Permit CITY TIGARD PLUMBING PERMIT
a, ; ;,i , DEVELOPMENT SERVICES PERMIT #: PLM2000 -00387
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/16/00
SITE ADDRESS: 12467 SW QUAIL CREEK LN PARCEL: 2S103C6 -08700
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5
BLOCK: LOT: 036 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 CTR 10/16/00 $36.25 27200000000
4230 GALEWOOD ST 5PCT CTR 10/16/00 $2.90 27200000000
SUITE 100
LAKE OSWEGO, OR 97035 Total $39.15
Phone 1: 387 -7538
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
Phone 1: 682 -6076 RP /Backflow Preventer
Reg #: LIC 6136 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 : , / !' �✓J4 . �d Permittee Signature: 44 p
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
09/14(Ut1 •"` • • Plan GheC��
R an Cri
1 OF TIGARD Plumbing Permit Application Commercial and ResidentiRECEIVED Data Re d In -iu
Dale to P.E. ��
rIGA D, ORA 97223`,p OAT 1 200 Date to DST
TIGARD� Permit ¢��raW{o -ago 3g7
• :503) 639 -417 � Related sWR it
Print or Type COMMUNITY DEVELOPMENT Called
Incomplete or illegible applications will not be accepted
. Qly i_Prtce.._•: 7otaii
FIKTURES (individual) .. . 16.60 Name of Development/Project e _ -- `--- -'
� {_ ` /�� 3 `_ Sink 1 ;
Job ( l�C� a [ V� Lavatory 16.60 t
$1:;i2
Trig" au .- rile ( 10.60 :
Address !
C'ty /5 :aEe yip Water ic - 7 16.69 j
! Bldg R 7/ UA 9 -3
4 1 Waver Cicsel 16.G0
- '- !-Foy c S. i -
N-r.
!n 0rlSSe 1- k. I 15.69 Suite _
Owner Mailing Addrees L70PCL �6�
Garbage Dispose 1660
3U e Ga m Frore Laundry Tray
City /State Zl� 16.66
Tl C C� /1LL O� _ - -
Washing Machine 16 c0
-- Drain/Floor 2'
Flame Floor Drai 10.£0 i
•
9 16.E0
! Suite 4 .
Add ress 1 0.60 I I
Occupant I 1
Zip Phone • Water Heaver a conversion 0 Bice k:nc
City/Slate p G pip re u'res 3 s ep arate mechanical permit.
I � 1
MFG Home New Water Service l 46.40 I �
'b bra S a�� S [ / MFG Hone New S aniStam Sewer 15.60 J
� j� Hose Sibs
f.lailing!��ry K c n �� r�v 111111 10.63 Contractor - �y Roof Dralns - 16.E0
c ( C07 a
Friortopenit �ip��r�g611�i (j(L`)7071 a � aa k i" a 1 DrinldngFcurlaln
issuance, a copy ( C -te 04rer Fix <'res (Sxcif�) -
ot alt G are Oreyol Coast, cnt. Board Lio. Pi ai _
required d If lo ■„ -
expired in COT Plumbing Lic.1
database 53.00 Na a Sewer - 1st 1J0' i 45.40 I ,
Water Service -1st 100'
Architect Sewer - each adcilional 10C'
i
Matting ddress NMI OT Will ' .
City/State Zip i 55.00 •
Engineer Storm & Rain Drain 1st 10C' 45.40
Storm 8 R3ir. Dra;n -each additions 100. 46.40
peso•? e ivo !r. to be done: 7.55 •
New 0' Repair 0 Replace with like kind: Yes O PJo O Commercial Back Flow Prevention Devl -e l ® �
Resiident:aN) Commercial O t3.6
t or t f pork: Residzn iai Back!kw Prevention Device
A Lions! des P J �, , ` t '� �� Catch Basin , 72.50
�l /� ���I C v Imp. of Exis!:ng Fl rrtlr•9 or SCeG2;lr Re per/hr _
r`,G moving or replacing any fixtures Inspectors 55.25
Are you capping, s O No 0 16.60
Ra prair, single ta:ni!y d�.tietl ng
If yes, see back. of form to indicate work performed by i Cif.? 359 ;raps
fixture. FAILURE TO ACCURATELY -,.. SED SEWER . QUANTii f TOTAL 1 `ar],.5�
CRFA 1%.:131 Is >9
I hereby 2 nCOULD g e. t t t h read cati.�n, t :at the in`crmaticn I som = -'• ^c or sr uav n is r :� irra 'e Ouaw 1
I herz5y z r r ect. +t hat I teat I h app e 3�' °�
I d, that t ern tae owner or authorized agent cf the owner, and - _ � -•� •
gn s come Orecon Slate Lava_ __ t SJ .C. tG� � ;;9 �
t . -1 br-� : :t• :d are ir, c :m.Eance v.;J' _ Dl.,
..c. plans l UC�L �1 -��
i (-A-- • Vg- "PLAN RE -_ _-_ I AL T
%m _ l liG 7� only cYt�r-4 :!alis > T i
t Person f ° - V Requ" ° '' `f t TOTAL j,Q , I
•..t:$ATii IC!J� 910" v : �t `i : ]z 3 . -. 1;7 'i r:. -r' a Ea _cn_ Fre�_ns:
t3 .-1 � i- i - _ `. bi It ree a $72.20 + 6�, •
rartlyar3 � n
. w •Mlnln ern F •e r.. ' 316. c��� '
J 8.4T H OUSE 5359.00 nd the flr5 i e l 25 + 5'.5 sure' ar;c s. m arc p r c�
31 6Ls ttae:irclu dosal tx ll nbin y rss�n.tha dwa Iing - =� - i
cvrlto[san "All �e�n Ccrr'I� =�a' p,�idtng; r.•Gu'rr. p al .,
10' ,f- e�o.sao
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /0—I ( AM PM BLD
Location /A. y S w £2 c i f ( C1t.c. Suite MEC
Contact Person Ph PLM - " 3 ?7
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 l Z
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out adef./
Water Service
Sanitary Sewer
Rain Drains
Fi
PART FAIL
M CHANICAL
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Other h /Sidewalk / Ins ector Ext other Date p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.