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Permit CITY TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2006-00001 A II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/3/2006 PARCEL: 2S 109DA -11700 SITE ADDRESS: 12957 SW BLACK WALNUT ST ZONING: R -7 SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 106 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 Description Date Amount 4230 GALEWOOD ST. STE. 100 LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 1/3/2006 $36.25 [TAX] 8% State Surcharl 1/3/2006 $2.90 Phone : 503 387 - 7538 Total $39.15 Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD. REQUIRED ITEMS AND REPORTS TUALATIN, OR 97062 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- 699 or 1- 800 - 332 -2344. Issued By: Permittee Signature: 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. Building Fixtures Plumbing Permit Applieatio€ FOR OFFICE USE ONLY • . I ('1 Receive I tq„ 7.n /�C.,.�OQ0Q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: .503.639.4171 Fax: 503.598. t 960 City of Tigard 1 - Rec 4 j � Permit No.� \!�{/J y1z;.',tlg c Date/By: Other Permit No.: 24 Hour Inspection Line: 503.639.4175 �Iq l Date Read /B I ' I 1 See Page 2 for s�.a Ready /By Internet: www.ci.tigard.or.us ,I � rr n\V l Notified/ Method: °pple R ' an $ mental Infor aC t -.... t .1 \t.:- e; . 14 ` `FEE • .SCHED[YL1f - ':' � :.;..,y d'r` .;` ' t•, 4 ' : •rn• �r. ( ..r' . .. .�.y "' ^: "`,t;! ..... .... ....�, i ,; ,.: x. . :;.. %. <,. .., . ... � v T �.,.,,... ..._ emoon For special information use checklist. ,[] New construction ❑ Demolition Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connect :on) ' t S. SFR (1) bath i ,.. ;,�.. •.. , •1.:• O 249.20 °'u . "C TEGbRY?? F°G�� S : Ctr.IOIVi, . - ,.,. , '�` ° uii • i `; _ ' , ' v i : , a.:,;..::- ..:_u- ,.-:. 1$ r..... ,,r..M..r,,,,,. " - -. :: . •.,'`., SFR (2) bath 350.00 �l- and 2- family dwelling ❑ Commercial/industrial SFR (3) bath 399.00 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 :,t:' i•, is !`' gi4i {ty` �,•`r ... • - '. : - ! : x . «*. ,. ,:... _ ; 4 n J"' « + r r ' �I Y �� Ts � �.1 1 Gt'��-7'IO , - .� ..t -, . '�" �' !rs�t: S ut �� , Catch basin or area drain Job site ad / a�f � 5 " -7 � �(.V j�iQ.G�C- �u --c•/ ILU- .c � bi di 16.60 City /State/ZIP: -7-/ q c. a IQ_ c 7. L/ Dryw'ell, leach line, or trench drain 16.60 Footing drain (no. linear ft.: ) Page 2 Suite/bldgfapt. no.: Project nan [,f ie (U/9c� /0(P Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 S IA) e e r i .e./'tcz_ / C9 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: - __) Page 2 Subdivision: /YI l'Yi L i* / n' ll'' �C.C9r� Z J L ot no.: /Q ("0 Q Fixture or item Tax map /parcel no.. (D ss r1 Absorption valve 16.60 % .: ?.; a_a , ilk: r'. 411.`4.; ;y,, •c :. ,..i: ' k preventer Paget vZ 7. .SS TP. I+ ; Q ; .t,111: . :,, - ... :k._ .. -: .., . . Bacicflow pr C1 < -<-/ T t t � , t , e . Backwater valve 16.60 '�� ,fir ii at; iI�. l?Cl_t�r 1 /_,.� / Clothes washer 16.60 Dishwasher 16.60 • Drinking fountain 16.60 1 A:, '''{:. .. v.� , 3: Wf.:. :`.1 A :'iJ ;'!. . kr ' "lr�"': ' ; f ,� . _ ' V' •,' +..` �(�.•fp �p.1 �:y,F3lzr`,: r..> t.i �r : , R A ?3' ': }', ,, kti111' :.! • ` : 1 '.• rs /su 16.60 ..,:: i. Ea•;-,. _'I,�F� !xt *:.++• ,y...7 �:r r tL,i' t ,. .. s:.: ..,...):.. :•' °.::... ". ' 15: ' • Name: D Cwt ())(�"- 7 S s `7 + ( nO C_ Expansion tank 16.60 • Address: L,� 3 c. S l l _.l LIZ - L ( e c 0 0 C`t./_ Fixture /sewer cap 16.60 City /State/ZIP:L.Ci- / <L C.1.. *L) ('( %CI 0g-- 4-1" / c�3 _42.) Floor drain/floor sink/hub 16.60 1 ( ) Garbage disposal 16.60 Phone: ( ) Fax: •,; ' : �... ,; Hose bib 16.60 :cr£n.': 1 ,. �, i .:i : a.c l? = 9.r ! 4NT- CT:1EI2S ©N� . ; ,: ``'�` " ��?��C , A�v.. -' ' M ` ;ci; . ` � � ., _ . .:: ;..:, - ..: t ..., lee ma 16.60 Business <.y <( 1 , r _. -, ..'r,:: s ' n •'.. er mane: e � ' ` 16.60 1 �,C /; /� a /`1��f. `., lam. j �'{}'). Ji/'; � Intercept /grease trap Contact name: t ss / ;'t\ .-..f) .: .(,r/i 'J.) Medical gas (value: $ ) Page 2 Address: i 0 3DC rnq.S 1 / {}' t `, / 1W Printer 16.60 /State/ZIP: J Roof drain (commercial) 16.60 Ci ry �u'"` � �'� 7 ` I l Sinic/basin/lavatory 16.60 Phone: (Sc 3) (L 9, - iU ci Fax: ' (-5-:=`.3) Y' q - , `' "y. Tub /shower /shower pan 16.60 . E -mail: Urinal _ 16.60 : ` ;:, ciyy) i'CON•'1 R d Oi " : t . : .' :ii: :', - :•:' Water closet 16.60 Business name: ti,- , �) �Jyr or, _� r "" Water heater 16.60 - L L S('r�t• C p� Other: _ .�: � -ss. , ' 00 � (. , ` L J' • ,.:; l?-a� - - - Subtotal City /State/ZIP: 7U, (.,[Gt..t (] /706o Minimum permit fee: 572.50 Phone: (56.3) (p S 1Y Fax: '0 . - 3) " , 9 - ) 7 (o E. Residential backflow minimum permit fee. 536.25 3 Go -.IS Plan review (25% of permit fee) CCB Lic.: � U Plumbing Lie. no.: '' yy �� /I �4 - State surcharge f8% of Hermit fee) a • yo Authorized signatyrrq- • 6 ta,.,_. , TOTAL PERMIT FEE 3 q /S - Print name j/ e r- n �/t- zi - -YLIu) pat/ l I , v S This permit application expires if a permit is not obtained -ithi 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. is\ Building \Pennits\PLMF- PertnitApp.doo 17103 440- 4616T( to /071COM/WEB) I' al 99LO- 269 -EDS Ua1 eEa :80 90 EO UeC CITY OFTIGARD BUILDING DIVISION PERMIT #: PI M2006-00001 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/31206 Phone: (503) 639-4171 ' I Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 1120/2006 TIME: 7:00AM PAGE: SITE ADDRESS: 12957 SW BLACK WALNUT ST CLASS OF WORK: SUBDIVISION: SUMMF RIDGE NO 2 LOT #: 106 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: Bacisf low prevent er for irrigation. OWNER: DON MORISSETTE COMMUNITIES, PHONE #: 5n387-7538 CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-59 Inspection Request Scheduled For: Date: 1/20/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 025349.01 5n6915945 Corrections/Comments/Instructions: Arr■- 191 • ° I PASS 1 PARTIAL APPROVAL 7 CANCEL 1 NO ACCESS fl FAIL fl CALL FOR INSPECTION ADDI IONAL EES ASSESSED In spector: 4//'‘ Date: j .i Phone #: (503) 718-