Permit CITY TIGARD PLUMBING PERMIT
D EVELOPMENT SERVICES PERMIT #: PLM2006 -00062
A �I DATE ISSUED: 2/3/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA -11800
SITE ADDRESS: 12933 SW BLACK WALNUT ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 107 JURISDICTION: TIG
Project Description: Backflow preventer 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
4230 GALEWOOD ST # 100 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 2/3/2006 $36.25
[TAX] 8% State Surcha 2/3/2006 $2.90
Phone : 503- 387 -7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 692 -5945
FAX 503- 692 -0768
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 or 1- 800 - 332 -2344.
Issued By: Jul /' �'1 �!�'/t ) Permittee Signature: ,s , P,
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.
i co Building Fixtures Plumbing Permit Ape a t' rGE1V FOR OFFICE USE ONLY
City of Tigard Received ,q �J /J
13125 SW Fall Blvd., Tigard, OR 97223 FEB 0 3 2006 Date/Hy --- ? ` % Permit No'.: \\ +y 9O ('� 6 /
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / H i v. \ Other Permit No.:
24- Hour Inspection Line: 503.639.4175 -, �(' : _� � ' �. ,�I� R c
Y o TI • ^1 . ��.� Date RcadyBy: �° ® Sec Page 2 for
Internet: wwwcl tigard.or.us Y "
Noh.6ed/Method: . Supplemental
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MI New construction ❑ Demolition
For special information use checklist.
Description I Qty. I Ea. J Total 1
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
; t3.+ 751. .:u � r ?k r f , : l
. i a fi h" 1i Y � .u�7 ', iliMi i73 : Jji ".,14i:11r: ' l SFR (1) bath 249.20
LI 1- and 2- family dwelling ❑ CommerciaVindustrial SFR (2) bath 350.00
CI Accessory building ID Multi-family SFR (3) bath 399.00 L
Master builder Each additional bath/kitchen 45.00
El ❑ Other
''t. ''� - � ' v ^P Iti ...�.."� a _'C 7R-7 r7 - r ' ' ` s -"�'
Fire sprinkler ( sq. ft) Page 2
_-.• s. tc ly,'',s �.. t :4 , it li * i , 4 i�5� . J 1 omy er ' c i e
>���". .. > � y .s.fl.�"�Y.��,I � ��t'� 3�.�'„>f� Sit utilities
Job site address: i 0-9 33 S tL 6/a.z/G, UX tL 7 Catch basin or area drain 16.60
City/State/ZIP: T l a,./LC < 0„a, Q •7 3 0a Drywell, leach line, or trench drain 16.60
no.: [ Project na p /!� Footing drain (no. linear ft.: ) Page 2
Suite/bldg./apt.
,� � � [ ``�/ Manufactured home utilities 1 10.00
Cross street/directions to job site:
�� 1 Manholes 16.60
r3 t/v 13e :e"o g f■-ek 1 ,p v-'7 Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivisiof i L-L/Yl /Y? (._f /..L.( 9 -6 I Lot no.: /07 Water service (no. linear ft.: ) - Page 2
Tax map /parcel no.: - CZ E il Fixture or item
r f x :,y - i , x. • . 1 . Absorption valve 16 60
t ,1 •i ,.. Wit, -:t 4. ! , T iii��t,i "`'ti'_:lt401, ,�'. Ks t • ,'' 4 l . y '-' ' i ca . � Y 4 ,,, � • .: . " '''' i ; i s ' P cam
• /__. .(.1')/ L' •- 'f: L$. 1 .. 4,.. • .. -. . l . . . . , o ,. Ba preven / Page 2 0 7, J
SC • - / r / w1 (..m 0 ax e / / 01,4.; _ , / ^ • Backwater valve 1 6.60
Clothes washer 1 6.60
Dishwasher 16.60
x e "fi ..x^!'i FIST I �t �1T s¢ 1 VAR • .. + I t . ; Drinking fountain 1 6.60
st. I �t... is �a'FS........... 1. r�. i_'? W Z ....r..b. .� fi� N ?�! �Y 7�'�t4' �!�.7'''..Cr : "� . ...,t,
Ejectors/sump 16.60
Name: DtrYl f'Y)c - i SS C- Fl" HOW) Zvi Expansion tank 16.60
Address: Z--/•,;„ 3c, S w _.( e.t.t.3 C) Ot,L. Fixture/sewer cap 16.60
City/StateJZIP:[ ./< e O SLO trG OP_ 7 3 3 S Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
i d o F1'i _ ?,U4 iepoi, ,,, J T 4 .R ' ; �, k a ' [!;< Hose bib 16.60
* ^::�5 .,'ieZ Ii�., >r := � aa'i?',,,w�'.'., � O a ,r. 4°.. Ice maker 16.60
Business name: lo_r) a g e_R_f).G OrP im Tit Interceptor/grease trap 16.60
Contact name:
Eli 6,-) „Sr CL.I}�Q - ' Medical gas (value: S ) Page 2
Address: i - D-D 0 SeW NI L/ S I /11 u I ZD Primer 16.60 -
City/State/ZIP:"-►� j (J �, 0 76, Roof drain (commercial) 16.60
( 503) 1 IG; 9 , - - -S Sys I C.5 �l � 7& S' Sink/basin/lavatory 16.60
Phone: Fax: - G
Tub /shower /shower pan 16.60
E -mail
_1I/ t or f �� ; Mi Urinal 16.60
, + x iYS ¢ �g u r � �t'. tD t °5 Phr d, " . l':: , �1^..jq f i t , 9 1, `�: 3ti;41 1 , I Wate closet 16.60
. w he ti.I.L ; ,ars " .. . tflt ;, i': t, ( . .
Business name: LaQN.Si"! �.� 0-r,...._9 c - m - z i/ G Water heater 16.60
-- - -
Address: . <JO v : / J C 1 �• Other:
City/State/ZIP: n ✓.1 ' 7U ( _ Subtotal 7 •
��
!'/ /�' Minimum permit fee: $72.50 3(0
;
Phone: (03) WYQ SW S" Fax: (503) (070? - 0 7 (0 g Residential backflow minimum permit fee: $36.25
CCB Lic.: 7 Plu mbing Lie. no.:
E� C
Authorized signa i L- e . e 1 State surcharge (8% of permit fee) �, f0
I Plan review (25% of permit fee)
TOTAL PERMIT FEE 1 3.'. (LS I
Print name`! ef) e J-u� DO/3/0 (A This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
i:' Building \PermitsWLMP- PermitApp.doc 12/03 440- 4616T(I 0 /02/COM/WEB)
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. .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PIN:1008-000Q
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2j3/2006
Phone: (503) 639-4171 Ak i A
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2/6/2006 TIME: 7:02AM PAGE: r
zo
SITE ADDRESS: 12933 SW MACK WALNUT ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 107 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
. DESCRIPTION: Sacfdlow preventer for irrigation.
OWNER: (X)N MORISSETTE COMMUNITIES, LLC, PHONE #: 603-397-7530
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 2/&2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 026337-01 603-692-5945 N
Corrections/Comments/Instructions:
•
7(27:e
•
F- 77-. PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
0 FAIL MI - ' LL FOR INSPECTION n ADDIT ONA FEES ASSESSED
Inspector: / \. ar
Date: e 16) • Phone #: (503) 718-