • ' - :••••";
.,.. :: i .• . - : ::-., • DESCRIPTION OF WORK - ..;:":-=":!......:="*.s, : :-, ' .; - Absorption valve
Larldg Cape. VOLGIC et C.,(-) j) Baddlow preventer i Page 2 X7- SS
Backwater valve 16.60
Clothes washer , 16.60 ,
' Dishwasher , 16.60
• Drinking foimtain 16.60
7'1E4:PROPERTY:OWNER': ••••• •-•• 1' 0 TENAIrt r-P-ii-':•. ;... :":,
Ejectordsunip 16.60
Name: Davi /II (NY'as.41.41.e. i-itrwleS I Expansion tank 16.60
AddreSS:4A 30 .S..U3 &at.a.v-3•00 CU Fixture/sewer cap 16.60
City/State/Zip: 1./3.4(--. C q1C1-3g Floor drain/floor sink/hub - 16.60
Garbage disposal . 16.60
Phone: Fax: Hose bib , 16.60 .
- 15LAppLICANT. ....'. r :.; . ; 2: 'SI - --' SICoNTACEPEIRSON: Ice malox 16.60
Name: el I cr) s.pan-a-up I Interceptor/prase trap 16.60
Address: 1 ....-0 0 CIA nI9sitM11 (W I Medical gas - value: S . Page 2
Primer ,
City/State/Zip: TtAiLial 0 A. 4 )10 (.0 4 - i 16.60
Roof drain (conmiescal) 16.60
Phone SO3 f.gocia- - 9i 1 Fax tog a.- 437/0 g Sink/basin/lavatory . -
16.60
. .
E-mail: . Tub/shower/shower pan 16.60
?,-% ';''.:.* -..,-: ..'.':',:;•?-; ';:.': -7. - :':i...., ''.1,.-._.:: Urinal 16.60
, ..
Business Name: La_rldscapt_ 0 rcidy% 1-r. a Water closet 16.60
Water heater 16.60
Address: P-?-00 SW rii tA-CUrny ten.1 - Other:
City/State/Zip:mAtutixttk- ""t R..... Other:
PhoneSie 0 a - 594 5 FaxSD3 (p901 - )f7 .- . .::.::-,---.::--,....." - •,- - .-__, - ,
CCB Lic. #: - 7e0 , -1 Plumb. Lic.#: I Subtotal S
fvlinimum Permit Fee 572.50 S
Authorized g lizin
Signaluts../C __Ai Date:?P611.34 Residential Backficnv Minimum Fee S3625 '-''gli ' .,
PI= Review (25% of Permit Fee) , S
Eli en Soa‘ r 1 State Surcharge (8% of Permit Fee) $ e2
(Please print name) TOTAL PERMIT FEE - S .,9. /_ S
Node= This permit application expires if a permit is not obtained within An new commercial buildings require 2 sets of plans with isometric or
lad days after it has been accepted as complete. riser Annan for plan review.
- *Fee methodology set by Tel-County Building Industry Service Board.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
4 BUP
Received A? 6.5- Date Requested ,/l e/ AM PM BUP
Location /2 0 A� //t/ 4 Suite S'SL MEC
Contact Person (V.P.PArj Ph ( ) TO l2 ^ S9 VS ilr) -OW
Contractor r_ i2 Ocf2 6 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 AWM
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
P FAIL
F+11'
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Sho Pan
Ot er: Q de
Final
t AS PART FAIL
E 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
ADA
Approach/Sidewalk D Inspector Ext
Other:
Final DO OT REMOVE this inspection record from the job site.
PASS PART FAIL