Permit '�/ l a CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00451
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/5/2007
PARCEL: 2S109AC - 06000
SITE ADDRESS: 13284 SW NICOLE LN ZONING: R -7
SUBDIVISION: WILSON RIDGE NO. 2 LOT: 028 JURISDICTION: TIG
PROJECT: WILSON RIDGE NO. 2
Project Description: Install landscape backflow device.
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
STONE BRIDGE HOMES NW, LLC
16869 SW 60TH #305 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 10/5/2007 $36.25
[TAX] 8% State Surcha 10/5/2007 $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 questio s to OUNC b •r (ling 503.246.6699 or 1.800.332.2344.
Issued By: p/i hi i i 1 / Permittee Signature: �tC�t ,
PP
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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Insured
Bonded - Insu CE IVED :,
Plumb' f ' �_% i ! _ 1, 1 inn? 1012 01.11C1: [ ONO
\� Received y,e�
C1 25 SW Hall slv f ,. r� • SF .. "� Da e/By: /OAP? Permit No.: PLM200? - e e iSj
'4F. ...• 1� : i � •. Plan Review
Phone: 503.639A17 +:.:�i, 1 ` � :' l o ' I Da
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24- Hour Inspection Line: 503.63 • tither Permit Na: _ _-xi • _ 1
Internet: www.ci ardor us m Ready/By: j edime
tib' Notitied/Mettrod: n� 0 See Page 2 for
Supplemental Information
TYPE OF WORK • • FEE* SCHEDULE
® New construction ❑ Demolition For special information um checklist
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 EL for each utility connection)
CATEGORY OF CONSTRUCTION.. SFR (1) bath 249.20 on
® I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ Master builder Each additionalbath/kitchen 45.00 '
❑ Other. Fire sprinkler (- sq. ft ) Page 2
' JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 13284 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/bldg. /apt. no.: I Project name: Wilson Ridge Phase 2 Lot 28 Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear IL: ) Page 2
Storm sewer (no. linear ft.: 1 Page 2
Subdivision: Wilson Ridge Phase 2 I Lot no.: 28 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map/parcel no.: 655 A7
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer / Page 2 34, -
Landscape Backflow Device Backwater valve 16.60
-
Clothes washer � 16.60
Dishwasher 16.60 .
® PROPERTY OWNER I ❑ TENANT Drinking fountain _ 16.60 '
Ejectors /sump 16.60
Name: Stone Bridge Homes NW LLC
Expansion tank 16.60
Address: 16869 SW 65 Ave # 505 i Fixturelsewer cap 16.60
City/State/ZIP: Lake Oswego, OR 97035 I Floor drain/floor sinklhub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
® APPLICANT 0 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 [6.60
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/showerishower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 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: $72.50
Phone: (503 -) 692 -5945 I Fax: (503) 692 -0768 Residential backtbw minimum permit fee: $36.25 .51.e • a S
CCB Lic.: 7804 Plumbing Lie. no.: Plan review (25% of permit tae)
�/� State surcharge (8% of permit lee) ,a • 90
Authorized signarlhu ��Cti ems) �!L/ "e1.
, a.t.1„
- TOTAL PERMIT FEE 37. t s
Print name: Ellen Sparrow I Date: 10 /04/07 Thls permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
phone: 503.692,5945 • fax: 503.692.0768 • 12200 SW Mygo tgcoiea giVaI€ if9Ottiti!striPliP ' Service Board.
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CITY OF TIGARD - . . Ai
BUILDING DIVISION PERMIT #: PLM2007 -Q0161
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10161 (J0i
Phone: (503) 639- 4171i�ll
Inspection Requests (24 Hrs.): (503) 639 -4175 �__
INSPECTION WORKSHEET FOR DATE: 10/24/2007 TIME: 7:00AM PAGE: 66
SITE ADDRESS: 13284 SW NICOL E LW CLASS OF WORK:
SUBDIVISION: WILSON RIDGE NO. 2 LOT #: 028 TYPE OF USE:
PROJECT NAME: WILSON RIDGE NO. 2
DESCRIPTION: Install landscape bacldlow device.
OWNER: STONE BRIDGE HOMES NW, LLC, PHONE #: 503 -387 -7577
CONTRACTOR: sonstimaIDORFAMEE,S RV, LLC, PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 10/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing fina! 058223 -01 503- 692 -5945 N
Corrections /Comments/ Instructions:
Co. rc f J 1.4. I44 9
PASS 111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
, ❑l FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: J V► hi... (`IN -.3- Date: 1012y to Phone #: (503) 718-