Permit ----` 4 CITY -OF TIGARD.
PLUMBING PERMIT
° • COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00310
TIGARD 13125 SW,Haii'Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/21/2008
PARCEL: 2S 109AC -04700
SITE ADDRESS: 13319 SW NICOLE LN ZONING: R -7
SUBDIVISION: WILSON RIDGE NO. 2 LOT: 015 JURISDICTION: TIG
PROJECT: WILSON RIDGE NO. 2
Project Description: Installing (1) 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 #505 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 7/21/2008 $36.25
[TAX] 12% State Surch 7/21/2008 $4.35
Phone : 503- 387 -7577 Total $40.60
Contractor:
LANDSCAPE OREGON, INC.
IN MYSLONY RD.
TUAL ATIN, OR 97062 REQUIRED ITEMS AND REPORTS
UAL
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: %'��Gr�Gri�
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.
P.
Plumbing Permit Application
Building Fixtures (� FOR OFFICE USE ONLY
Cit of Tigard �o R ece i ve d
Ill
■ 13 125 SW Hall Blvd., Tigard, OR 97�� �ij
. , ax: .598.196 � `� A , Ian Review - ' i � 170 yj Permit No.:
= Phone: 503.639411 F 503 `. �+ �, /
�� � �G ��� ti DateB
Inspection Line: 5036394175
Other Permit No.: -
TIGARD . . ►
Internet: www•tigazd- or.gov m+_
Notified/Method;
app emcatal Iotormation
� h
® New construction - -
Q Dem on F or spec information use checklist
❑ Addition /replacement ❑ p��: - Description D
• e ) elling ( cludes ft. for ea connection
)
,...: 2492
-_ - - ':' :. - C , A .TEGORY. OF' CQNST RUCTION ;;;::;-'; - •, � :? _!! � . -;:: FR (1) bath it
Qty. Ea. Total
' dsl• sin 100 ch utility co 'on
S 0I
❑ 1- and 2- family dwelling ❑ Commercial/ Industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath
399.00
❑ Othe Each additional bath/kitchen
❑ Master builder 45.00
J913;SiTE I1V Fire sprinkler (__ sq. ft) I Page 2
_.. - :: ,`_, - ::: :'. ORMATION ANDi- LOCATION .:_ :: _ __ ;.. -
Job site address: � �' G• - Site utlL'ties
�` 3 l q /Li r C )/ (CJl_/1 -s�, Catch basin or area drain i 16.50
City /State/ZIP: .T j b e. C' 7 „)• .)- y Ato_a. Dry well, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: (,(j i fSCIh. feL�(!L / C/ Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: M cnrmd home utilities 110.00
f , I J l Manholes 16.60
S'L , L l• - , - t l, ' r-N •-i- - _ _ Rain drain connector 16.60
J'" r u e. Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: -_) Page 2
Subdivision: Li..) j I SLY) d9�: Q hits _ a, I Lot no.: S Water service (no. linear R : _) Page 2
Tax map/parcel no.: (G S A ! Fixture or item
Absorption valve 16.60 •
: • . :. : : :. : - - ,: DESCRI OF WORT &`` : =-
. • _ . - ...... _ . .- - _... ' Backflow prevenkr x Page 2 1
Landscape Irrigation Backflow Device Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
!?.❑ RORER d TX. _W1:ER' = _ _
• I _ =- +: , _ - .
-._. - Drinking fountain 16.60
P
Name: Stone Bridge Homes LLC Ejectors/sump - 16.60
rm
Expansion lank 16.60
Address: 16869 SW 65 Ave #505
Fixture/sewer cap 16.60
City/State/ZIP: Lake Oswego, OR 97035 Floor draim'floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
0 • APPLICANT ±. = c.., .. • Hose bb
..... -. : : :•0=CO..�1TACC :PERSbN'. 16:60
Business name: Landscape Oregon, Inc
ice maker 16.60
Interceptor /grease trap 16.60
Contact name: Ellen Sparrow Medical gas (value; $ _) Page 2
Address: 12200 SW Myslony Road Primer 16.60
City / State/ZIP: Tualatin, OR 97062 Roof drain (commercial) 16.60
Phone: (503) 692 -5945 Fax:: (503 -) 692 -0768 Sink/6asin/levamy 16.60
E-mail: clle
n@alaadscapeo regon. corn
Tub/shower/shower pan 16.60
.� -�, � �• k - •--" _ - -- - - Urinal
�^ 16.6C
: : : . : - - � a : _L. „• -- Water cl oset
_,,, . •°
_ - :::•..-... . •..: .. ,- : COIVTRACTUR. : ; :�. : :;.. :� _= c'. - : "; i r '• _- 16.60
Business name: Landscaper Oregon, Inc Water heater 16.60
Address: 12200 SW Myslony Road Other.
City / State/ZIP: Tualatin, OR 97062 Subtotal
PhDoer (503 692 -5945 Minimum permit fee: $72.50
Fax: (503 -) 692 -5945 Residential backflow minimum permit fee: $36.25 36.25
Lk. no.:
Plan review (25% of permit fee)
CCB Lie.: 7804 Plumbing L
: 2 State surcharge (12% of permit fee) 4.35
Authorized signature
TOTAL PERMIT FEE 40.60
Print name: Ellen Sparrow 1 Date? 17 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.
I: 1B16 lding ',PerrninhPL\ff•PmnitApp.d 70 12/27/06
44 7 4 6!e ?(10/a7/CO*N WEB)
L 89L0 uell3 d6L :LO 80 61. Inf
CITY OF TIGARD .,
BUILDING DIVISION PERMIT #: PLM2008 -00310 .. A.
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/21/2006
Phone: (503) 639 -4171 �,„ , ��l
Inspection Requests (24 Hrs.): (503) 639 -4175 -' °
INSPECTION WORKSHEET FOR DATE: 8/12/2008 TIME: 7:00AM PAGE: 1
SITE ADDRESS: 13319 SW NICOLE LN CLASS OF WORK:
SUBDIVISION: WILSON RIDGE' NO. 2 LOT #: 015 TYPE OF USE:
PROJECT NAME: WILSON RIDGE NO. 2
DESCRIPTION: Installing (1) backf low preventer.
OWNER: STONE BRIDGE HOMES NW LLC, PHONE #: 50:3 - 387.7577
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692.5945
Inspection Request Scheduled For: Date: 8/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 074082 -01 503 -692- 5945 N
Corrections /Comments /Instructions: n
De v ■ G 4. e Y1� S
Qi C. C , & c✓ l •
r ape_ '‘
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
El FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: wM� ► ■ \t Date: $) i 2 CSC) Phone #: (503) 718- •