Permit r y CITY OF T I GA R D PLUMBING PERMIT
o PERMIT #: PLM2000 -00312
' � j lj DEVELOPMENT H O MEN
B9 So RV 2CES 639 -4171 DATE ISSUED:
SITE ADDRESS: 12189 SW QUAIL CREEK LN PARCEL: 2S103CB -11100
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 069 JURISDICTION: TIG
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
Remarks: Installation of residential backflow prevention device.
FEES
Owner:
Type By Date Amount Receipt
DON MORISSETTE HOMES PRMT DEB 8/18/00 $25.00 0004585
4230 SW GALEWOOD ST 5PCT DEB 8/18/00 $2.00 0004585
STE 100
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 Final Inspection
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.
Issued B • I _ / a 41111. Permittee Signature: .
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busin ss day
06/08/99 TUE 10:57 FAX 503 598 1960 CITY OF TIGARD 2002
CITY OF TIGARD Plumbing Permit Applicati EO Plan -
13125 SW FULL BLVD. Commercial and Resider1 C oeec /i
TIGARD, OR 97223 rlY0®
p Da:e Rec :.a Q - G
(503) 639 -4171 \G 1 i Date to P E. =
Print or Type � ease tc
Incomplete or illegible applications will � ccepted Fermi '1 P L I � ' 1 $ C g 7 -G' "2---
t Felted $7.'R x
Called
Name of Deve:opmentPrcject -= F IXTURE S ;(1r dlVldual): " =.;_ :' `;. - -`. _ Otf .I, PRICE- I AMT /,
C-Or '�9 - ..
Job alka.. -c e.- *e t, uyt i Sink 11.50 I
Address StreetAddress_ w �- I Suite Lavatory 11.56 I
1.-( / l� D k_ Tub or TubiShower Comb. I Q 1 f 11.50 I �
T[
Bldg >Y City /State Zi i � Shower I 11.50
QJ)L'L f2 / 7�a� Water Closet ( 11.50
Name J Q I
Do mm-i SS c:1 tfarile S Clsrwasher i 11.50
Owner Mail ng Address Suite Garbage Disposal ( 11.50
L/ g 30 SID - °ti(rtt CGS l ashing Machine 11.50
CitylS:ate Zip Phone Floor Crain/Poor Sink 2° 11.50 i
Lek-Kt vSiV eC /t) 0 (Z, 790- 69 S le 3" I 11.50 i
Narre
4 .. !, 11 50
Occupant Wailin . ss Suite Water Heater C convers cn 0 Ike kind I 11.53
Ges pipino requires a separate mechanical permit i
City /State Zip Phone Laundry Room Tray 11.53 I
Urinal 11.53
(-idol ccolx- P ro Grass 1--( el se e-, Other Fixtures (Specify) i 15.00 l •
Contractor I Mailing Address Suite I
I99 �y S city /CcnSineut I
Prier to permit City/State Zip Phone b FO - Sewer - 1st 100' I 38.00
issuance, a copy lu1 f Sfin vt11>'. 01'97010 G1271p all Sawer - each additional 100' I 32 00
of all licenses are Grego Const. Cont. Board tic* E. Date
required if Water Service -1st 100' I 38 00
0 01 3 (, , 813 / /OOC�o
expired in COT Plumbing Lie. t I Exp. Date Water Service - each addltional 20C' I 32.00
database I Storm & Rain Drain - 1st 100' 38.00 I
Name .
Storm & Rain Drain - each additional 100' 32.00
Architect Mobile Home Space 32.00
or - Mailing Address Suite Commercial Back Flow Prevention Devloe or Anti- 32.00
I - Pollution Device
Engineer i City/State Zip Phone Residential Bacxflow Prevention Device' i 19.00 / I
(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 O _ Catch Basin 11.50
Additional description of work: Insp. of Existing Plumbing 50.00 I
per/hr I
Are you capping, moving or replacing any fixtures? I Speclaily Requested Inspections • 50.00 perhr
Yes 0 No 0 Rein Drain, single family dwelling 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 c T ?t' : •``. '
I hereby acknowledge that : have read this application. tha: the information Isoroe:rlc er riser diagram is required if Quan:iiy Taal is ? o : '/"
given is correct, that I am the owner or authorized agent of the owner, and 'SUBTOTAL - - ' cp
that plans submitted are in compiance with Cregon State Laws. • 1. • -, '" - ••: �S '•
S)&aettmret gent Date 9, S%s SURCHARGE � ,c
Contact Person Rod Phone "PLAN REVIEW 25% OF SUBTOTAL
Requime :rdy ii fixure qty. total Is >9 . .
: -.r__ . r= ',!.: : .. : � r.� =_ =i:�a TOTAL
r .
.x.1:al��{�r�US,�:S�Z8.4Q a : _ • �_'. _ _. 3 = � = si ?ccti. ?i aria :Y.. :y� : �. -.._ °u:l ._ . � �. / �_.�. �.
'• u„ . .. t - .•: := =- -- • r ::r• := 0 'Minimum permit fee is $50 + 5% surcharge, except Residential Bacidlow
i- �L }}��``rr��.y�pp l!am�pps� A^ nn ��., -.. - � .. - -- s:,__.
�.!„nYV�?T s' "; -uv w�u > is :- . ':c._rn „- rii�m
::tits tg ,1i0aesa7¢ °p(u ltifi #i.4 ales iii 41Ij.0trti da ntit -:> ::�3 > Prevention Device, whbh is $25 ± 5% surchar9e
: -- - All New Commercial Buildings require plans with isometric or riser diagram
:_'100faeY canna seyier9lorrr. -- ' - . vratar', --- t§ _ ;
,�_,.:._- ...� : ... . -.. � -�• -- --- and plan review
•:1d5:s :`or mslplumapp.dc: 572/55
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 9 (� AM PM BLD
Location / 2/ Sy 5 w Ca C Suite MEC
Contact Person Ph 62V- G0 PLM Ac'U — i-' 3i ?/
Contractor Ph el 2 (7 SWR
BUILDING 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
Drywall Nailing
Firewall
Fire Sprinkler t '
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
MB _
ost & Beam
Under Slab /` 0l
Top Out C'�� N
Water Servic
Sanitary Sewer
Rain Drains
Fin
PART FAIL ,.2y)
C HANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk C� 'Z
Date / Inspector Ext"�
Other ate p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
-CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
!�' Q BUP
Date Requested l - - AM PM BLD
Location / 2 / g-9 5 6v Q u G I ( Cam` / Suite MEC
Contact Person J / Ph 9 -- ti? 3 /r' PLM „ v "0 3 , Z—
Contractor Ph SWR
BUILDING 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
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLU IN
s Beam
Under Slab ti
Top Out 2 04g 19W
Water Service
Sanitary Sewer
Rain Drains
F'
FAIL
MECHANIC
os & beam
Rough In
Gas Line
e Dampers
;'= PART FAIL
ECTRICAL
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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date 9 Inspector Ext
Final
PASS PART FAIL D • NOT REMOVE this inspection record from the job site.