Permit • • I ,e
C ITY OF TIGARD PLUMBING PERMIT
i� DEVELOPMENT SERVICES PERMIT #: PLM2003 -00545
II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/16/03
SITE ADDRESS: 12325 SW WINTERVIEW DR PARCEL: 2S110BC -03800
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 009 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 #100 [PLUMB] Permit Fee 10/16/03 $36.25
LAKE OSWEGO, OR 97035- [TAX] 8% State Tax 10/16/03 $2.90
Total $39.15
Phone : 503 387 - 3875
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : 503 - 692 - 5945 RP /Backflow Preventer
Final Inspection
Reg #: LIC LCB: 7804
PLM ALL PHASES - PLt
•
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
Issued By: Permittee Signature: DA 1774/ er7
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Oct 14 03 04: 32p dan edmonds 5 0 3 - 6 9 2 - 0 7 68 p . 2
FOR OFFICE USE ONLY
Plumbing Permit :.j,;0- • 40 0 ! I 6 Received , Plumbing n
....., ....... _...../ Date/BriO/ k i.i Pennit No.T .
Planning A v at Sewer
City of Tigard OCT 14 200Aht* Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/8y. Permit No.:
TIG i ! .. , Post-Review
Phone: 503-639-4171 Fax: 5034.1-0 Land Usc
Internet: www.citigard.or.us L 1f
NG DIV ,..'101;;;;Ilk Date/By: C.ase No.:
, Contact jagit kg Sec Page 2 for
-4 ° I •
24-hour Inspection Request 503-639-4175 - Name/Method: 7/6 ats. '. Supplemental Information.
',*. 1 '• - -''.:,,f.'• :!.-:-- : f • TYPE OF WORK , , .• • ' .- , ...:7, - ;:-: : :.: : !;'' ,..:, - .-••• • ' FEE* SCHEDULEIfor Speilillitforinition ifse i.heeklistl .
New onstruction IUII Demolition
ddi n/alteration/replacement 0 Other:
.. . . , .1 CATEGORY OF CONSTRUCTIOW, -:. •_
1 a. & dwelling Commercial/Industrial
Acce sory Building . B_Multi-Family
Mas 0 Other:
OB SITEINFORMA and LOCATION ...., • '- :.:- - SFR (3) bath
Each additional bath/kitchen
Fire sprinkler - sq. ft.:
Job site ddress: / 4 3 D-5 S u., Le 4 n -k-rvi ci.i...) De.. . _ -.-:-:'':,':- : :- -..';-:.-.--.:
Suite #: 1 BldgJApt.#:
Project a71icy n L000 01 / tzr c
lai Family dweet/
Cross s eDirections to job site: 7,Nptieivo;1dzyiiiiimsFee:ea,...). 1 Tot a l .,_..
:- RR ` 1: : ( 1 (2 . 1 : )) : .: : bab ", 7:11des,100 ft. fir each utility eanfieconnection) .': • • - . -.' ,
Catch basin/area drain -;
Drywell/leach line/trench drain
Footing drain (no. linear ft.)
Manufactured home utilities 249.20
350.00
399.00
0 Builder
45.00
_ Page 2 ,
-•.'.• SitelItilities:':.%,` ,, . .. `• '4-17‘..:. ': - .- ""' ' :-.
16.60
16.60
Pro me:
Page 2
110.00
S4.0 &LL Li r.70 le .(a Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdi "
vl ion:Thorn u: o 0 a... I Lot # Storm sewer (no. linear ft.) Page 2
Tax ma /parcel #: to S A (.‘>
Water service (no. linear ft.)
- Page 2
DESCRIPTION OF WORIC .;:: - ' .. ..: . . ' - ,- .2.5. : .. :. : 7 ..- iii:Itim • - : , ' . :.. ... "-.. ' ::"'•
Absorption valve 16.60
.... - •,',..'- ''..-- ':: ',- '-:;'.., '••••••, • • s - ''
Lartrrt Cap t, laCt.C.IC ae..13 LCe) . Backflow preventer / Page 2 c .1.'7_ s5"
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
'ISI.TROPERTY.OWNER - •- - .1 0 TENANT -,-• 'z • • . ,•-: '...-, Ejectors/sunip 16.60
Name: DOn ni CYY -icl-ri<.S Expansion tank 16.60
_
Address: 4-a 30 Su) &a-La_voc) 0 a, Fixture/sewer cap , 16.60
City/State/Zip: tisie--ie_ OSI-Lie.-56 glOaS Floor drain/floor sink/hub .. • 16.60
Garbage disposal 16.60
Phone: Fax: Hose bib 16.60
.APPLICANT -, • .: 'z ."."-"- • " SICONTACTPERSON ,- : -: --.-- - Ice maker
16.60
Name: el j. cry Sparrato Interceptor/grease trap 16.60
Address: Dbr3 0 S rYtiSICY9 RJD Medical gas - value: $ Page 2
Primer 16.60
City/St ate/Zip: Tikakal 0 l 970 to --. Roof drain (commercial) 16.60
PhoneSb3 Locia- - $ q 451 FaxS13 bq a.- 07102 Siolc/basinflavatory 16.60 _
E-mail: . Tub/shower/shower pan 16.60
' '. '' • : - . ' ' Y' ''-'.^ - ,.CONTRACTOR - - . - ..: ..........C.•:, .....: ; Urinal 16.60
Water closet 16.60
Business Name: Lo.ncl.SCafge_. 0 rtitIVN
Water heater 16.60
Address: 1 -0c) D.,13 1/14.Ctivrv-1 len- Other: . .
City/S .ate/Zip:mA.C1.1.0-t '6 R._ -- q - 7 a° a- Other: .
PhoneSh3 &la- S Li S raxg CP9c1 - orBeE . - ....- :-.:-- .-..-'•.,.;, Plarritsing'Perrait Feiis ..' ,;.2:'7,5 . . ' I
- lD Li Plumb. Lic.#: Subtotal S
CCB Lic. #:
Minimum Permit Fee $72.50 S 36 . a s
Residential Backflow Minimum Fee $36.25
S A i u gn th a o tu rizr-rdzi-1--4 -40/44-A-ezz Date: i 1 03 Plan Review Permit Fee) $
E 1 1 er) Ss,pcii r2rt13 State Surcharge (8% of Permit Fee) $ &. 96
(Please print name) TOTAL PERMIT FEE $ 39.. , 5
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or
180 days after It has been accepted as complete. riser diagram for plan review.
- • *Fee 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 Date Requested ) D..--/ AM PM BUP
Location 1 L3a-S 1Q1 n4*_/ Suite MEC
Contact Person 4 - -' Ph ( ) c`'1 5 3 - 0 5 7 1 1 S -
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: n Q� �/o w l � C . 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
RT FAIL
011271
Post & Beam
Under Slab
Rough -In
Water Service 0
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
S ower Pan
the 6 F P/J (JV
Fin
S PART FAIL
HANICAL
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: 111 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date I I , Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL