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Permit ■ f r�� CITY OF TIGARD PLUMBING PERMIT i DEVELOPMENT SERVICES PERMIT #: PLM2006 - 10047 mss"" R11 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/27/2006 PARCEL: 2S 109DA -08300 SITE ADDRESS: 15117 SW HAZELCREST WAY ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 077 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 4230 GALEWOOD ST. STE. 100 Description Date Amount LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 4/6/2006 $36.25 [TAX] 8% State Surcha 4/6/2006 $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. r Permittee Signature: cs 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. I Bui`uMfng Fixtures E � FOR OFFICE USE ONLY ��� Plumbing Permit Appli'anl� City Receive '. . Permit N r� � Clt Of Tigard �p � t) Da[eBy� -;;;z7--06" C�/ 1 1 bF•.� ��% V � .7 13125 SW Mall Blvd., Tigard, OR 07223 H t • Plan Review Phone: 503.639.4171 Fax: 503.598 1951) /4'ar.a) i� Date/By: Other Permit No. 24- Hour Inspection Line: 503.639.417.5 \ - c 0 r b` D ate Read JB fur's' p See Page 2 for �G+ .r Y Y� Internet: www.ci.ti . ird- ir. is G © �( � NG 11 NotificdRvtcthod: Supplemental Information ,__ EEx.'SCFI N New construction ❑ Demolition For special information use checklist. - Description 1 Qty. 1 Ea. I Total ❑ Addition /alteration. /replaccmcnt ❑ Other: New 1- 2- family dwellings (includes 100 I. for each utility connection) .. •.. ,:. : CATEGORY OF''. CONSTRUCTIO SFR (1) bath 249.20 El and 2- family dwelling Commercial/industrial SFR (2) bath 350.00 SFR (3) bath 399.00 ❑ Accessory building ❑ Multi - family - -__- -- . -.- Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB: SITE fNF O1(MATION. AND LOCATION,;. • Site utilities Job site address: `7 S ci2 f (e.r e,Sr L. LI CIL/ Catch basin or area drain 16.60 L II 1 City /State /ZIP: 7 el { t LC( Q/rZ cJ 7 - ) y Drywell, leach line, or trench drain 16.50 - aryl n LL t• - (, 6. 7 Footing drain linear n (no. neal fl.: Page 2 I Suite/ bldg. /apt. no. L fruject n Manufactured home utilities - 1 In OQ Cross street/directions to job site: Manholes 16 60 'LL - _ R ) c _ I Ci iZL /CC-) Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft : ) Page 2 . + I Lot no.: Water service (no. linear ft.: ) Page 2 Subdivision:S'_Z KL( - -_ Fixture or item l Inc map/parcel no.: 1 C� 16 60 I -_, Absorption valve DESCItIP - 1 ON OF WORK Backflow preventer t Page 2 7 . SS 7 - 1. ri:: • %( .'. / ('/,/ - - i �f 7 . %. "i . ;1 � j ; : ! C Backwater valve 16.60 Clothes washer 16.60 - -' " Dishwasher 16.60 _.. Drinking fountain 16 GO • • I'ROFPRTY_'OWNER . :.,0 ; TENANT , Ejectors/sump I 16.00 . • Name: J ' r : . _ - _ , ( V L L I 'Loh E. Li C ixpansion tank 16.60 Address: z-/ -. • !.' . t / Fixture /sewer cap 16.60 - / c .. f l ''_� Floor drain /floor sink/hub 16.60 l Fax: ( ) • City/Stale/Ztl': � = ' � t / - Garbage disposal 16.60 Phone: ( ) Hose I 16.60 "' . ' APPI.ICANT . CnNTt�CT , RSON; 'r:: '''' Ice ma er H bb :.. .. .. - - -- :L. .' :.. 1 k I 16.60 Business name: i7 ,_ -,_;' r'. • - L "r ; Interceptor /grease trap I I 16 60 • Contact name: . 's ; Medical gas (value: $ ) I Pace 2 • Address: i (- ( f 1 a f , r .. re Primer 16.60 J N R o of drain (commercial) 16.60 - City /State /7.IP f i fa ; li ii i- ` 16 60 i -- - Sintc/basin /lavatory Phone: (::o.' ∎) .. . .. I Fax:: (_ =_,.. -5) i_ y'•.i _ L •'.'' .ai. 16 • Tub /shower /shower pan • E -mail: urinal ' I6.60 - CONTRACTOR Water Close[ 16.6(7 . / l - ... Water heater 1 0.60 Business nante '! 1 -.. - - i }' - -1 l .• j'- Address: - Other: - - - - - - - Subtotal • City /State/ZIP: 77,e a. cn.zLa-9-2/'I •'(,;L 4 .&,, -t- r� � Minirnumpermit lee $72.50 Phone: 3) C' (� �) �c L / 7 - (CI Residential back low minimum permit fee' $36 25 .� ' c - CCB Lie.: 7 "{ L 'c.�L - lu Fax: rnbing Lic. no.. Plan review (25% of permit tee) __- 4 _ ___ _ _1, ]' State surcharge (8% of permit feel ,� , c 2Ct gnat t Authorized si `,� �C L"� / '! .��'CL Z�7 TOTAL PERMIT: E E 3q LS _ Print nam ` - ' - - - Da?) �� This permit application expires if a permit is not obtained '.thin � - ma L r_ - 1 180 days after it has been accepted as complete. 'Fee methodology set by Tri -County Building Industry Se:vice li it d ∎.i11aildin4 \P-nuii;•',PI.MO -Pei mi,:\;r, :I. IiO I 440 46 16T(I 0 /02 /COM/WEB) a' d .99LO -ass-cos u 9 II 3 e9T :L0 90 L2 -aeW • CITY =OF TIGARD,. / Lin BUILDING DIVISION PERMIT #:o�0 ` l0 v 4/7 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 h m�i Inspection Requests (24 Hrs.): (503) 639 -4175 � INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: ] J C - `' f ( CLASS OF WORK: SUBDIVISION: / LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION' OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 - z8-0,c Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments/ Instructions: • ASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL J CALL FOR INSPECTION ❑ ADDITI•NAL FEES ASSESSED fp Inspector: Date: 10 .41P Phone #: (503) 718- ��