Permit ' iii CIT O F TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00302
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/16/2008
PARCEL: 2S 109AC - 05600
SITE ADDRESS: 13183 SW NICOLE LN ZONING: R -7
SUBDIVISION: WILSON RIDGE NO. 2 LOT: 024 JURISDICTION: TIG
PROJECT: WILSON RIDGE II
Project Description: Installing backflow preventer.
CLASS OF WORK: ALT 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
STONE BRIDGE HOMES NW LLC
16869 SW 65TH AVE Description Date Amount
#505 [PLUMB] Permit Fee 7/16/2008 $36.25
LAKE OSWEGO, OR 97035 [TAX] 12% State Surch 7/16/2008 $4.35
Phone : 503- 387 -7577 Total $40.60
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.
..--2 Issued Nermittee Signature: �r��?5 ,
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.
Plumbitl Permit A Ilea ti cEINIS
Building Fixtures
City of Tigard �� 1 Zod� FOR OFFICE use ONLY = a 13125 SW Hall Blvd, Tigard, OR 97223 e fIGA 118611117,„„„ -
Phone: 503.639.4171 Fax: 50 3.598,10 G D � 1Q D Rev;ew �' 1 wit No.; .
T I G A R D Inspection Line: 503.639.4175 ` 'n .wl f `
lntemet: www.ti and 1 1+�� �� Other Permit
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® New construction ❑ Demolition For special information use checklist
Description [ Qty. l Ea. I Total
❑ Addition /alteration/replacement ❑ Other.
„:: • , a .. :.. New 1- 2- family dwellings (includes 100 ft. for each utility connection)
w . .
C . .. ... - : 249.20
. 51Z- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 950
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen
❑ Master builder ❑ Other: 45.00
1;. '1!.: c Fire spriakler ( sq. B.) f Page 2
:: _. JOB OHMA'I70NY:
. SITE ; 1N. 'F : .. . .. . .. .. : ... . .: .. . .. <: = :y Site utilities
Job site address:/ .3 i -3 N I C O / C /A/ Catch basin or area drain I 16.60
Thriven, Thriven, leach line, or trench drain 16.60
t iS G + -?1 Q cL AA (l Footing drain (no. linear ft.: ) Page 2
Suite/bldglapt. no.: 1 Project name:
Cross street/directions ro job site: ! •1 1
Manufactured home utilities 110.00
S L.A.) /+ '�'L�C �t �1 -N � Manholes 16.60
/ ` s22) /33 YZ.1 Rain drain connector 16.60
#V t'' rC . 3 l (_ i Sanitary sewer (no. linear R: _) _ Page 2
Storm sewer (no. linear R.: _) Page 2
Subdivision: L 1 i s E r i k c Lc 1 •�' Lot no r /
Fixture or item
Water service (no. linear ft: _) Page 2
C. 7+ L `7
Tax map /parcel no.: ���
_ - Absorption valve
1.1 - : , ?: - . s -` `: DESCRIPT)q \' OF :'iv.CR : _:=_ - g>
.., ... •�"' - _ Backflow preventer x Page 2 1
Landscape Irrigation Backfiow Device Backwater valve I 16.60
Clothes washer 16.60
Dishwasher 16.60
'' ❑ PROPERTY ^ pl1'IVER - Drinking fountain 16.60
.
- - - -- '. Ejectors/sump 16.60
Na ne: Stone Bridge Rouses LLC
Expansion tank
ExP 16.60
Address: 16869 SW 65 Ave #505 Fixture/sewer cap 16.60
City/State/21P: Lake Oswego, OR 97035 Floor drain/Door sink/hub 16.60
Phone: ( ) I Fax: ( ) Garbage disposal 16.60
, = r' ., Floss bib 16.60
-. , . --3:' ` ❑ COi\'TACT,PE,RSON _
Icx maker 16.60
Business name: Landscape Oregon, Inc
Interceptor; grease trap 16.60
Contact name: Ellen Sparrow Medical gas (value: $ _) Page 2
Address: 12200 SR' Myslony Road Primer 16.60 i
City/State /ZIP: Tualatin, OR 97062 Roof drain (commercial) 16.60
Phone: (503) 692 -5945 Fax: : (50.3-) 692 -0768 Stal /baslnRevatory 16.60
Tub /shower/shower pan 16.60
E -mail: ellenClandscapearegon.com
Urinal 16.60
. , ,.. ... - ' CO1VTitA R ., :''...1::.''.2 . : 4. , •- �r= Vrater los 16.60
Business name: Landscaper Oregon, Inc Water beater 16.60
Address: 12200 SW Myslony Road Other.
City /State/ZIP: Tualatin, OR 97062 Subtotal
Minimum permit fee: $72.50 36.25
Phone: (503) 692 -5945 + Fax: (503 -) 692 -5945 Residential backflow minimum permit fee: $36.25
CCB Lic.: 7804 Plumbing Lie, no.: Plan review (25% of permit fee) '
Authorized signature:
State surcharge (12%ofpermit fee) 435
f TOTAL PERMIT FEE 40.60
Print name: Ellen Sparrow D) ) ( 10 J , 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: lBuatenglPernui5 LAW - PermitApp.doe 12/27/06 4046167(10.'02/COWWEB)
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CITY OF TIGARD -
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BUILDING DIVISION PERMIT #: PI_M200&Q0302
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1612008
Phone: (503) 639 -4171 A i 1
Inspection Requests (24 Hrs.): (503) 639 -4175 .viii _..
INSPECTION WORKSHEET FOR DATE: 7/24/2008 TIME: 7 :00AM PAGE: 4
SITE ADDRESS: 13183 SW NICOLE LN CLASS OF WORK:
SUBDIVISION: WILSON RIDGE NO. 2 LOT #: 024 TYPE OF USE:
PROJECT NAME: WILSON RIDGE II
DESCRIPTION: Installing backflow preventer.
OWNER: STONE BRIDGE HOMES NW LLC, PHONE #: 503-387 -7577
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503 - 692 - 5946
Inspection Request Scheduled For: Date: 7124 2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 073159-01 503692 -5645 N
Corrections/Comments/Instructions: U —r— ,_ 0 S ,�1
00 ... L e CV c -�C, �� -�K.. 1c-e �/�d c.. ` t a ✓T
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[PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C r l \ ' v M . . J C L \i\-. Date: - 2 ) 2‘A VAC Phone #: (503) 718-