Permit j ,, CITY OF TIGARD PLUMBING PERMIT
at PERMIT #: PLM2004 -00196
� i�, DEVELOPMENT H BMENg Tigard, SERVICES 639 -4171 DATE ISSUED: 5/3/2004
SITE ADDRESS: 12345. SW WINTERVIEW DR PARCEL: 2S110BC -03700
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: - LOT: 008 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 preventer. .
- FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES
4230 GALEWOOD ST • [PLUMB] Permit Fee 5/3/2004 $36.25
8 TE 100 [TAX] 8% State Surcharl 5/3/2004 $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 : 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: -- j - � . r.�.el i� Permittee Signature: dYi Q e_/,( -12-7.-,
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Apr 30 04 09:41a dan edmonds 503 - 692 -0768 p.2
Plumbing Permit Application FOR OFFICE E ONLY'
f RECEIVED ��1 i, Mo -:r �07
City of Tigard namnay Permit No.:
13125 SW Hall Blvd P� Review Other
Tigard, Oregon 97223 APR 3 0 2004 Permit No.:
Phone: 503- 639 -4171 :8,,,,a-598-19.60 Rost- Review Land Use
Internet www.ci.tigard UI1 I . x
� GRD : 1 ;,.: ` ;I` lhte/B
24 -hour Inspection Req �yyp f I� _'^ � �� I �- liluris.: 1 ei See page 2 for
lCN Supplemental Information.
-' • .- • . - :' ' - :. ::TYPE OF WORK - .' ; :`;;: .j.r.:: ::. :. 'FEE* SCHEDULE• for'
( specFal'itiformatloa rise cheddist)
New construction emolition
Addition/alteration/ Description Qty. 6ee(ea.) Total
(` lacement Other:
mP Al � : -New •1' -.8e `Z•- faiutgy:dwelhmgs •
• CATEGORY OF CONSTRUCTION.... •,: ,. ; == .,'.;:.; : • :(Indudes.ZOO IL for rae6'o ttTity'eonneceioA) •
0 I & 2- Family dwelling ❑ Commercial/Industrial SFR (t) bath 249.20
SFR (2) bath 350.00
['Accessory Building [] Multi- Family
SFR (3) bath 399.00
❑ Master Builder 4 Other: Each additional bath/kitchen 45.00
• . JOB SITE' INFORMATION and LOCATION • • : ::. -: _.4.: • Fire sprinkler - sq. R: Pa 2
Job site address: /a3 / s Su. Wir p Via` D2 , i -- --
:•:,i';' ; ,., -•_s:: - Site :Ilfiilitics..
Suite #: I BldgJApt #: Catch baainfatea drain 16.60
Project Name:`i'hCYn Orris i- i s' DrywdYkach line/trench drain 16.60
Cross street/Directions to job site: Footing drain (no_ linear ft) Page 2
Manufactured home utilities 110.00
( :_L , t.) [iih - �`M ( yip Manholes 16.60
Rain drain cormector 16.60
Sanitary sewer (no. linear R) , Page 2 _
SubdivisionrrheYVr;,L .• I L #: 0g' Storm sewer (no. linear ft.) Page 2
Tax map /parcel #: lit (3 S Water service (no. linear ft:) Page 2
. : ' -. -.. "' ..Fuitture :Item
G1 1 : 1C (l G��,�J �) A Ption v al v e
La nds Ca p G C Baddlow preventer I 16.60 Page 2
f 1 1 �e 2 ,.1'7- 5S'
Backwater valve 16.60
Clothes washer 16.60
• Dishwasher 16.60
PROPERTY OWNER Drinking fountain 16.60
(' I]:TENANT. Ejectors/sump
Name: D m a•YrsS� • 1171cs :' Expansion tank 16.60_
16.60
Address:9 A 30 Su &41..R..e.woo cL Fixture/sewer cap 16.60
City /State/Zip: LO -11.. isles q7Ci Floor drain/floor sink/hub • 16.60
Phone: I Fax: Garbage disposal 16.60
J Hose bib
[SAPPLICANT •' .. :. 16.60
�[CON3'ACTPf�' SAN• ' "���
tee maker 16.60
Name: El J t.9') Spar - an-0
Address: I � a0 0 Ci r)'1sJLJAL R.D Interceptor/grease ga trap _ P age 2
City /State/Zip: ,>L D te g70 a.._, R o o . 16.60
PhoneS03 to 9a. - S? y$ Fax coq a- 071 F R drain (coamrrraal) 16.60
Sirtk/basnt/lavatorJ 16 -60
E -mail: . Tub/shower/shower pan 16.60
• • . ` . - : • : C O N T R A C T O R . . - : - ..: : :-;...''.7;:;.:'-'-:. - _ Urinal 16.60
Business Name: LardSc pt O e C., Water closet 1 6.60
_ Address: I 'D-D-0 ��) ry) .rdirny eri. water heater 16.60
City /State/Zip: - p J _
e' K " g7aCfl �" Other
Phon
a
•
3 id t1- S7`1S f Fax (p .1 - Orjl'oe * -• • . :' *: •.".• .�j;5'S ' •
CCB Lic. #: 7,rt -/ ( Plumb. Lic. #: Subtotal S _
Authorized Minimum Permit Fee S72.50 S
SignatureL� L L
- 1) ,L ) Dat�' c317`� Residential Barkflow Minimum Fee $36.25 ` • � - `S
ET/ d� Plan Review (25% of Permit Fee) S
v� p print name) State Surcharge (8% of Permit Fee) S , 96
Notice: This permit app6eaiiou expires ifa permit is not obtained within TOTAL PERIYIIT FEE p , s 39. / S
180 days alter it has been accepted as complete. riser new diagram require 2 sets of plans with isometric or
- riser diagram [or plan review.
Wee 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 ` Y c P Date Requ �ed 51 � 2 � ' AM PM BUP
Location / 2 3 Z(z L2. JJJ la h Suite L 7 MEC
Contact Person r fr7 Ph ( X99 ?- - 5 y 5 PLM2,iJ(7 /96%•
Contractor rig Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: 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
Showe an
Oth= •
.mar
PA = 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 D �� Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL