Permit C ITY OF TIGARD PLUMBING PERMIT
� DEVELOPMENT SERVICES PERMIT #: PL
J II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/9/2005
PARCEL: 2S109DA -04200
SITE ADDRESS: 12798 SW WILLOW POINT LN ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 019 JURISDICTION: TIG
Project Description: Backflow prevention device for irrigation.
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
Owner: FEES
DON MORISSETTE COMMUNITIES LLC Description Date Amount
4320 GALEWOOD ST #100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 11/8/2005 $36.25
[TAX] 8% State Surchari 11/8/2005 $2.90
Phone : 503 387 - 7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD. REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Phone : 503- 692 -5945
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- : • ough O ' R 952 -0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
callin• 03- 6 -66• : • 1-8Q-332-2344.
Issu = d By: = . � !�� �. J _ Permittee Sign .4310,,-.
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building fixtures
STa'baS'O�/y/
g
Plumbing Permit t A E `' `.
(( DIjD Il ., Ga .t w 1 W FOR ■ :OFFICE USE OWN
City Of Tigard • Received / Q Jut .
Tigard, OR 97223 NOV tcB Permit No.: /Jj�(�'� at //
13125 SW Hall Blvd.,
Phone: 503.639.4171 Fax: 503.598.1960 ' " ®� o 1U 1 Plao Revie °"`~�
24 Hour Inspection Line: 503,639.4175 �,.' Other Permit No.:
,., 1 1 :\ Date/B
Y
Internet ww echo Line:
CITY OF TI ! . _. Date Ready/By: j 1 ®Sce ee ar 2 t
A 1 Notified/Method: w
�� "R SWP( Pa nf�l [nformatlon
j\EI T UTM DIVISION FEE- SCHEDULE
New construction
0 Demolition For special information use checklist.
❑ Addition /alteration/replacement Description I Qty. I Ea. j Total
❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath
MI
1 - and 2 family dwelling 25
❑ Commercial/industrial SFR (2) bath 350.00
o
❑ Accessory building O Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder 0 Other:
*' :: Fire sprinkler ( sq. R) e 2
' ..• :.., . „•, : ` .JOR SI .INFORMATIOV•• i4P4D • LOCATIO N Page
Job site address: , /�, Site utilities
!ate G ` 7 S W Wt) Imo 1 a 1n+ Catch basin or area drain 16.60
City/State2IP: 7-/ �� Q 7 -
9 a-� Drywell, leach lime, or trench drain 16.60
Suite/bldg./apt. no.: I Project name: Footing drain (no. linear ft: ) Page 2
�i�rnmlt �lGt�e� 9
Cross street/directions to job site: Manufactured home utilities 110.00
SW 6 L e� Q n N d_ t p n Manholes 16.60
�""' `- 1� f,J Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
ILO M l •�QQ I Lot no.:IQ
Water service (no. linear ft.: ) Page 2
Subdivisio
Tax map/parcel no.: b S' s- A_ I Fixture or Item • ` • Absorption valve 16.60
.. : • DESCRIPTION OF WORK
/ , / ` Backflow preventer Page 2
L SL ap6 /rre 0 O Uri box/cf G�t°L[! j Backwater valve 16.60 a 7 �_
C Clothes washer 16.60
Dishwasher 16.60
` - '''.. :•; "•r. - ...... I *.'.Q • • Drinking fountain • �' :.: . 0 `I'E11A1�7 16.60
Name: D� PY ' ss e.7 i. HOW) a Ejectors/stlarp 16.60
Expansion tank 16.60
Address: i---/a 3c) S W Gezi et-a.) o oc
C Fixture/seater cap 16.60
City/StateJZIP:( .fie OE w er0 Ole. 703 3 S Floor drain/floor sink/hub
16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
' . • (-. AP•P' T • .. • Hose bib
, = CONTACT•PERSO • • - 16.60
i . T�r''1 C._1 Ice maker 16.60
Business name;
L.�ld .5 Ciao -� Ore a
Contact name: / Interceptor/grease trap 16.60
� en ( , . (Z TY Medical ) P
Address: a lt� I gas (value: S Page 2
NS-111 j �Q Primer 16.60
City /State/ZIP :-j,� Q-tln. , Gtr , .J q 700 Roof drain(cotrtmercial)
16.60
Phone: (503) (G C _.�9(iS I Fax: : (5 6. Q , Q - C.','� Sink/basin/lavatory 16.60
E-mail: Tub /shower /shower pan 16.60
Urinal 16.60
'•CONTRACTOR •
Water closet •
Business name: L�Lf.See.ep L O 11)? �) G Wat h eat er 16.60 �.
c/ 16.60
. .-(0
Address: / ?O s /f J Ll Si(� �^ p (.r p , � Other.
•
City/State/ZIP: 7741/..14/4-?n, 7741/..14/4-?n, ( HZ -/ I ie i._ _ sub
Phone: 3) � Sy�� Fax: 7 r' Q v? Minimum permit fee: S7.50
�p g' Residential backflow minimum permit fee: 536.25 as' ' c
CCB Lie.: 7 to Plumbing Lic, no.: Plan renew (25% of permit fee)
Authorized sigma State surcharge (B% of permit fee) a.. q0
40a4,4,..er.4
TOTAL PERMIT FEE 3 y . 1 s I
Print came .o `/ et) Dat 0g 1 ° This permit application expires if a permit Is not obtained within
/ 180 days after it has been accepted as complete.
I:�BuildiaglpaouMPllvrP -p �tAPp "Fee methodology set by Tri- County Building Industry Service Board.
-doe 11/03 4 40. 46161( 10/02/COM/WEB)
2' 89L0- 269 -EOS Uai 4170:20 80 80 Aoki
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00626
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2005
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ° __..
INSPECTION WORKSHEET FOR DATE: 11/10/2005 TIME: 7:02AM PAGE: 96
SITE ADDRESS: 12798 SW WILLOW POINT LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 019 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Backflow prevention device for irrigation.
OWNER: DON MORISSEI I E COMMUNITIES LLC, PHONE #: 503- 387 -7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503.692-5945
Inspection Request Scheduled For: Date: 11/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final . 020901 -02 503-692-5945 N
Corrections /Comments / Instructions:
g o,,k /ow co_
c"
g PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: c 1i ii t M, \; Date: In j o J nC Phone #: (503) 718 -
•
r'"
CITY OF TIGARD -- .
BUILDING DIVISION PERMIT #: PLM2005.00626
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/9/2005
Phone: (503) 639 -4171 A..p11 i�f' I I
Inspection Requests (24 Hrs.): (503) 639 -4175 -�'!. ° °I .
INSPECTION WORKSHEET FOR DATE: 11/10/2005 TIME: 7:02AM PAGE: 97
SITE ADDRESS: 12798 SW WILLOW POINT LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 019 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Backflow prevention device for irrigation.
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503.387 -7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 11/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RP /backflow preventer 020901 -01 503-692 -5945 N
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (TO Li-n i 1 h t u-e. Date: f J POI 03`' Phone #: (503) 718-