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Permit T r CITY TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2003 -00292 Aa- c � 1 1 1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 6/20/03 SITE ADDRESS: 12385 SW ASPEN RIDGE DR PARCEL: 2S 110BC -TS034 SUBDIVISION: THORNWOOD ZONING: R - BLOCK: LOT: 034 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 irrigation backflow preventer. FEES Owner: Description Date Amount DON MORISSETTE HOMES 4230 GALEWOOD STE #100 [PLUMB] Permit Fee 6/20/03 $36.25 LAKE OSWEGO, OR 97035 [TAX] 8% State Tax 6/20/03 $2.90 • Total $39.15 Phone : 503- 387 -7538 Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD. TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone : 503 RP /Backflow Preventer Final Inspection Reg #: PLM 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: ,E� ;C�tiG,LGi_ .< 4�(,(_ Permittee Signature: /� / Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day Jw k IIl 03 01:43p den edmonds 503 - 692 -0768 pI.4 P ubing Per = nut =App cat FOR OFFICE USE ONLY Received p Plumbing L �-- . LJ (� 11 V i Date.By� p6 Permit No? D,3 - op 0 L City of Ti and Planning Approval Sewer g JUN 2003 Date/By: PermitNo.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 DateBy:. Permit No.: Phone: 503- 639 -4171 C ' Fax • C 5 0 3 T 5 9 8 - I Post- Review Land Use st , � Date/By: r11 �•+ Internet: www.ci._tigar DIVISION .. e' Contact Juris.: f C ri : ,�J� e. s.: El See Page 2 for 24 -hour Inspection Request: 503- 639 - 4175 "`'" "' Name/Method r SImplementallnformation. : ; ' .TYPE. OF WORK ::•:. • .: _ :�::'= : FEE *'SCHEDULE:(for: special information. use,checklist):. : [ , New construction ❑ Demolition Description I Qty. I Fec(ea.) I Total I❑ Addition/alteration /replacement [] Other: .; : ,New 1 -:& ••2 family, dwellings:: .,(i cludes' ft :for. each utility connection) CATEGORY OF.CONS,TRUCTIOLV. '.. :; SFR (1) bath 249.20 1 & 2- Family dwelling El Commercial/Industrial . ElAccessory Building SFR (2) bath 350.00 - ry g ❑ Multi- Family SFR (3) bath 399.00 ❑ Master Builder ❑ Other: . Each additional bath/kitchen 45.00 Y I. .'. ; JOB SITEINFORMATION_ and :LOCATION `.'- Fire sprinkler - sq. ft.: Paget Job site address:/-13 b'S .4 /2.10 :$ite Utilitics : :• ..; i : ;<-,,,, , Suite #: I Bldg./Apt. #: Catch basin/area drain 16.60 Project Name: C,DCC LiD 3 (-/ Drywell/Ieach line/trench drain 16.60 - 1E 1 7n L Footing drain (no. linear fl.) Page 2 Cross street/Directions to job site: Manufactured home utilities 110.00 ‘1 A / - L 1 / /h.97l%' Manholes I6.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.) . Page 2 Subdivision: 7h r01 LL Oe'CL. Lot # :34/ Storm sewer (no. linear ft.) Page 2 Tax map /parcel #: , S-5' A e-, Water service Sno_ linear ft.) Page 2 :,::: ;: ?:::: _ : Fixture or itein - . '.. :.':. _13ESCRIPTION.OF.WORK -; : ;:.: .. .' :,...: :: Absorption valve 16.60 ; •_t aS C i'.- -Q-Q ,'i L;7 Cf7PL, Backflow preventer / Page 2 ,r7 . SS f361-c-cC iAn() J ./ /) i: e- Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Thinking fountain 16.60 . OP.FRTY• OWNER: :::• '. : ':.•:•:. _ ` : ?.' Ejectors/sump 16.60 Name: Doll TY?L'Yi s S C7 {-e Perri s S Expansion tank . 16.60 Address: 4 ' o St ti GCe GeL.uoe_c . .4?-674- Fixture/sewer cap 16.60 City/State/Zip: Floordrain/floorsink/hub 16 :60 Y p: LLLiCe. 6Sc.vtcj'cs a,e9 Garbage disposal 16.60 Phone: Fax: Hose bib 16.60 PPLICANT:." ` : : :':: >` :.: :CONTACT:PERSON .;;;;:: `.: - Ice maker 16.60 Name: /e4 'X f,Ce_.rTa -vJ Interceptor /grease trap 16.60 Address: /, -D-OC3 ,S W il t V L ie.0 Medical gas - value: $ Page 2 City /State /ZiP7u el LU 7 !'t. / r` -- 6:, Primer . 1 6.60 �OZ' Roof drain (commercial) 16.60 , Phone: .-.3 ( - S9 v 6 + Fax: S 69cA - 67l 1 Sink/basin/lavatory 16.60 E -mail: Tub /shower /shower pan . 16.60 l :.. :...:::_ : ;CONTRACTOR::-: ::•:'::< :. Urinal 16.60 t l t Waer closet Name: LeTilacSecl . G> 6n - )C.., 16.60 Address: LA:10G ZU.7 "Li S /rniy kip Water heater - 16.60 • p D/1_. q 'y(1 Other: Ci /State /Zi :•7 t {cc�a�rt� �, Other: Phone503 (pQ L - S ILI5' Fax: 5c)3 (pia -07( g . .- . .. °Plunttiing:Pe.-mit :Fees* �. -- . :: . -. CCB Lic. #: 17 �D v Plumb. Lic. #: Subtotal $ Authorized Minimum Permit Fee $72.50 $ Residential Backllow Minimum Fe:�•2t T Plan Review (25% of Permit Fee) $ 24, .• o25 Si L pJL _ Date: / ���� . G I / e-1 Sf &r r c - w State Surcharge (8% of Permit Fee) S ? , r7'© (Please print name) TOTAL PERMIT FEE $ 31- / S _ 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.