Permit . .
-A - CITY OF TIGARD PLUMBING PERMIT
,iliA' PERMIT #: PLM2000 -00290
DEVELOPMENT SERVICES DATE ISSUED: 8/8/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12197 SW QUAIL CREEK LN PARCEL: 2S103C6 -11200
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 070 JURISDICTION: TIG
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
Remarks: Installation of residential backflow prevention device.
FEES
Owner:
Type By Date Amount Receipt
DON MORISSETTE HOMES PRMT DLH 8/8/00 $25.00 0004317
4230 SW GALEWOOD SPOT DLH 8/8/00 $2.00 0004317
LAKE OSWEGO, OR 97035
Total $27.00
Phone 1: 503 - 387 -7538
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
Phone 1: 682 -6076 RP /Backflow Preventer
Reg #: LIC 00006136
PLM 11558
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
o 4/ 4'A � 6V77
Issued By: Permittee Signature: "971E6
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
06!08(99 TUE 10:57 FAX 503 598 1960 CITY CF TIGARD J �00_
• CITy OF TIGARD Plumbing Permit Application I !�l Plan Cr:eckX
13125 SW HALL BLVD. Commercial and Residential `veQ 1 Redd By
DatetoPE.
TIGARD, OR 97223 GCE Da:e Recd
RE
(503) 639.4171 75* Date lc Cr
Print or Type � S Permi R P��`Ie2o Da - pOo?9D
In or illegible applications will I�t be aG 'lta
.04 Related $7/AR a
ti e..` Called
Name of Deve;opment/Projec � �+ FIXTUR :{IndivldrliW`;= lAii : r =, _] °Q7r " : 1A7; :;
Job at-L - 4ot•1L LOT I Sink . ES 11.50
Address SreetAdAress Sari „ I, Lavatory 11.56
02/ ` Sou L Ls Tub or TubiShower Comb. 11•5C
Bldg f! Ci !State Z !
S Shower Only 11• A
9u ca_. o cir ,) 3 11.50
Name
Water Closet i
bsn rfoYiSS -1c.. tolayn Clst:washer ' 11.50
Owner Melina Address Suite Garbage Disposal _ I 11.50
L. 30 SW C -�alut 'c' /l ashing Machine I 11.50
City1S:ate Zip Phone Floor Cram /Floor Sink 2° 11.50
Le-Lke vSwecto 012 790- toy 5(o ,
Narre 3" 11.50
•
q° 11 50
Occupant Wailing Ad • Ss Suite Water Heater O conversion 0 Ike kind 11.50
ties piping requires a separate mechanical permit.
City /State Zip Phone Laundry Room Tray 11.53 1
I Urinal 11.50
Name Other Fixtures (Specify) l i 15.0.)
. 1.!- laCCILp P ro &rasS LQnd scaP:;
Contractor Mailing Address Suite
1 9 S Situ JCi n Smuri.l? D
Pricr to permit City/Slate Zip (Ione L. e2 - Sewer - 1st 100' 98.00
Issuance, a copy l L-" I dr «>; OjZ9707U (p otl7 Sawer - each additional 100' 32 00
of all licenses are Orega Cont. Cont. Board Lie.* . Da.e
required if � J)3(p $/31 f ao c ..e Water Service -1st 100' 38 00
expired In COT Plumbing Lie. 0 Exp. Date' Water Service - each additional 200' 32.00
database t Storm & Rain Drain - 1st 100'
38.00
Name .
Storm & Rain Drain - each additIona1100' 32.00
Architect Mobile Home Space 32.00 J
or - Mai7!ng Address Suite Commercial Back Flow Prevention Devl^e or Anti- 32.00
• • Pollution Device
Engineer f CIty/State Zip Phone Residential Endow Prevention Device' t l 18.00 i9 la
(Irrigation timing devices require a separate
Describe work to be done: restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 11.50
Residential C Commercial 0 Catch Basin 11.50
Additional description of work: Insp. of Existing Plumbing 50.00
• perI it
S peclaily Requested Inspections 50.00
Are you capping, moving or replacing any fixtures? I pedlr
Yes 0 No 0 Rain Drain., single family dwelling I 45.00
if yes, see back of form to indicate work performed by Grease Traps I 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL. _ 4 ?t ' > J/ ,
I hereby acknowledge that l have read this application, that the information Isometricer riser daeram is required if Quan:!iy Total is > 9 1 /;; I :=
given is correct, that I am the owner or authorized agent of the owner, and 'SUBTOTAL i. • . I -=v6
-
that plans submitted are in compilance with Cregon State Laws. - - _ 1 � = "'., •
51&eet>rrvei`Ow . ant � � v. S.% SURCHARGE 7: I
Contact Person Phone "PLAN REVIEW 25% OF SUBTOTAL ," :i:
Requied xdy ii tixure qty. total la > 9 - : `' :i
„=.. _:,:._ .. :_ � : , - :_� TOTAL r7 !
C`'TSATKkh?US WAP,4 - _ a�af; rffsl� - 'L' i
i;2p - . 1:1 0 SE�2901?0 = F r i, r i - :a_'.a �-, —
* =313 Im tlt}t1$E 3 � . s r _ _ s ' "x%`.'.! 'Minimum permit fee is $53 + 5% surcharge, except Residential Bacicflow
A9 - _ _ _ - -i °T? "^ °" = Prererttlon Device, whi :h is $25' 5 °r6 surcharge
ip� ri is -_10.1 aes ariE_s fM4l s _ eaa il_ jiEi n tfinci tii r ' '� —
tlA4rOX'454sati sevre gtarrri - 0 - *Al _ : sQt➢r r3 a
454 :�'-'j "Ali New Commercial Buildings require plans with isometric or riserdiag;ain
I _<� BL ,__- ,_._ .—_ �_.. ��. :, :ter and plan review
i:lds:s :`armslolumapp.dc: S/2199
CITY OF TIGARD BUILDING INSPECTION DIVISION Ms _ a d 1 3 7
. 24 -Hcsur Inspection Line: 6394175 Business Line: 6394171
2 BUP
Date Requested e - 1 X03 AM PM BLD
Location /XI q1 s w gut 4 r/ (:4-(.4- Suite MEC
Contact Person 9 - Ph obi j — t(,e37 401,0 /0 0092.0
Contractor Ph SWR
UILDIN Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation /i
Drywall Nailing ■ `
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Mjsc:
Fina ( /�
'PART FAIL / )(-D
diii Post & Beam
Under Slab
Top Out 11
Water Servic -
Sanitary Sewer —
Rain Drains
A � RT FAIL
MECHANICAL
Post & Beam A \r„ Rough In 8 Gas Line
Smoke Dampe s�
Final `'�'
PASS PART FAIL
ELECTRICAL 4
Service y \O:
Rough In '\
UG /Slab i. • 4 p
Low Voltage 0.1
`\
Fire Alarm
Final
PASS PART FAIL
V ----
fill /Grading
Sanitary Sewer
Storm Drain � [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line C % [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA �(, (�
A the ach�pde�pralk ( Date , 4 66 Inspector •" �-N Exx 1
0 PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION s 1 3 q
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
G BUP
0> Date Requested � 7 AM / PM BLD
Location / 2.iq 7 s& Q i 4 i'l Gt t J. Suite MEC
Contact Person J / 2'7 Ph Car 37 , — 6' 00296
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: a 1 An A 0 6 �G� �� .\
Slab v UlJ 0 ) SIT
Post & Beam �
Ext Sheath /Shear r L Z ! D o - 0015/0 C / G - ,
Ina Sheath /Shear I . /� t � 2 O — 0 0 � 6 7 , / ∎ C Jt
Framing � (�
Insulation \ L.�
Drywall Nailing
Firewall
Fire Sprinkler ■tlr 0 0 / - 0 .
Fire Alarm 1 S `
Susp'd Ceiling '— l.ilJ� • ��•
Roof 11 ,�,,
Misc: 1/7,6L_ ro - J-v1A •
Final
PASS ART FAIL � � } ' + 1 - - -""
Post
MBIN
V)) �� �r-� 6�� S
Under Slab (� ( i V w�� S - -�� S ., Q 5
Top Out �7 J
Water Service On
Sanitary Sewer
Rain Drains
�� 400 FAIL
ECHANICAL
• : Beam
Rough In
Gas Line
SI' •ke Dampers
PART FAIL
RICAL
Service
Rough In
UG /Slab
Low Voltage
. Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date qg/0 Inspector \" ` E; ' 1
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.