Permit Fr,
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00291
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/9/2007
PARCEL: 1S134DB
SITE ADDRESS: 11396 SW MEGAN TERR ZONING: R - 4.5
SUBDIVISION: DAKOTA GLEN LOT: 009 JURISDICTION: TIG
PROJECT: DAKOTA GLEN
Project Description: Install landscape backflow device.
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 Description Date Amount
4230 GALEWOOD ST SUITE 100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 7/9/2007 $36.25
[TAX] 8% State Surcha 7/9/2007 $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.
Issue
drift � / // I _ _ � // Permittee Signature: 11 (K
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.
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5 SW Hall Blvd.
Dste/±t Permit No.:
Phone: 503.639.417] • " 13 _, > VA Plan Review Other Permit No.: MST
266 /�1Ck}72.
24- Hour Inspection Line: 503.639.4 .5
Internet: wwvv.ci.tigard.or.us ��� �� .. It �;� I DatefBy:
. - t Dale Ready/By: em ® 2 , 4 . ' V Notified /Method: 1 Supplemental In formation
TYP � , FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist
Description I Qty. [ Ea. 1 Total
❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.29
® I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
C) Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath /kitchen 45.00
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page s
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 11396 SW Megan Catch basin or area drain 16.60
City /Slate /ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60 '
Suite/bldg. /apt. no.: Project name: Dakota Glen 09 Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW North Dakta 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 I Lot no.: 09 Water service (no. linear ft.: ) Page 2
Tax map /parcel no,: 655 C3 Fixture or item
Absorption valve 1 6.60
DESCRIPTION OF WORK Backflow preventer / Page 2 d-) s J
Landscape Backflow Device Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER E: TENANT
Drinking fountain 16.60
Ejectors /sump 16.60
Name: Don Morissette Homes Expansion tank 16.60
Address: 4230 SW Galewood Fixture/sewer cap 16.60
City / State/ZIP: Lake Oswego, OR 97034 Floor drainifloor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
® APPLICANT El CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Landscape Oregon, Inc.
Interceptor/grease Imp 16.60
Contact name: Ellen Sparrow Medical gas (value: S ) I Page 2
Address: 12200 SW Myslony Street Primer 16.60
City/State/ZIP: Tualatin, OR 97062 Roof drain (commercial) _ 16.60
Phone: (503) 692 -5945 Fax: : (503) 692 -0768 Sink/basin/lavatory 16.60
Tub/shower/shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Landscape Oregon, Inc. Water heater 1,6.60
Address: 12200 SW Myslony Street Other:
City/State/ZIP: Tualatin, OR 97062 Subtotal
Minimum permit fee: S72.50
r Phone: (503 -) 692 -5945 Fax: (503) 692 -0765 Residential backflow minimum permit fee: S36.25 -y 6, � S
CCB Lic.: 7804 Plumbing Lic, no.: Plan review (25% of fee)
// )) State surcharge (8% of permit fee) ; c C C
Authorized sigratur, ,��� X (��} TOTAL PERMIT FEE
Print name: Ellen Sparrow Date: 07/09/07 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 • 12200 SW M /$lePiV61: stRMI itflivet§ rg Service Board.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007-00291
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/912007
Phone: (503) 639-4171 , .40:Vpirt
Inspection Requests (24 Hrs.): (503) 639-4175 ,„_,tik -11.
INSPECTION WORKSHEET FOR DATE: 7/10/2007 TIME: 7:00AM PAGE: 66
SITE ADDRESS: 11396 SW MEGAN TERR CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 009 TYPE OF USE:
PROJECT NAME: DAKOTA GLEN
DESCRIPTION: Install landscape becl4low device.
OWNER: DON MORISSETTE HOMES INC, PHONE #: 503-387-7538 ,
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 7/10/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 051672-01 503-692-5946 N
Corrections /Comments/ Instructions:
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El PASS It - 1. - TIAL APPROVAL El CANCEL fl NO ACCESS
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1;1 FAIL n CALL FOR INSPECTION Ei ADDITIONAL FEES ASSESSED
Inspector: 1 4)(" 4/
Date: 17 . ' Phone #: (503) 718-