Permit C ITY OF TIGARD PLUMBING PERMIT
.4 DEVELOPMENT SERVICES PERMIT #: PLM2006 -00018
- ..� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/12/2006 PARCEL: 2 5109
S 109DA -04100
SITE ADDRESS: 12876 SW PINE VIEW ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 018 JURISDICTION: TIG
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:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
DON MORISSETTE COMMUNITIES LLC Description Date Amount
4230 GALEWOOD ST STE 100 .
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 1/12/2006 $36.25
[TAX] 8% State Surchari 1/12/2006 $2.90
Phone : 503 387 - 7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD. REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
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 -246-6 99 or 1-800- 332 -2344. �t-
Issued By: -i% � Permittee Signature: f aMd
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
Building Fixtures ``''
PIumbing Permit Appli es FOR OFFICE USE ONLY
City of Tigard o Received/ / r
13125 SW Hall Blvd., Tigard, OR 9722 '1 �, Date/By:/'' k` �,6 • Al• Permit No al ?mod " - D/
Phone: 503.639.4171 Fax: 503.598.1960 L PN ' , - w Plan Review
24- Hour Inspection Line: 503.639.4175 '(� 1 . ' `: j Date/By:
Other Permit No.:
Internet: www.eltigard.or.us C � Q � ' L �- •� I .. Date Read 2 fo
. o y / , � / El See Page r
; ,, . y . 1r ,, ; . A ,.- . . .t, : C:a _ G `�\{'a, � n � _ I Notified/Method: • ' �I Supplemental (ofonualion • • 3:`.. •:L:.::r�'. .47r�w.lys. ..a I..9 y> ,� �.�' , 7.� .f: • - .'� %! .� ,y.' :." _
New construction . .... . , .. _ .... !.... .. , ... ;•. ;. •ti k , ; ? :; • + � .. 1"!.::2.:
., .. � ? >; . ± i ' .FE E , .; SG}HE��3LE', :•....
❑ Demolition ' ' ",. For special information use checklist.
❑ Addition/alteration/replacement Description J Qry. I Ea. 1 Total
❑ Other:
? }'. ,� : +•, . r - � R : _ ,.','. „ I ,� :• New 1- 2- family dwellings (includes (00 R. c
:' !,' ` . 7'T. 1 ' ; �'Cl' �R> f+:
c*# _ .r r ' ;;�; for each utility connection)
r.r, 4 ►, • - �.,._,.... ,;.:; SFR (1) bath � 249.20
\ ISkl- and 2-family dwelling ❑ Commercialindustrial 1V SFR (2) bath 350.00 }
1:3 Accessory building 0 Multi -family SFR (3) bath 399.00
1:3 Master builder Each additional bath/kitchen 45.00
❑ Other:
ti'l. '`a1r"'^2�: (a N Fire sprinkler ( sq. Page 2
.. :. ' `.' SI.. fie.• t;;: i ,,,, : ; . 1 q. ft.) Pa e
1 ' :4 . i . . 7 .,: . r`C •1 . . _ . !s t ) I:SUL N � • Cn ". c'a• : :. r:: S I
'»•:: ��`' "� `• -a••' i te utilities
Job site address: /aF7( _ca .) P/f) e
V/ «-) Catch basin or area drain 16.60
City /State/ZIP: 1 6.60
T�e�aa.eL � Q 97 � -a- � Drywell, leach line, or trench drain
Suite/bldg. /apt. no.: I Project nam J . �, 2 �r - j Footing drain (no. linear ft.: ) Page 2
Cross
s' �street/directions to job site:
� "'7 Manufactured home utilities 1 1000
.rek, 13C c B _ ete Manholes 16.60
R p Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision qp - P. Lag Water service (no. linear ft.:
9 ei I Lot no.: � � W ( ) Page 2
Tax map /parcel no.: (_DS - Z. A - Fixture or Item
• ':':= >';i. valve 1
.- '::•-... �' �,,.. �' . `l� "�
'• :�=iU SC il
E��•:a �! :.: .. Absorption 16.60
P ::' :' Backflow preventer I Page 2
4 -CC! r, I rr / 9Iri_7; J"}'1 �)( /.!c f tfr �l r ;/ t , ; i e i Backwater valve 16.60 a �
La ,)
Clothes washer 16.60 ■
�� Dishwasher 16.60
a �c r,'' �• F •kii?i •s. .;% ;:, _ � tik: 1 4;. ; D fountain 16.60
Ejectors/sump 16.60
Name:
D inn ✓y)/,Y/ s .� ,. C
Expansion tank 16.60
Address: La 30 S (...0 & l.. t e C. 0 o cut Fixture/sewer cap 16.60
City/State/ZEP: ,t G () i, (1 C c%C) Q/e. y '71 3_ 5 Fl drain/floor sink/hub
1 16.60
Phone: ( ) Fax: ( ) Garbage
disposal 1 6.60
Sri _ _Cft;�:a` ._,..,_�`T yJ4r• ,:.,.,. :.v,•.: , -,.:
.,: . "a!5:� '�'� � • `•� �` "-P c; - ';ir'�`•{.�•i :.... ,•.: •• ' �.. ^. ... Hose bib 16.60
1 � , cr i+.....:..I•.,. +9na'S : ,;:,;:• F,:�, :.j�, ���Fp�'S'O1Yr. 'r:: ?:' Ice maker 16.60
Business name:
l�r, i/ Cc�'� a r . L".., G
Contact name: 'v--= /) � p a,t/ , S Interceptor/grease trap 16.60
`� , � Medical gas (value: $ ) Page 2
Address: / 0 L)O . w l y.5 1 t m J
/, ' 2'U Primes 1 6.60
City/State/ZIP :'- ( &hn , C,k_ 1 7( (, cL Roof drain (commercial) 16.60
Phone: CSC/3) tG C' j2 --- S % U J .5 I Fax: ( ) 6, y :l - C". i ‘:., , f,„ Sink/basin/lavatory 16.60
E -mail: Tub /shower /shower pan 16.60
. J Urinal •
'_ t20 4.. 16.60
::; ,..• .. :i,. ° j . ';. /11:1 A C b Rs ti..;.' .A.i • .s..:,. .' i.... ,
�� .: <:.,.., r: .. .: ; .:::.:., . . !.:: ' Water closet 16.60
Business name:La/wi5e, G >re.t'' / r.
'"'77--�� f J� ��1 ... Water heater 1660
Address: / �-a-GO J (.L/ M. -f ...5.101 Other. ----
1
City/Slate/ZIP: '(u�� U /7U� Subtotal
F ax: Minimum permit fee: $72.50
Phone:
) (Q • - a - O3) &,9C - O r7lo g' Residential backflow minimum permit fee: 536.25 .36 -a. S
CCB Lic.: 7 &t) permit Plumbing Lic. no.: Plan review (25% of peit fee)
Authorized sig J ex State surcharge (8% of permit fee) e .2 . 9
L TOTAL PEicM1 i F_ -r -r- 1.3q./ S
Print name`/ � aalfo �l J , \ I Dahl - 14.- 04i I I T his permit application expires if a permit Is not obtained , : :thin
180 days after it has been accepted as complete.
; *Fee methodology set by Tri -County Building Industry Service Board.
tApp.doe 12/03 440.4616T(10/02/COM/WER)
2' d 99L0- 269 -E0S Uaii eL2 =60 90 21 UeC
' CITY OF TIC.A4.RD
BUILDING DIVISION; PERMIT #: PLM2006-OOt118
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/121200f;
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/20/2006 TIME: 7 :00AM PAGE: 90
SITE ADDRESS: 12376 SW PINE VIEW ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 019 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Backflow preventer for irrigation..
OWNER: DON MORISSET E COMMUNITIES LLC, PHONE #: 503 -387- 7638
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 1/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 025348 -01 503-692 -5945 N
Corrections /Comments /Instructions:
•
Er‘
PARTIAL APPROVAL CANCEL NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL EES ASSESSED
10 / 11 ' Inspector: Date: ( vCJ v Phone #: (503) 718 -
tit