Permit -C
ip a CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00356
DATE ISSUED: 8/28/2008
TIGARD
1 3125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134D6 -10000
SITE ADDRESS: 11068 SW NORTH DAKOTA ST ZONING: R - 4.5
SUBDIVISION: DAKOTA GLEN LOT: 002 JURISDICTION: TIG
PROJECT: DAKOTA GLEN •
Project Description: Install residential backflow for irrigation system.
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
DON MORISSETTE HOMES INC Description Date Amount
4230 GALEWOOD ST SUITE 100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 8/28/2008 $36.25
[TAX] 12% State Surcha 8/28/2008 $4.35
. Phone : 503- 387 -7538 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 dired questions
to OU NC by calling 503.246.6699 or 1.800.332.2344.
Issued 0_444,4)1,i Permittee Signet ,
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.
�4 a
Plumbing Permit Application��j RECEIVED
Building Fixtures iW FOR OFFICE USE ONLY
Ci W Tigard RCCC7V p n p p r/ aDD oa S0o
n 13125 SW Ha11 Blvd., Tigard, OR 97223 AUG 2 8 200 DatdB : 0410 DO a . � ( PernlrNo 1 $ 3
0 Phone: 503.639.417] Fax: 503.598.1960 Play Review
ADS Da e/By Other Permit No.:
TIGARD
In.spection Line: 503,639.4175 CITY OFTIGARD
Internet www•tigard- or.gov
e
:- - . - . _ _ Q pplcmeatat Information
_. .:.1 . TYPE OE "WORK - _ - -- - -- - -
BUILDING DIVISION N I
- ...FEE = . ..SCHEDULE . - - - . �`
® New construction ❑ Demolition For special information use checklist
❑ Addition/alteration/replacement ❑ Other Description I Qty. Ea. Total
= New 1- 2- family dwellings (includes 100 R for each utility connection) ;` , `':': ; CATEGORY- OF CONSTRUCTION:: = ::.;. :. SFR (l) bath 24920
i- and 2- family dwelling ❑ Cornmercialfindustrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath kitchen
❑ Master builder ❑ Other. 45.00
_r ._ B Fire n ( 9 )
sprinkler s . ft pi 2
JO SITE.INFQ)i 1kTIOIY AVD LOCATION .:; - = Slteutilities
Job site address: ) I Q (7 S j olr DLLte.01 S , r Catch basin or area drain I 16.00
City /State2IP: 1- !6 /6t OR... q'1 .2- ..3 Drywell, leach line, or trench drain 16.60
Suite/bldgJapt no.: I Project name) kD fa &i u.•) Footing drain (no. linear t:1 Page 2
Cross streetldirections to job site: Manufactured home utilities 110.00
-
L Manholes 16.60
i"l C ' tf. ' - e.s ) tt'''Th CXLJ i1L. • ' Rain drain connector 16.60
Sanitary sewer (no. linear ft .: 1 Page 2
Storm sewer (no. linear e.:1 Page 2
Subdivision: )Lt L� #-� (j[ fir` Lot no.: C a--- Pater service (no. linear I : ) Page 2 -
Tax map /parcel no.: o 5 S L,3 Fixture or Item
t
. Absorption valve
DESCRIPTION OF'WORK'.' _.�: ' _- . Fi:.?.!: : - ,
. - - :: cicfl
a ow• p enter x P� 1
B
Landscape Irrigation Backflow Device Backwater a 16.
7 Clothes washer 16,60 •
�r Dishwasher
16.60
... ., _ . - • concern
;0_PRO['ERTS'O�'1'1`ER' • ' : = '�:' 11 - TE \ A.!YT : ,: - _ 16.60
/ -= Ejectors/sump 16.60
Name: - DOA) Hp/1 i .5 f 77 AkHg S Expansion tank 16.60
Address: 16869 SW 65 Ave /i505
Fixture/sewer cap 16.60
City /State2IP: Lake Oswego, OR 97035 Floor drain/floor sink/hub 16.60
Phone: ( ) I Fax: ( ) Garbage disposal 16.60
: .D CO�TACI H ose bib
!0PLIC4NT._ - 16.60
: AP
ice ntaLer 16.60
Business name: Landscape Oregon, lnc
Interceptor /grcue trap 16.60
Contact name: Ellen Sparrow Medical gas (value: S _) _ Page 2
Address: 12200 SW Myslony Road Primer _ 16.60
City/StateiZIP: Tualatin, OR 97062 Roof drain (commercial) 16.60
Phone: (503) 692 -5945 Sink/basin/lavatory 16.60
( ) Fax: (503 -) 692 -0768
Tub /shower /shower pan 16.60
E -mail: ellen@landscapeoregon.com
Urinal .16.60
_,..:' CONTRACTQR: -;.r;•c'�;___,:,__.`.::.' ..- ,: :;
_ Water - - closet 16.60
Business name: Landscaper Oregon, Inc , Water heater 16.60
Address: 12200 SW Myslony Road Other:
City /State2EP: Tualatin, OR 97062 Subtotal
Phone: (50.3) 692 -5945 Fax: (503 -) 692 -5945 Minimum permit fee: 572.50
Residential backflow minimum permit fee: 53625 36.25
CCB Lic.: 7804 Plumbing Lic. no.: Plan review (25 °l0 of permit fee)
Authorized si tu_ re• ��� X� State surcharge (12% of permit fee) 4.35
�Yp 2.. � TA �
,i TOTAL PERMIT FEE 40.60
Print name: Ellen i Sparrow /��
`
P Dat� a V 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.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006 -00356
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/2812000
Phone: (503) 639 -4171 Ai
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/8/2008 TIME: 7:00AM PAGE: 29
SITE ADDRESS: 11068 SW NORTH DAKOTA ST CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 002 TYPE OF USE:
PROJECT NAME: DAKOTA GLEN
DESCRIPTION: Install residential backflow for irrigation system.
OWNER: DON MORISSEITE HOMES INC, PHONE #: 503- 387 -7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503692 -5946
Inspection Request Scheduled For: Date: 9 /0/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
39 Plumbing final 075189.01 503-692 -5945 N
Corrections /Comments /Instructions:
O RAd 1 CrL rk-e_ek
C? r-- f S
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:(1/b'`*.A-s1 \ \\ Date: 9 \QAO() Phone #: (503) 718-