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Permit CITY TIGARD PLUMBING PERMIT All DEVELOPMENT SERVICES PERMIT #: PLM2006 - 10005 DATE ISSUED: 3/1/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 109DA - 07900 SITE ADDRESS: 14993 SW HAZELCREST TERR ZONING: R - SUBDIVISION: SUMMIT RIDGE LOT: 056 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 Description Date Amount 4230 GALEWOOD ST STE 100 LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 3/31/2006 $36.25 [TAX] 8% State Surcha 3/31/2006 $2.90 Phone : 503- 387 -7538 Total $39.15 Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD. TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 692 -5945 FAX 503- 692 -0768 Reg #: LIC 7804 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: p � ^ � ' Permittee Signature: Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Fixtures . . „...... „ „ „ tr , iv ED • Plumbing Permit A 11 1.; MC , FOR OFFICE USE ONLY City of Tigard Received Permit N 13125 SW Hall Blvd., Tigard, OR 97223 MAR 1 2006 DateBy: ' .-- �o a d, Phone: 503.639.4171 Fax: 503.598.1960 Plan Review 4. ilk . � Other Permit No.: 24- Hour Inspection Line: 503.639 .41 , ;f1: ' Date/By: JnteInternet: www.ci.tigard.or. � ��� ® F T1 `J is =' �' `�' I Date jedJMe i El See Page 2 for X13 ax- ;i�•'.}`li #'; :,.yA5,. :•r2;F..,r. Ss''BI - �.� ^ � -�,. Notified/Method: 1 Supplemental information • 1 1:51 � 'r .� i ,,r 7E. lf'. a' j+�, !M' S ' ,7 >ti - `f : ;R i•=l +;;i s�. . <, •.-. + .+ft /e T.1; e0* �`. C I '7yt. . G' Y 'Y Y a i l� ,i '• '. . l ..i. ` • 1 •..:I ^, .. ''- + ' /n:.._ 1 ✓:�:!` t... .. d.; st�•r 'al:.k� �;;{.r;"�; ,�w`Yi� 'i .1,,,:, >�- ta;i ;1 � � 'E�F ;:: '$C�7 3 �; n L� . E'.' . Ig New construction ❑ Demolition For special information use checklist. ❑ Addition/alteration /replacement ❑ Other: Description Qty. Ea. Total r _ + -. _ _ j New 1- 2- family dwellings (includes 100 ft. for each utility connection) <` 4• � $ '� • ,. ^t .�, ;,: .. - - - .•,... , -, .. . onnection rc ,i:flvft M,t f :� :t�'' t? E O.RY..`«;04. -i. G(?V• � I i _ y,. ..r. _ sa. ,t:.w ... . l.;.n.. „.,.•.r.tr r.1.t� dsOO�E " "•,'r ='kl', • t ,(, . , r SFR (I) bath .zc;t• ,�� w'Cf t�:i�:fi�i :t?� r.I:_`s��t j 249.20 i and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 • ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: i ' : 4 �` a r- ' +v v:mo:• Fires sprinkler s t. Pa IA s it l ;'' • 'T • . 6 11 §1•�!���,;� , � , "1(7* 1�x �r1 r Y ..•. !.r,:6 -ntr,: : ^; � r 1' f ti P ( q. f ) c 2 g .. � , . - �b vnr= .:.�,nfu >w`•:..rir3 ?� `:. ,: • < /3 Site utilities fob site address: / Lt ClCi 3 S t eicc2 c 1 f r. - f - f7 e . e- Catch basin or area drain 16.60 City/State/ZIP: T f[. Cl .; i t 0 /C- 9 7 ��y Drywell, leach fine, or trench drain 16.60 1 Suite/bldg. /apt. no.: I Project namcS LLrn p' R 5 % Footing drain (no. linear ft.: _) Page 2 Cross strect/directions to job site: 5F _ Manufactured home utilities 1 10.00 Manholes 16.60 S be eC [ C ; Lce:._- 61D. Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: S LL )1 `- t i �-� e. I Lot no.:S 1 (_ Water service (no. linear ft.: ) Page 2 i ci ' g Tax map /parcel no.: CO < .S.. A Fixture or item ;iu " a' wa ' s .' ` ;:.: ;''t l :k,':I_ ; . tl . :.- Absorption valve 16.60 t ' +i.... „1,% . ...'l: ;,b;ESCRiETCON ;VV' p' r+� i,.• = ; .:';i ,,,,' ";1 (W9s a:. <, ;P;E..., y:..• Backflow preventer i f Page 2 .;1? ? • 55.. Lc,....)- SC' 0_,19,,,, ... f K r ' . / ` .1 77 '- r el _ / o.0 �°to G/eC: i t ,f' Backwater valve 16.60 J Clothes washer 1 6.60 Dishwasher 16.60 t ©, 'n0 r }.i; . 6: ,_..r - :,a -..,. _, Drinking fountain ��55,, « 'F �* � .... ,�§`,��,`. T]X i, p,:QWt'��i , � ' R': µ'ri �?uw 1•.. i _ . r I,a.1;� ?;.L: +.v ;:; '- ".: tl: 'n,..�N' Diki f � 16.60 ' XI S . : :. ,+, ., i .> ::tiltl�. • • -• :, ,,;, {.:. . : " • I '_••Y.Iv: +. �K1IIRl.., i , .6 t ip� ��.' "•'1' r r.;. ••_,r -1 1E rrl ' in(' Ejectors /sump 16.60 Nanne: b c) ry) i y 1 S S F' .1. f C s COmmLl it 11 CS �� Expansion tank 16.60 Address: L ,Q.. 3 L' S L I.. (_;, - j ' t Q._) 0 ,..),,L. Fixture/sewer cap 16.60 City/ State/ZIP: Lcr- / L () _. : (} ("< /C Og ' • 7 L3 E Floor drain/floor sink /hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 3;ji f ".I4 FI . r.l'. " ':r� :: 1 _ : •:l r ' p.1r' %:G 1 • h �? s1 t • i J L ')CC21ltiii..Tr' . -' �t1 $� W 4 00 `' r .,?(. i :; .. Hose bib - l A:9 �: try it! ;16 + . .: ,.< a : * .::l! 7.-!"' ' tl",., "„ CT . )SRS� ; ; ' 16.60 - r : : ; +<u�: ... .'1..:. •s.. +..' Ice maker Business name: 16 :60 I�Ct/ L� /i �: !� / _T-f-) Interceptor/grease trap 16.60 Contact name: till l .� r f.6 Medical gas (value: S ) Page 2 Address: o---c..)0 � ( � µ 1 S � /Y t,1 � I ri ' L t,Q Primer 16.60 City/State/ZIP : -t'1 f & u � A , J ,� L , J 7 G , •, 0, Roof drain (commercial) 16.60 Phone: (56 1 (:' 9 -- - j `/L/ cj' Fax: : (.5 & y� - 6 '.1(G,.S2 Sink /basin/lavatory 16.60 Tub /shower /shower pan 16.60 F l' E-mail: it 1 .'iac', , r .; T r_ >r,.. Urinal 16.60 � :h: :- tV i.. " , CON. �n .O� i.... ; :.ek.l i .' ,'::;._s,; ' - l±Y� w'I:'+.. , . t, r, :.'. .. �r �/V• t..... :: ;•� .."1.. ' { �'�.::? ' � 1 ' i�(i , T L'.. ,7' i - -... .. r.. :::y . , . ..' «3ex..r.... }ia1. `,t'- =tr„ W ater closet 16.60 Business name: - 1-1 �Si+L. (. [ , J .� < ��TT' (J ) ' j ,...4,.., �. Water heater I 16.60 Address: /,�.D-'OG 40 al q y c yi t Other: 1 City / State/ZIP: 7u ��rt 0� z ' / 7Ueo Z - - - - -- Subtotal c- i // Minimum permit fee: $72.50 Phone: .3) i�Y'' t� s- . Fax: (5O3) (oQa - 0 7 6 g Residential backflow minimum permit fee: $36.25 -5 / CCB Lie.: 7 kU Plumbing Lie, no.: Plan review (25% of permit fee) Authorized signa .64.-/i -1 TOTAL PERMIT F - State sur (8% of permit fee) !, ` I FEE - I , r $ Print name r � ' C.cJ Da . ")-3 JU(, I This permit application expires if a permit is not obtained +• ith 1 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board i:lBuilding\PcmutstPLAW-Permit App. Joc 1203 440- 4616T(l0 /02/COM/IVEB) E' 99L0- ZG9 -EOS Uaii eEZ =LD 90 TO JeN CITY OF TIGARD - ftH O(Q -/0OO5 BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 l � DATE ISSUED: Phone: (503) 639 -4171 *AO Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1 / G (0 TIME: PAGE: SITE ADDRESS: - I "I'" b� kid Ores( 1 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message -sA e Corrections /Comments/ Instructions: PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: " l /t Date: t I " Phone #: (503) 718- 7---Y 7--1 CITY OF TIGARD - A- BUILDING DIVISION PERMIT #:-2, _ 7(] 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639- 4171 � AI Inspection Requests (24 Hrs.): (503) 639 -4175 ' 'I L. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / Li -9 9 #: T�,�i CLASS OF WORK: SUBDIVISION: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 - Z- CS l" Pour Time: Code # Inspection Description t( Confirm # Contact # /- 9 Message ‘3 9 v40411;01-, elk,vvvv-1/4.---,‘ s Corrections /Comments /Instructions: Attita _ ._..t.14 `2i r tj. ,e (1 i 4 c '.4t, \ b"' il v { ❑ PASS ,❑ PARTIAL APPROVAL El CANCEL ❑ NO ACCESS El FAIL FALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r .. - Inspector: � ` �� Date. . Phone #: (503) 718- 2 v /