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Permit r C ITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2006 -10037 DATE ISSUED: 3/21 /2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA -12400 SITE ADDRESS: 12987 SW KOSTEL LN ZONING: R -7 SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 113 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 #100 Description Date Amount LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 4/5/2006 $36.25 [TAX] 8% State Surcha 4/5/2006 $2.90 Phone : 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: 2 �� , h Permittee Signature: _ .e A Y ,, ci 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 , Biiildfne,Fixtures R • Plumbing Permit A p a ® VES FOR OFFICE USE ONLY City of Tigard Received 13125 SW Hall Blvd., Tigard, OR 97223 MAR 21 2006 Date/B a‘176-1--- Permit No \� v ' AO! _ 1003 7 Phone: 503.639.4171 Fax: 503.598.1960 / /tb� : °+ • Plan Review 1 2�V� Q 24- Flour Inspection Line: 503.639 41 5 I i''' + \ Date/By; Other Permit No.: Internet www ct tigard or us ��� 01 1� 8 '�' I Date Ready/By: 1n.' :: � e, ■• � :r r NotifiedMIethod: � See Page Z for j�gqWryI`,,' SSI; "i It ij,4 x -s^fr alA, R � , r Fitlf ., . ' ,. ';._ �} ;p , „ c �_' � � _ Supplemental Information tb;Y� r7 .�.,yn { .+ .:E!�F2� Zr v /Q t f y 9 ,•� '4id,^. , ye p ! ,'•: rk�t� � Pn ,nT ��!ili* �?if' A�.M �. a� =n.' • "1 t C•'15 a1,:. ,,.. CF :: d i �:.,�.:a.` L��:s: : - „'l� ..a �;� S� t ,A�,�itgj "'1' , t ; �g �t;'yy,� 4 , J�, t`.;., :7.`n.':. p . - ..,. . +y tu,<_ �" 3 ��fl� 7t�1 -�n , � �.� {if7';')7 r;•7!� X,�+. '',' � t3� �!� • M ,Y ff �t' �r„�.,� !'i r � _f'.. . � a i �.1e�.t;�. \v. ��i'i'AV,'MSId tcl "fk...:4:m ,r'il..r: ^.:i v .: r. �;., %, �� .;.., � E New construction ❑ Demolition For special information use checklist. 0 Addie'ration/replacement ' ❑ Other: Description Qty, Ea. Total tion /alt .i ' Ad dz irkv , �,.,.�,, : te,b .�,,,. _ New 1- 2- family dwellings (includes 100 ft. for each utility connect i I,fri;..f:�;i�'^')i+. :!„+n1�� � ,-t✓ a0 .'�, :- a,�.�i�' ^ L. :._wa. -c�.� �,,<. ,,,... g ( Y _Y'.W:4'1'it'.�Y.7W'�n'_. r:t'4 { }'w '1 a /h. t , yu�{ • 'I I t r l� A \ 1 ,:L i�'tii�-i:"v.y.�,.:n.',. ) "``� { r l".i i ,CI. • Y - 'w fi K• ,' 'f 1iY ( Fns:`... 1 . y.. aWi<.' d�dn�4. i . ✓: ° :i',�tf'Hi�;iu „'s.•i'�,'' SFR(I)bath 249.20 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder ❑Other: Each additional bath/ldtchen 45.00 r h �`' 7 ' a m } fe i t "tg" A 3 i 2 '� y , Fire sprinkler ( sq. ft. r! r�z4;:,: i &' �1, t1d `}i,� 'tit,,. ©�(d,;}I VI @•�7 }� p 7`^l itM k + a'��i t 7'1 y } 'Fr tv� .r r tt Q ft.) Page 2 o 5t?a � i'� 1p•:1,1,','' Site utilities Yob site address: /Q G" 6 1.0 KoS �.- ,� �� Catch basin or area drain 16.60 City/State /ZIP: _ 4 Lt 0 ) 2 ej 7 D- D-L- Drywell, leach line, or trench drain 1 6.60 Suite/bldg. /apt. no I Project name: Stan iyi L.¢ l e, / 13 Footing drain (no. linear R.: ) Page 2 Cross street/directions to job site: Manufactured home utilities 110.00 iS C 6 f r6-e42 ,.-p )-PO ' Manholes 16.60 K Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision. L_L fl-i /ll 0 lei CI O Lot no.:(I 3 Water service (no. linear ft.: ) Page 2 Tax map /parcel I10.: [p S� ! � At - I Fixture or item 4y+ .. e * ,•n t ,:.• v.ylcr+.:,rz,..' : . • Absorption valve ,m,,i t1.,.i: " >.'x� ?t,' 4/V,f , :1 s :0:0 R i,v:� :O' i,:{(,�:4 . `;t;. � : iif .-: ,? i +:':: zi":;,:.: r ' :' !�y I Page 2 �• n v�: ...r,:.��JCr.:,61tr'lr•ak��i:, „ �:',' c,ArtSll� +t� ::'i ".� 1 . , / r•:, ;Ili! Eackflow preventer / Page 2 7 • SS Lc. ) Sl' af e !i-!-1 'sf Cch u-y1 A, Cl-Gf�fi01,C 1 i f > >. Backwater valve .�_,Z�/• lX, 16,60 Clothes washer 16 60 Dishwashe 16.60 .� pp I � rra t, _� ' a ' Y? ^'�1 21 t ' 'a.ttia 'W' t °; I: wa:'�. ,, l :'?:. `: , j. ,•m :.:, D rinking in °1 =%! � �5� �_l`1y}F t� founts 16.60 ,.- : Ftma. izr. s...°:l' !:h;...:. � 'r . .'i 0 V ,',4 '.4t' 1.i..,,,''... I .S3i t',• G' ;1 ",' .Jf�, 4 4;•1' ' '' '- • 'itr. it5.s..1.:. •y y 9}. h ^.':.a•.a. , „.ar:L?:.- :r:t>nt=s Ejectors/sump - Name: b 137 iTh an S S t. 7z. -1- /- f zW) xv � 16.60 Address: L fa 30 s �y Expansion tank 16.60 Gam` C. -- &-) C) DCt - Fixture/sewer cap 16.60 City/State/Z1P:Lc:L k< .' LC) . iG OP - -/ 7 63 J Floor drain/floor sin)c/hub • 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 F 3 T, ,y 50 cam F I r�rsp ,P 3t ,= r � 0 i ,s t '= N-,, uw....a,',.' ' ��' Hose bib .., lwa : l , W - L i r r rr �s; 16.6 � 8Lt 1t -JR s I_ ! � t�.7 �t.6 f 3. ,�'. � ,c• ,�- ,+'t. -„ � ., y � *�� "' ,�'' � name: r Ice maker 16.60 Business Wa La e/ rs'< - ce..e r T� c. Interceptor /grease trap 16.60 Contact name: el/ p 624, - ' Medical gas (value: $ ) Page 2 Address: i -.D-C) () S-W n'l J°. /,m� iZC) Primer 16.611 City /State/ZIP: ��� 1 Roof drain co �� I ! l C U 2- ' ` l ?G' (� o- (commercial) 1 6.60 Phone: (503) (e) j, - S 9 /J I Fax: : (5 L, lt_R - & .3&,,i>" Sink/basin/lavatory 16.60 E -mail: Tub /shower /shower pan 16.60 'r ; li .:IT r +S:i;)i'JC f 4 7 , , 'TG'E�,r .� bn`r•�yi rt .M ec•�"�b'�r'y �p,� .,,�,.... , , - .•,c. Urinal 16.60 •5 , }< r /"v i i•� r `' 4 'ii j"h '"i 8 • " P RIZII i''it�,i ,. a' ,7, 6i `1 1 : rii f.:i iFr .. ,: 1 54Y,' -','• ,s,.4• ' ;+2. Sb''..i�e.,e, u i1A1 d 0 L.:l j rr/ +r.- "..: :' , "o! 1';1 Water closet ,: . ,.-�. 16.60 Business name: j f)ti_Se "2 0. 67").-"E, � ��-) C Water heater 16.60 Address: f ?-D-00 722_ � '1 Li f YI G y RIO Other . " ,� eta ' -u .? .' t ' 7w` . 7i L (1.. 7069 Phone: (�j(1,3) ��Ja '9 S Fax: (�C' ) / Minimum pe fee` $72.: 0 Y 3 Ca �'� - 070 E' Residential backflow minimum permit fee: $36.25 3(0• o1S CCB Lie.: 7 :7 Plumbing Lie. no.: Plan review (25% of permit fee) Authorized signs 1 / e� 7 State surcharge (S% of permit fee) - q v � ` TOTAL PERMIT FEE 3 9 • / S PrinEname l 1 1 L( � c,,/�r ) Dat3/ d-/7 to • I This permit application expires if a permit is not obtained within ( 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board . r\ duilding\Pcmuts\PLMF•PermitApp. due 12/03 440 -46 6 T(10 /02/COM/W$n) ' d 139L0- Z69-EOS uatj3 e217:60 90 iZ JeW CITY OF TIGARD p L BUILDING DIVISION PERMIT #: ap0 - M 3 7 13125 SW Hall Blvd., Tigard, OR 97223 ` DATE ISSUED: Phone: (503) 639 -4171 1 pmy� ii� ' � l Inspection Requests (24 Hrs.): (503) 639 -4175 `:_.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: I D- g 0 7 / CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: - 1 -0 ,' Pour Time: Code # Ins ection Description Confirm # Contact # Message • 3611 puLy, to - s 5 44c Corrections /Comments /Instructions: • //r • ASS n PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ft h / k f / Date: `- ?/ J Phone #: (503) 718 -