Permit 41'
CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00339
11 . 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/11/2006
PARCEL: 2S 109AD - 15300
SITE ADDRESS: 14923 SW GREENFIELD DR ZONING: R -
SUBDIVISION: SUMMIT RIDGE NO. 4 LOT: 135 JURISDICTION: TIG
Project Description: Backflow 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
4230 GALEWOOD ST #100 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 7/11/2006 $36.25
[TAX] 8% State Surcha 7/11/2006 $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: TZ 7r � 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.
�'3 uilding Fixtures
Plumbing Permit App I �/ ®/
ED FOR OFFICE USE ONLY .
Cit y of Ti g and JUL 1 1 2006 Rec
Date / d • -/ J 1 "7 CJf Permit No.: 1 " �
\ 1 76e . ff9
13125 SW Hail Blvd., Tigard, OR 97223
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TIGAR /.fz»::t t'�U�y�, + `'a Date /By: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 ` 1-1.1
Internet: www.ci.tigard.or.us BUILDING DIVI <<. 4� Notified/Method: ateRe By: nta t nmrr
` I S See Page 2
u erne nation
.,.... .. .. °TI'1?E'OV: •
'.•••'::.:- - F);E.':
New construction Fors special information anon use check/isr.
❑ Demolition Description P f 1 Qty. Ea. J Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
` . " • .:. CATEOORV'OF CONSTJ.?UCTION ;; : •
.....�•.... :. .:.. .. i;: `. I:'':; SFR (l)bath 249.20
l and 2- family dwelling El Commercial industrial SFR (2) bath 350.00
❑ cessory building El Multi- family SFR (3) bath 399 00
❑Master builder El Other: Each additional bath/kitchen 45.00
:..: ... .......... Fire sprinkler ( sq. ft.) Page 2 •
r .. '
., ' JOBc :SI FL 'INFORMATION..;AND. ,LOCAT[ON, ' •, Site utilities
Job site address: / Li 9 a 3 . 1L4J & r . f .JC( Catch basin or area drain 16.60
City/State/ZIP: Ti GI (�( 4 /, Q'/ 9 7 a y Drywell, leach line, or trench drain -�_ 16.60
Suite/61dg. /apt.no.: [ Project n - y"y) -' ( e., / 3,5-:- I Fooling drain (no. linear ft.: ) _ Page
Manufactured home utilities 110.00
Cross street/directions to job site:
SILL) e kQ Manholes 16.60
i i Rain drain connector 16.60
1 Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: _) Page 2
r
Subdivisiort�. tJ jy , LP R-�-d Lot no.:43 Water service (no. linear R.: ) Page 2
Tax map /parcel no.: r !! Fixture or item
` n • 7 . Absorption valve 1 16.60
. - DESCRIPTION. OF WO•RTC :
Backflow preventer Page 2 �'-] - .SS
L_Z-( r �!' 1. /cv'. ./- ! . (.."/ :' /. t: ^, i �/r : ....:!./ _' .. - -„,: :. . ......
, Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
PR4)PERTY. }„OWN'ER F..'tt _ Drinking fountain D king f 16.60
,. . Q'. ENANT. ...,.' '-...
_ Ejectors /sump 16.60
r C. ,
Name: . : * :),-. - y, .' �!_• -,.�.: _ -. ;t�:• :nom. -r _, .LIT) E .i C- LCTxpansiontank 16.60 ,
Address: L/_) • -3,_, r L , L.-: .- f t ° L' t ' + Cr '• L Fixture /sewer cap 16.60
City /State /ZIP: • c'r /'< , . _' l i C.' C' -i L. :I• IL2 • Floor drain/floor sink/hub 16.60
Garbage Phone: ( ) Fax: ( ) rbage disposal 16.60
"'`' ` APPLA
ICNT' I -Lose bib I 16.60
..-.. .. a,.:. ...= ., ... .- . ,.... . •'. -"'.." t .0 "I' :;PERSON •" .. -
Ice maker 1 16.60
Business name: te ,- d ! j•i, -; i ,
f _ 'r' ,-,c,(:),). �, r' Interceptor /grease trap I 16.60
Contact name: ✓„r� t ) i�
.� Jf- _. ,r - ;,( Medical gas (value: $ ) Page 2
Address:
i t-'t- 1(l. lYILj.t;i(`Yl :. lc C.) Primer 16.60 -
City/State/ZIP:--iii. it.{ d ; ' - /l t . , . . -J . . ,. Roof drain (commercial) 16.60
: -( -,) - -- _ "' I Fax (. ,.:. ') i.' : -. - Sink /basin/lavatory I G,60
Phone: (
Tub /shower /shower pan 1 6.60
E -mail:
Urinal 16.60
-
CONTRACTOR Water closet 16.60
Business name: , 'r, ; : (- Water heater 16.60
Address: , c. - `i / r I _ .' : g- Other:
City/State /ZIP: '72Ea.e /L --,ct '°'0 f` "4 l L3& •L:•,_ Minimum permit fee' S 572.50
Phone: (`jL 3) teuQ '�/C/S" Fax: 6,Ct 3) 6) ■:,? » £Y7 (n E Residential bacicflow minimum permit fee' $36 25 34,.. -S
CCB Lie.: 7 - L) Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized sigma X D State surcharge (8% of permit fee) oZ , q
�' = "� = �� t.- TOT?! PERMIT FEE 39 ,, ( S
Print name ./ Cy) .� d-t , Zi 'YZ+ - - c. ) Dar I ) J J p t This permit application expires if a permit is not obtained ^'thin
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
i:\ BuildingTermirslPLMF- PcrmiIApp.doc 12/0? 440 - 46.16410 /C2.COMJW^B)
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.
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: PLM2006- 00339
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7111120176
Phone: (503) 639 -4171 �� "�WNn�iiglll 7:11 lit •
Inspection Requests (24 Hrs.): (503) 639 -4175 ... W
INSPECTION WORKSHEET FOR DATE: 7/1712006 TIME: 7.04AM PAGE: 5
SITE ADDRESS: 4923 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO.4 LOT #: 135 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO.4
DESCRIPTION: i3ackflov+r device for irrigation.
OWNER: DON MORISSE i 1E COMMUNITIES, LLC, PHONE #: 503-307 -7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 5016915945
Inspection Request Scheduled For: Date: 71/ 7/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 033157 -01 503- 682 -5945 N
Corrections /Comments /Instructions:
. Vi,/
Y 1_, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i
Inspector: 4 r Date: .f. �, Phone #: (503) 718 - . 2 - • / - -q
_ _