Permit •
"CITY OF TIGARD PLUMBING PERMIT
VII
l4, DEVELOPMENT SERVICES PERMIT #: PLM2006 -00129
13 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/12/2006
PARCEL: 2S 109DB -02300
SITE ADDRESS: 14994 SW BLACK WALNUT TERR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 061 JURISDICTION: TIG
Project Description: Backflow prevention device 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 Description Date Amount
4230 GALEWOOD ST STE #100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 4/12/2006 $36.25
[TAX] 8% State Surcharl 4/12/2006 $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 24..699 or 1-800-332-2344.
Issued y: i !L �� _ Permittee Signature: ),1-A '
-A , �,
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.
ding Fixtures M h faoo5 0026c
Plumbing Permit Arikation FOR OFFICE USE ONLY
City g 1�� Received /l 1/ a 71 ,/ Permit N o.: ,
Cit of Tigard P Q�
Phone: 503.639.4171 Fax: 503.598.1960 1� Date/By: 7 / e1/.90v6 €2,/./.9 13125 SW Hall Blvd., Tigard, OR 97223 +� Plan Review
"k] ''y e 1 / /,w 1 i1 Other Permit Na.:
�� b j \� � a � lric ii i Da Re
Internet: www.ci.tigard.or.us 4 . ! ' �" D a t e Ready/By: 1 S See Pape 2 for
24- Hour Inspection Line: 503.639.4175 LJ� . �7i� - m
• $'a `LJ Q � Information
�.� C L' Noti6ed/M � Supplemental
fi
• , ..',t.:::::_ :. ".FEE.. CFI ..
few construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CA,TEGOIRX.,OF:.CONSTRUC' ION,''; !! SFR (1) bath 249.20 t
,1- and 2-family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building 113 Multi-family SFR (3) bath 399.00
- Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( _ sq. ft.) Page 2
a- ;'ru : 'rjj' • IIOB: SI ' E ^INFORM Site utilities
Job site address: ri/ .=7 y Li Si.(.) Pj 1 t C CC U-6i- Litt_ LT 7 (.4' r Lt 4 Catch basin or area drain 16.60 ,
City/State /ZIP: '7 / zi M.A. tL. o /‹,. C� 7 ) .-1-/ Drywell, leach line, or trench drain J • 16.60 ,
no.: Project rta � 7 Footing drain (no. linear ft.. ) Page 2
Suite/bldg./apt.
J trgL.L. /Yi /'V1 (.7' a _/ 6 � .! / I
Manufactured home utilities 1 10 00
Cross street/directions to job site:
Manholes 16.60
S LU I?) fJ e_ - C .13.--f\ C _ IUD 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: S t.Lr11 FYI i.r 1z t.cLci C L no.: (D 1 Fixture or item
Tax map /parcel no.: is C f'\
l Absorption valve 16 60
. . . DES'C1 T-1 ; OB .W ' ..
,: :,� :; '. Back flow eventer / Page 2 �.7 SS
taw r4 --C(' (1 ,' (..r i !7 �'% ' / - .7)''' b o. f K T - ,/,... . J Nj.;
' ; / F Backwater valve 16.60
f Clothes washer 16 60 '
Dishwasher 16.60
. 0 :. . . •• . Drinking fountain 16.60
PR,.0 :Y ';• . ..:`❑ "I'EA1v C... .
<.. .., .. ::9 , ... . , , N . 't Ejectors /sump 16.60
Name: D ,.-- (')(. Ir t .s .;; " .L . _1 e - rn m L i hl.Ld i e S L.L)C.Bxpansion tank 16.60 ,
--
Address: y,a 3 c, S L.L' c-,-.._ ( t . L' 0 <'i 4__ Fixture /sewer cap 16.60
City /State /DP:L'i /< C- L . S i. (; t'.%C ! L) k. (..-1 / C. � - Floor drain/floor sink/hub 16.60
Phone: ( ) / Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
A1P '.OT;PEI2
::. , XCANT'1` "G
.,, .. `. NTAC •:
ice maker 1 16.60
Business name: L ( (•.eL(' -C. /5 /ter / /! .i yl, .r..../..,..!, <' Interceptor /o ease trap 16.60
Contact name: ..1----,,,11 ) ...Sp a f r Le Medical gas (value: $ ) Page 2
( G-#' c.
Address: i � D L L -J �) I"YI L� S I /'Yt t r �. D Primer 16.60
(,LO
City/ State/ZIP:^ o lam, ' J � � 7/ ' ' . )---- Roof drain (commercial) 16.60
c �, , U j ` ,. 1 Sink/basin/lavatory 16.60
Phone: (5c! ::3) ( - G ) C / - J / Fax :: (5, �_.,` ' - .�) . /72' '
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
�`',.... Water closet 16.60
•
Business name: L n(4S( , l f) . d , Orr' ( ,,/ )y- ./; r Water heater 16.60
Address: /• _)- -- (jC� ,S 0_,/ n) L/ . S. CA. Other:
1 Subtotal
City/State/ZIP: 'n(,(L,[,; --? p' ,1 04 .. -4. .i-
Minimum permit fee: $72.50
Phone: Cie {3) (nd . yes Fax: 5 (n 9e - 07 �g Residential backflow minimum permit fee: 536.25 31- "
CCB Lie.: 7 kU Plumbing Lie, no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee) a , r7 CJ
Authorized signs 1 to l f���� ? TOTAL PERMIT FEE 3 , l S
I
Print name: , // ef) ��? j r ' - y7)u, Dat - - 1I - Ole.' This permit application expires if a permit is not obtained thin
/ ' 180 days after it has been accepted as complete.
*Fee methodology set by Tn -County Building Industry Service Boar d
i:\ Building \Perrnits1PLMF.PcmoApp.doc 12/03 440 - 4C 16T( I 0 /02 /COM/WES3)
2• d 89L0- 269 -EOS u e
T i 3 25 =60 90 I T Jcild
CITY ������W��������
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BUILDING DIVISION PERMIT #: PU4200600129
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4K1212008
Phone: (503) 639-4171
Inspection Requests (24Hmj:(GO3)G3Q'4175 .��� « �11.
INSPECTION WORKSHEET FOR DATE: 4/25/2006 TIME: 7:00Alvi PAGE: 84
SITE ADDRESS: 14994 SW BLACK WALNUT TERR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 061 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Uaucf|mm prevention device for irrigation.
OWNER: DON k40FNSSETTE COMMUNITIES LLC PHONE #: 50a-587-763D
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-892-5945
Inspection Request Scheduled For: Date: 4K25/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 028532-01 5O3-592-594b W
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Corrections/Comments/Instructions:
Aj—P- | PAROALAPPRDVAL �� CAN{�EL 7 NDACCESS
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I I FAIL CALL FOR INSPECTION �� ADDITIONAL FEES ASSESSED
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Inspector: Kg ' Oate: 4 / , Phonm #: (5O3} 718' ��� ^� I
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