Permit C ITY OF TIGARD PLUMBING PERMIT
P ERMIT #: PLM2004 -00391
tw�� DEVELOPMENT SERVICES DATE ISSUED: 8/27/2004
j
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
•
SITE ADDRESS: 12082 SW WHISTLER'S LP PARCEL: 2S103CC -13500
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 082 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: Backflow device.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES [PLUMB] Permit Fee 8/27/2004 $36.25
STE 100 GALEWOOD ST [TAX] 8% State Surcharp 8/27/2004 $2.90
STE
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 - 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: ,Z) ��., Permittee Signature: i
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business�ay
RECEIVED
Buij.dint Fixtures r
Plumbing Permit Applicatirdk 2 6 2004
FOR OFFICE USE ONLY
City of Tigard CITY OF TIGARri Receiv _
13125 SW Hall Blvd., Tigard, OR 97223 BUILDING DIVI Pla Re Qy Pemvt �� 7�yl ��
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review t/� ! /
24- Hour Inspection Line: 503.639.4175 I l i �'■ 1htrJBy Other Permit No.:
Internet: www.ci.tigard.or.us Date Ready/8y !wv ® See Page for
NotiBed/Mcthod t ) ' I Supplemental l ta(oratatlon
• - TYPE OF .WORK : • .: - FEE' . SCHED•LE :
,
For special information use checklist
NNew construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Other Description Qty. I Ea. I Total
•
New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF - CONSTRUCTION.. : • 249.20
SFR (1) bath
1- and 2- family dwelling ❑ C - ommerciallmdustrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder CI Other:
TOW 5 E LIIFORMATIOTI ;AND' LOCAT[O1V Fire sprinkler ( sq. ft.) Page 2
` - . ..
Job site address: /oZi�3 '1 (�'� Loh; � Site utilities
ea d µ ,54- j coop Catch basin or area drain 16.60
City/State/ZIP: 'III f (, i tt Q�
/ Cr 7 a-33 Drywall, leach line, or trench drain 1 6.60
Suite/bldg./apt. no.: I Project namej,v LV £_ L07- keg.-- Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: Manufactured home utilities 110.00
,IA) / �/ �- Pt-tie- Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivisiah j %tieeS �� A
l IL I Lot no.:�� Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: L9 S S 8 S Fixture or item
'DESCRIPTION OF WORK • • . • - • Absorption valve 16.60
Backflow preventer
/ Page 2 ,.,27, $S
✓!) (4.ejC f , Oz.(' G%/e : , Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
�PROPERT e..=OWNER•. _ Q ,fp .l 16.60
Name: ,� I' n . , J . . • - .
EjDrinking fountain
ecWrs/surr>p
�[/' ' #7 SSC'.f /1 16.60
Address: 4 -7 4 ,; . ) > Expansion tank 16.60
3 L2 S ti_i G<<(c C CIO e-,c'L. Fixture/sewercap
' _ 16.60
City/State/ZZIP:
� /,' G (% .. L(.) I G Q/2 . y 7 [yam 5 Floor drain/floor sink/hub
16.60
Phone: ( ) Fax: ( ) Garbage disposal
16.60
• XAPPI:ICANT ' r UItITA,CT :pERSOAI ' - Hose bib 16.60
Business name: L ! ' S - Ice maker
l ei,p -r,: 0I !'lj[,3'1 T's ,, 16.60
Contact name: ; .+ { Interceptor/grease dap 16.60
f .� ��� ``'� Medical
Address: / -CC) £ [..L) gas (value: S ) Page 2
/iv 12 Cr/ /Ma Primer 16.60
City/State/ZIP:T 1 u�n J ' J j 7 G ; (6Z Roof drain (commerc
/ "�- 16.60
c3) & C/ -S.-VC/5- Fax: / 76:4'
Sink/basin/lavatory
I (Sc3) t^ 9�� - G` or y 16.60
Phone: (S
E -mail: Tub/shower /shower pan 16.60
CONTRACTOR _ Urinal 1660
Business name:' - • • Water closet 16.60
�1 <•/)L!Seey:).G 07 4-9o- -r Z- G Water heater
Address: I 1 6.60
/, -,)-GG S 1/) rn Li _S-1 CY) la r: I I Other City/State/ZIP: ' --in "/Q "*74,)62 •s-- Subtotal
Phone: (56.3) (tyYo2 S.S Fax: (�G. Minimum permit fee:
`
��°� d 7 (Cr g Residential backflow minimum permit f - 34p -
CCB Lic.: 7 ec )
State surcharge (8% of permit fee Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized sign 7 S
LP-IL . fc LG
a, y
Print name `l Wi TOTAL PERMIT FEE -' / Dat t : This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
i:�outleinMert,du1P[�1tr- rm,r,w e.,c ,gym. ..- ,.�.•- Y -- _ 'Fee methodology set by Tri-County Building Industry Service Board.
d 2S : EO 4,0 92 2n1:1 Z•d
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 13- Date Requested 9 q — ? AM PM BUP
Location / - O D-- LIt_ kA /!/J Suite MEC
Contact Person Ph ( ) PLM,GY) C IO 0 3 9
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 /W
PASS PART FAIL -N Cam / /
PLUMBING
I / i
Post & Beam
Under Slab
Rough-In /C� i
Water Service
Water f
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain -
Shower Pan �i � .
....._
Other: /''
y •
- PART FAIL ,�- f
�'il {' HANICAL �'-
Post & Beam f i .
Rough -In
Gas Line .
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 0 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: 0 Unable to inspect — no access
Fire Supply Line
ADA
/17\e,
Approach/Sidewalk Date �I Inspector Ext
Other:
Final D • NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL