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Permit A ' CITY OF TIGARD ORIGINAL GPERMIT ��s DEVELOPMENT SERVICES PERMIT #: PLM2000 -00198 � ��� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/14/00 SITE ADDRESS: 12540 SW QUAIL CREEK LN PARCEL: 2S104DA -00600 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5 BLOCK: LOT: 043 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 device. • FEES Owner: Type By Date Amount Receipt DON MORISSETTE HOMES INC PRMT DLH 6/13/00 $25.00 0002929 4230 SW GALEWOOD SUITE #100 5PCT DLH 6/13/00 $2.00 0002929 LAKE OSWEGO, OR 97035 Total $27.00 Phone 1: 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. Issued By: Ze Permittee Signature: / Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day 06/06/99 TUE 10:57 FAX 503 598 1960 CITY OF TIGARD 0002 CITY OF TIGARD Plumbing Permit Application Plan Clerk X 13125 SW el_v[ ECEIVED Commercial and Residential Reed By /M / TIGARD, OR 97223 Dare Recd 4/7/0--0 (503) 639 -4171 JUN 0 7 2000 Date to P.E. P T Print or Type / Permit* Date to 3T ( COMMUNI 1�� i�l� � o • ille g i ble applications will not be accepted /� L-•SOoo - DO /9? Related MR # Called Name of DeveopmenUProjec = UR _ (!indivtduai - ` = -.- ; '91 ' PRICE_ . ,ItAT - Job (L- VAotltu) `13 Sink 11.50 Address Street , ddress I Suite Lavatory 11.50 • i i-10 ) Q' - C.rY• Car - Tub or TubiShower Comb. 11.50 • • • _ • _ • Bldg # .. • City/State • . - Zip • • 1191Ka o1�47ay . Shower • Only 11.50 Name Water Closet 11.50 _ _ born 1rerri SS e..+ . YerrheS CIshwasher 11,50 Owner Mang Ad S uite G arbage Disposal 11.50 wa3o Sly Getie-vood. Washing Machine 11.50 City/Sate Zip Phone Floor CraWFloor Sink 2° 11.50 Lake 0Stucgo O le, 790 - G SI S(o • • Nacre 3° 11.50 • • 4° 11 50 Occupant yang , s 5 Suite Water Heater 0 conversion 0 Ike kind 11.50 • Gas piping requires a separate mechanical permit. • City/State Zip Phone Laundry Room Tray 11.50 I r Urinal 11.50 Cape— W O Grass Ism el Sle_, Other Fbcbaas (Specify) 16.017 Contractor Maaatg Address uite 98 F1 S Stu k ntrn4J Prier to permit City/State Zip Phone L fa- Sewer -1st 100' 38.00 Issuancer a copy LL j SP p)ik O2 97o7O 1,074, an Sewer - each additional 100' 32.00 of all licenses are onst. Cont. Board Uc.# E. Date required if Oregon Const. $ • /3 /JaOGo . Water Service - 1st 100 38.00 expired In COT Plumbing Lit. L Ems. Date: Water Service - each additional 200' 32.00 • database I Storm & Rain Drain - 1st 100' 38.00 Name • Storm & Rain Drain - each additional 100' 32.00 . Architect Mobile Home Space . 32.00 or - Mating Address Suite Commercial Bads Fleur Prevention Devise or Ant- 32.00 • • Pollution Device Engineer I City/State Zip Phone Residential Bacudlow Prevention Device' f 19.00 p9 eD • (Irrigatiac tlmirl6 devices require a separate 1 Des ibe work to be done: . restricted energy permit.) New Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 11.50 Resident. 1 0 Commercial 0 Catch Bin 11.50 Additional description of work: . Insp. of Existing ?lambing 50.00 • per/hr you capping, movin or replacing any fixtures? Specially Requested Inspections • per /l Are Y moving Y perinr Yes 0 No 0 Rain Drain, single family dwelling 45.00 If yes, see back of form to indicate work performed by Grease Traps 11.50 fixture. FAILURE TO ACCURATELY REPORT FIXTURE WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL 1 '' I hereby acknowledge that l have read this application, that the information Isomeric cr riser diagram Is required if Quan9ly Taal is s• 9 I given Is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL =:_ - that plans submitted are in compliance with Cregon Stale Laws. / - == L� J � � � L V. E°�, SURCHARGE :: Contact Person Phone "PLAN REVIEW 25% OF SUBTOTAL - _ Requiee :r+y it finite qtr. total Is '9 4,302. :Lit?. 7Pea- - r -21—Mi YV--Wi li _ gig _ _ - TOTAL - - _ _ ..... . - .. _ ....._. � � , = _ -= , _rte ._ ._ra= =�'��� 7-�_ -= ! X313 D 2 50+00 „ TStimm O >� 4 �. `,_r._ •�,_ .,.. igt: ; _sa = :.1 !nn.,f. :V 'Minimum permit fee is $50 + 5% surcharge, except Residential Bazkilow CS .1�.• _a; :la,y.s w- �r., 1. _ �.,�r .,. r .�+?In _ *�. surcharge I : ` s A , Preve - gfIn Devic. w d h i s S2 + 5% rttAtilV(Olsatiita M s 12 * tqI = *_- Ail New Commercial Buildings require plans with isometric or riser diagram and plan review I: 1da:s'1xmslolumapp.dc: S ISS 06/08/99 TUE 10:59 FAX 503 598 1960 CITY OF Tlti Attu .c.,..-., 1 ,• . • " • . . . „ .. , • . . _ . . . • I . ..__ ., . , ' • . . • PLEASE COMPLETE: . - . - " • • • - • . • - . • . . . ... - .. ..--;.'"-•'g'fi.''':'":F,TFiffufetiti-i''•-•:?•b.'•1:1'is-i-':`:fr:intil:'!..i•;:g,'•::Iiill'hiftff.§..-:',01:aitiVi]:ANCOR10 ittOfriftiid.:;:Ai.4.A.i'dit:1 - • . c v ;,,;.:.,g Ro ,,,4 4ffitiega l:::i. w.g1.0.:;.:.:1 .- ,..,.........• .. , a • • Sink - . Lavatory • : - . ... ... . • Tub or Tub/Shower Combination • • . . • Shower Only - . . • • • . . • Water ClOtet ''.• • . Dishwasher . . • • -1 • - Garbage Disposal • • - Washing Machine ' • • • - . • .,:_ . . - - • . Floor Drain/Floor Sink 2" • -. - • - . • . • • . • • - 4" • • . _ . • , _ . . _ . . Water Heater i • . • • . .1 • Laundry Room Tray . . • . . : Urinal • . . . . . . • • . • - • . - . . .... _:•:.:.- Other.FixtUres (Specify) .. . . ... , . .. . . ... . .. _ - • . , 1-- 'X-i2:.--- :--, . . . - - /9-CI -flax) . . . Prezzethan .2) c.c • .: / • -- •' • , . . •• • .• . .. _ _ • -. ,. . ...- ._.. - - : 1 .-,..-• • , . . . . . - • .' - . .. • . .. .. .. . . • . .. - • , .. . , . , . . . - • . • • , • • • • • • . • - • . . . . • . COMMENTS REGARDING ABOVE: • •. • • • • • . . . . .. . . - . . 11: tzforrnsip.urn app. doe SNAG • • . . • • . • • CITY OF.TIGARD BUILDING INSPECTION DIVISION ST 24 =Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested f i AM PM BLD Location / 2. i Ct0 S A✓ `mow Af CA-#-4 Suite MEC Contact Person Ph 68'z roe 74 - ec 2 17 p pP - Gd19 7 Contractor Ph SWR BUILDING Tenant/Owner ELC - Retaining Wall ELR Footing F Alir oundation Access: FPS • i 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 PAS5 PART FAIL C.UMBING) Post & Beam Under Slab Top Out Water Service Sanitary Sewer Ra' • ains c PAS PART FAIL ' MECHANICAL 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 Approach/Sidewalk Other Date Inspector Ext 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 BUP Date Requested f_0 AM PM BLD Location / IS40 5 Q4 t cJ Otta Suite MEC Contact Person V/ or, Ph 2.0C - zi g3 PLM Ppvv - 95 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 LUMBII�s Beam Under Sla // Top Out &OW VOA Water S mice Sanitary we ""k�'*'� Rain Drains F' P S PART FAIL MECHANICAL 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 7 1 3 4aS___ Other Date Inspector / Ext % . Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.