Permit ,
�' CITY OF TIGARD
II
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2006 - 00580
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/4/2006
PARCEL: 1 S134DB -10900
SITE ADDRESS: 11374 SW MEGAN TERR ZONING: R - 4.5
SUBDIVISION: DAKOTA GLEN LOT: 011 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 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:=Za .�►. 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.
S.
Plumbing Permit Appiicatioxvc ii
City of Tigard : 13125 SW Hall Blvd., Tigard, OR 9BEG / ..
y ` �/ )( '2� PermitNo i g 4 7 )
13125 SW Hall Blvd., Tigard, OR 97 y C/`
Phone: 503.639.4171 Fax: 503.598.1960 ® 4 / Uuu Plan Revi
a , i, Other Permit No.:
24 -Hour Inspection Line: 503.639.4175 tin _ . ■ . ■ a `� �) ate Re .ruri6_
Internet: www.citigard.or.us T(Ga 0 -.4-'w Date adpBy: 0 See Page 2 for
city �y r,, Dale /Method: Supplemental Information
TYE'� ,
Q0 t R IVIN." FEE"' SCHEDULE
® New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea, I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family I SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler (_ sq. It) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 11374 SW Megan Terrace Catch basin or area drain 16.60
City /State /ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Dakota Glenn Footing drain (no. linear R.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions 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 Lot no.: 11 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: 655 C 2
Absorption valve 16.60
DESCRIPTION OF WORK
Backf ow preventer f Page 2 ,) 7 , S '
Landscape Backflow Device Backwater valve 16.60
16.60
Clothes washer j 16.60
Dishwasher 16.60
® PROPERTY OWNER I El 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/StateJZIP: Lake Oswego, OR 97034 Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
® 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: $ ) 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
Busin name: Landscape Oregon, Inc. Water heater 16.60
Address: 12200 SW Myslony Street Other:
City/State/ZIP: Tualatin, OR 97062 Subtotal
Minimum permit fee: $72.50 �� .
Phone: (503 - ) 692 - 5945 Fax: (503) 692 - 0768 Residential back minimum permit fee: $36.25
CCB Lic.: 7804 Plumbing Lie. no.: Plan review (25% of permit fee)
Authorized signature: State surcharge (8% of permit fee) `
TOTAL PERMIT FEE 'g 't, 1 ,ST
Print name: Ellen Sparrow Date: 12/04 /06 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
'Tee methodology set by 'Tri -County Building Industry Service Board.
ZauildinK WermiIS\Pt.M- Pern 06/05 4404616T(10/02/COM/WEB)
Z 99L0 u d9L:Zl. 90 b0 oeO
. •
CITY OF TIGARD , (
. -
BUILDING DIVISION PERMIT #: PLt■A2006-00680
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/40006
Phone: (503) 639-4171 , • Atliiilitit\
Inspection Requests (24 Hrs.): (503) 639-4175 ,_ ,J11- - l -L,
INSPECTION WORKSHEET FOR DATE: 12/512006 TIME: 7:00AM PAGE: 10
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SITE ADDRESS: 11374 SW MEGAN TERR CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 011 TYPE OF USE:
PROJECT NAME: DAKOTA GLEN
DESCRIPTION: Backflow 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 04064401 603-692-5945 N
Corrections/Comments/Instructions:
(
•
(0 j
1
/./
gi PASS I PARTIAL APPROVAL 0 CANCEL _ NO ACCESS
fl FAIL I I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: -- ( 6 6 Phone #: (503) 718-