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Permit •r 1 1°, CITY! OF TIGARD PLUMBING PERMIT � DEVELOPMENT SERVICES PERMIT #: PLM2004 -00402 ' �I ! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/2/2004 SITE ADDRESS: 12390 SW WINTERVIEW DR PARCEL: 2S1106C -04200 SUBDIVISION: THORNWOOD ZONING: R -7 BLOCK: LOT: 013 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: Installation of backflow device. FEES Owner: Description Date Amount DON MORISSETTE HOMES [PLUMB] Permit Fee 9/2/2004 $36.25 4230 GALEWOOD ST. #100 LAKE OSWEGO, OR 97035 [TAX] 8% State Surcharl 9/2/2004 $2.90 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 $ . L , ,�� Permittee Signature: ,p cz. Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day . Building Fixtures ), lambing Permit Application e'r FOR OFFICE USE ONLY City of Tigard n eVj xeeeived 13125 SW Hall Blvd., Tigard, OR 97223 n - Dan Eteview y: q _ 4Q Permit No.?� L��r�2,ed51 d� y(�L Phone: 503.639.4171 Fax: 503.598.1960 ® ® ® ®���_ C` ' ''; •• Plan B Other Permit No.: 24- Hour Inspection Line: 503.639.4175 q \\q��J ® ' _• Date Ready/By: • larit iii See Page 2 for Internet: www.ei.tigard.or.trs CC " i.y Notified/Method: 1 f (f Supplemental Information • • . , ... TYPE O)? • W'ORK� Q O \ \t� � .. FEE `SCHED New construction io For special information use checklist 44 Description + Qty. I Ea. I Total ❑ Addition/alteration/replacement 0 Other: New 1- 2 -family dwellings (includes l00 ft. for each utility connection) , :- :... ,. :CATEGORY' "•OR a CONSTRUCTYON..,•=";- _' .' : - SFR (1) bath 249.20 � 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building 0 Multi-family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 Fire sprinkler ( sq. ft) Page 2 -" ,-..'9::L, :.. u; , .pJ(R MArnJ .. • L ' 1"1 - .1 - e - Q INFORIT utilities Job site address: / &3! O co wiateryieLb J.Jf ti e..., Catch basin or area drain 16.60 City/ State/ZIP: 7-, el a . i Q k_ qr7 ).3 Orywelt, leach line, or trench drain 16.60 Suite/bldg./apt no.: ! I Project name Th n U ) po for 13 Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: . 1 e _ _ TN Manholes 16.60 Li.) rn Rain drain connector 16.60 Sanitary sewer (no. linear ft.: Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision Water service (no. linear ft.: ) Page 2 'n'1 cynwO oat- L ot no.: 15 Fixture or item Tax map/parcel no.: ID tj 5 ia, (O Absorption valve 16.60 • DES C R IP T ION OF WO - • : : • . , : Backflow preventer f Page 2 07 . SS"' • 1--‘4,x Sr ape,. ; r-ri l a ! i?'1 ha_ce fjl:L t.,l cl e"); i,; Backwater valve 1 6.60 I Clothes washer 16.60 Dishwasher 16.60 " PROPERW 9WIYER; = ; . , ,t. t Nr , `• Drinking fountain 16.60 � Ejectots/surrtp 16.60 Name: bon itY)f s-7 S S c_74-# FA---11-7 ?7 C S Expansion tank 16.60 Address: LcZ 3.) S L , 6 % c e_,C' 0 oct Fixture/sewer cap 16.60 City/State/ZIP :LCA-KG () L_t) JG CDA '7b3 5 Floor drain/floor sink/hub 16.60 Phone: ( ) I Fax: ( ) Garbage disposal 16.60 "' Hose bib 1 6.60 .: , i _ ':.. - ; : PiPP1:ICANT ' , , ' `: : ' - - .* - C©thi CT 'PERSO- Ice maker 16.60 Business name: L1.Lr S &tie OreV(y .L-1') C.., Interceptor /grease trap 16.60 Contact name 7� f +' r / L.� 1 • J� LC r ✓t! Medical gas (value: $ ) Page 2 Address: a C U a-11) ! tiS-/ In i ; , 121) Pruner I 1 6.60 Ciry/State/ZIP:- ((4 a_4 , G (L- , J 1 / . 61 Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: (503) (' e1:.;1 -S%ys Fax: : (52 6, Y_q - 0 "A. Tub/shower /shower pan 16.60 E -mail: Urinal 16.60 • - ..... _ . - . " :- CONTRACTOR . : . Water closet 16.60 Business name:L Lras(u.r).t_ 077 � C Water heater • 16.60 Address: / s _ S /y) !YI 11,5./C;4.1-1 . /2-0 Other: I City/State/ZIP: 'n'( -,� QQ 7Q� �- Subtotal Minimum permit fee: $72.50 Phone: 64'3) &Qcq S'i-J5 Fax: (503) 69Q - Q7(p r Residential bacldlow minimum permit fee: $36.25 3 (t . -S CCB Lic.: 7 r , c Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) a , 4 CI A u t h o r i z e d signs g 6L „ , 7 TOTAL PERMIT FEE [ 9 . I S Print nameg j/ efi 9a, rvU.) I Date / a ft t� This permit application expires If a permit is not obtained within f' I /// 180 days after it has been accepted ns complete. *Fee methodology set by Tri-County Building Industry Service Board. ism ;talnePe,mulPthis.Permitaro.dee 12/03 440 -- z - dd - - e0E:121O b0 20 daS CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) INSPECTION DIVISION Business Line: (503) MST �[ BUP Received 1 Date Requested � / T ' �AM PM BUP Location / D-3 Cj K/ /` kat MEC Contact Person Ph ( ) PLM a06 '-1)6 %B Z Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation 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 PASS PART FAIL :f y" PLUMBING + Post & Beam , Under Slab - _ Rough -In �► Water Service /i Sanitary Sewer Rain Drains Catch Basin Manhole Storm Drain f/ Shower Pan 6 r Other: (� P ART 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 Ei Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date / 14 (" I nspector v Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL