Permit IN CITY OF TIGARD PLUMBING PERMIT
' COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00486
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/30/2007
PARCEL: 2S109AC -05100
SITE ADDRESS: 13275 SW NICOLE LN ZONING: R -7
SUBDIVISION: WILSON RIDGE NO. 2 LOT: 019 JURISDICTION: TIG
PROJECT: WILSON RIDGE NO. 2
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:
TUBISHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
STONE BRIDE HOMES NW, LLC
16869 SW 65TH AVE. #505 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 10/30/2007 $36.25
[TAX] 8% State Surcha 10/30/2007 $2.90
Phone : 503- 387 -7577 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: Permittee Signature: ern C-9 Cex&-e/
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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Plumbine Permit App1' FOR OFFICE USE ONLY
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City of Tigard DateiBy : If/ A70 7 3. Permit Na N12ocl _G1� 9.gi
13125 SW Hall Blvd, Tigard, OR 97223 OCT t t I Plan Rene //
Phone: 503.639.4171 Fax: 503.598.1960 mr n ;� . Data'By: Other Permit No,:
,_
24 Hour Inspection Line: 503.639.4175 jl 1-, - �� NadfedN ! Supplemental Date Ready/By: r° ° H See Page 2 for
w
Internet wwci.tigard.or.us �' �lY�rr I z • lementalInformation
._..._ � •
® New construction Demo " f For s pecia l i n f orm ati o n t • e chectrl
Description � Qty. I En. Total
El 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 SFR (3) balk 399.00
❑Master builder ❑ Each additional bativldtchen 45.00
Fire sprinkler ( sq. ft.) Page 2
.. _ :JOB SII'E :1NFOR L4TION AND LOCATION ` _ _ - Site adlities
Job site address: 13275 SW Nicole Lane Catch basin or area drain 16.60
City /State/ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60
Suite/bldgJapt. no.: ' I Project name: Wilson Ridge Phase 2 Lot 19 Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.6D
Rain drain connector 16.60
Sanitary sewer (no. linear R: _) Page 2
Storm sewer (no. linear ft.: ) Page 2
p Subdivision: Wilson Ridge Phase 2 I Lot no.: 19 water service (no. linear fl.: ) Page 2
ti Fixture or item
Tax map/pancel no.: 655 A7
16.
: :: :_' .- ` - : DESCRIFYTOPI OF. WORK : _ _ - Absorption v ow prey Page 2 ;- 5S • . Bacldl en ter
C Landscape Backtlow Device Backwater valve 16.60
,,_1 Clothes washer 16.60
Dishwasher 16.60
-
_. ,...: ; _ OPERTY fountain
.. :_ ..
D � � g o
,_.:.. ®: O'WPII;R- : : I - - - .. TEI�AP... ?.
Ejectorsisump 16.60
Name: Stone Bridge Homes NW LLC Expansion tank 16.60
Address: 16869 SW 65th Ave 11 505 Fixture/sewer cap 16.60
City /State/ZIP: Lake Oswego, OR 97035 Floor drain/floor sink/1mb 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
.....:. - LICMT -; :- � .; .�' COVTACT` :. c
® APP _ Ice maker 16.60 Hose bib
Business name: Landscape Oregon, Inc. Interceptor /grease trap 16.60 .
Contact name: Ellen Sparrow Medical gas (value: S ) 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
Tubishower /shower pan 16.60
E -mail:
Urinal 16.60
O = R' ater
=.
CONTRACTOR : = c 16.60
Business name: Landscape Oregon, Inc. Water heater 16.60
Address: 12200 SW Myslony Street Other:
City/State/ZIP: Tualatin, OR 97062 Subtotal
Minimum permit fee: 372.50
Phone: (503 -) 692 -5945 Fax: (503) 692 -0768 Residential backflow minimum permit fee: $36.25 ��' o7--5
CCB Lic.: 7804 Plumbing Lic. no.: Plan review (25% of permit fee) c
State surcharge (8% of permit fee) . ! 0
Authorized signature s-Z. �� TOTAL PERMIT FEE 9y, 'S •
Print name: Elko Sparrow Date: 10/29/07 This permit application expires if a permit Is not obtained within
180 days after it has been accepted as completes
*Fee methodology set by Tri- County Building Industry Service Board.
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I 89LO Z69 - £09 Ue113 d66 :ZO LO 6Z PO
CITY OF TIGARD'
BUILDING DIVISION PERMIT #: PLM2007- 004L36
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/30/2007
Phone: (503) 639 -4171 Apd,
Inspection Requests (24 Hrs.): (503) 639 -4175 . �L J FIJI.
INSPECTION WORKSHEET FOR DATE: 11/7/2007 TIME: 7 :00AM PAGE: 28
SITE ADDRESS: 13275 SW NICOLE LW CLASS OF WORK:
SUBDIVISION: WILSON RIDGE NO. 2 LOT #: 019 TYPE OF USE:
PROJECT NAME: WyLSON RIDGE NO. 2
DESCRIPTION: Bar :Mow preventer for irrigation.
OWNER: STONE BRIDE HOMES NW, LLC, PHONE #: 503387 -7577
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 11/7/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 05917(3-01 503-692 -5945 N
Corrections /Comments /Instructions:
CAce.,0 P LJA.‘1,,A. 91,J
JJ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 -/D \i`M^t- Date: ) 11'1 to Phone #: (503) 718-