Permit '. C1TY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2006 -00578
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TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/4/2006
PARCEL: 1 S134DB -11400
SITE ADDRESS: 11008 SW BRENDEN LN ZONING: R -4.5
SUBDIVISION: DAKOTA GLEN LOT: 016 JURISDICTION: TIG
Project Description: Back 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 HOMES, INC.
4230 GALEWOOD ST # 100 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 12/4/2006 $36.25
[TAX] 8% State Surcha 12/4/2006 $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: / � y j c� Permittee Signature: 7 2� �,G. e.. -1
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.
A . . . i •
Bonded - insured
;itI I' 2006
Plumb; s • o . . _- �,: � _ , ; 1 3 f f FOR OFFICE UsE ONLY
,:�':•
C agar 1 ° ` r .i ,�of, •
a Received
l i ' . ��
.. /tr GI' �j 0 Permit No.:P fM% "
125 SW Hall Blw � C D B y:
rl: ' !' / O 4%.�ii� " TNT -`,,"• 'TV A - ''Plan Review'
Phone: 503.639.417 ax: 55 . 7.1'..11
,� y i /B Date/Ay: : ' 1 Other Penni:lo.:
24 Hour Inspection Line: 175, � `' D ate Read Jty/ El See Page 2 for
� v. y: I
Internet: ww�w.ci-tigard 1I Ok I1 � ! � !rIr Notified /Method: Supplemental Inforrnation
L3 ,nritPliat "..' (y FEE* SCHEDULE
® New construction El Demolition For special information use checklist
Description 1 Qty. I Ea. 1 Total 1
❑ Addition/alteration/replacement ❑ Other. New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
El Accessory building El Multi-family SFR (3) bath 399.00
❑ Master builder ❑ Qther: Each additional bathikitchen 45.00
Fire sprinkler ( sq. ft.) Page 2
. JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 11008 SW Brenden Lane Catch basin or area drain 16.60
City/State /ZIP: Tigard, OR 97224 Drysvell, leach line, or trench drain 16.60
I Suite/bldg. /apt. no.: I Project name: Dakota Glen 16
Footing drain (no. linear 6.: ) Page 2
Manufactured home utilities 1 10.00
Cross streetidirections to job site: SW North Dakota Street
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Dakota Glen l Lot no.: 16 Water service (no. linear fl : ) Page 2
Tax map/ parcel no.: 655 C 2 Fixture or item
. Absorption valve • 16.60
DESCRIPTION OF WORK
Backflow preventer J Page 2 7 . S.S
Landscape Backflow Device Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER DI TENANT
Drinking fountain 16.60
Ejectors/sump 16.60
Name: Don Morissette Homes Expansion tank 16.60
Address: 4230 SW Galewood Fixture /server cap 16.60
CityiState/ZIP: Lake Oswego, OR 97034 Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
Z APPLICANT ® CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Landscape Oregon, inc.
Interceptor/grease trap 16.60
Contact name: Ellen Sparrow Medical gas (value: S ) Page 2
Address: 12200 SW Myslony Street Primer 16.60
City/State /ZIP: Tualatin, OR 97062 . Roof drain (commercial) 16.60
Sink /basini]avatory 16.60
Phone: (503) 692 -5945 Fax: : (503) 692 -0768
Tub/shower /shower pan 16.60
E -mail Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Landscape Oregon, Inc. Water heater 16.60
Address: 12200 SW Myslony Street Other. •
O
City /State /ZIP: Tualatin, OR 97062 Subtotal
Minimum permit fee: $72.50 .
Phone: (503-) 692 -5945 /LO Fax: (503) 692 -0768 Residential backflow minimum permit fee: $36.25 C L '
CCB Lie.: 7804 \\/") Plumbing Lie. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fcc) 2.. 1'U
Authorized signature: Cp i e_,--) /i
, (,,,�. '- f�� TOTAL PERMIT FEE - /
Print name: Elicit Sparrow J Date: 12/04;06 This permit application expires if a permit is not obtained within
180 days after it has•been accepted as complete.
phone: 503.692.5945 • fax: 503,692,0768 e 12200 SW My 1F3Flipc8h?doig'RE➢Nciitir cetle@�}.&i39714 Service Board
t'. Building 'Pcrrniti'PLbt- PermitApp.doc 06 ;05 44c-es &T(: 0/021COMwaB}
Z'd 99L0 calla 0 917:90 90 170 oec
CITY OF TIGARD
BUILDING DIVISION ti PERMIT #: PLIVI2006-00578
13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 12/4/2006
Phone: (503) 639-4171 , 44 /hitilii m r/
Inspection Requests (24 Hrs.): (503) 639-4175 .--ta- -.1. '
INSPECTION WORKSHEET FOR DATE: 12/5/2006 TIME: 7:00AM PAGE: 31
SITE ADDRESS: 11008 SW BRENDEN LI CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 016 TYPE OF USE:
PROJECT NAME: DAKOTA GLEN
DESCRIPTION: Back preventer for irrigation.
OWNER: DON MORISSE! I E HOMES, INC., PHONE #: 503-387-7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 12/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 040638-01 503-692-5945 N
Corrections/Comments/Instructions:
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T My ____ ( y( 4
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Ci iiiI ( //1) Y '
VI • . S PARTIAL APPROVAL El CANCEL I I NO ACCESS
_
Li FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: \ 4'1 ' (1
Date: \ 7■(<16 Phone #: (503) 718-
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