Permit C ITY OF T IGA R D PLUMBING PERMIT
PERMIT #: PLM2005 -00235
— L �I�"
DEVELOPMENT H B r S O ERV 2CES -639 -4171 DATE ISSUED:. 6/2/2005
PARCEL: 2S 109DA -08800
SITE ADDRESS: 12928 SW SUMMIT RIDGE ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 082 JURISDICTION: TIG
Project Description: Irrigation backflow.
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
LAKE OSWEGO, OR 97035 • [PLUMB] Permit Fee 6/2/2005 $36.25
[TAX] 8% State Surcharp 6/2/2005 $2.90
Phone : 503 387 - 7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD. REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Phone : 503- 692 -5945
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 or 1- 800 - 332 -234 •
Issued By: Permittee Signature: r (.aj(' '-
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.
E® . .
Building Fixtures B.C'
�
Plumbing Permit Appliq i 2 005 FOR OFFICE USE ONLY • • .
City of Tigard r , Received Permit N• • }C �!a„��
Dat e/Br J .� (/[l 13125 SW Hall Blvd., Tigard, OR 9722 v F TlC3 , 0 l 1 I , , Plan Revie
Phone: 503.639.4171 Fax: 503.598. V Lrn.. r� Other Permit NirV1t
LD G .r }�'il Date/By: o. STaOt ' ��
Q
24 - Hour Inspection Line: 503.639. �Sr( _i. t` 'W Date Ready /By: -I nth' 21 See Page 2 for
Internet: www.ci.tigard.or.us 1 t NotiliaUtvlcthutl: , 1. / Supplemental Information
•
- TYPE OF WORK FEE* SCHEDULE
N S New construction ❑ Demolition For special information use checklist.
\ Description I Qty. I Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
N I- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
•
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder ❑ Other: Each additional bath/kitchen 45.00
Fire sprinkler ( sq. ft.) Page 2
• JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: /..Q ' a 7 .caUr/ri LI - /QLa p e, ,D-A. Catch basin or area drain 16.60 •
L
City/State/ZIP: 7 ajLe._„ 0 R Q 7 "-o-Cif Drywall, leach line, or trench drain 16.60
�'}c (
Suite/bldgJapt. no.: Project nrn m, i..-1- f4� a 9C 8 Footi drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
�+ ,. ll // /� ,, nn ,�� Manholes 16.60
SA-L-) h� >r• I-7'Cn� A-b Rain drain connector 16.60
• Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: SLLryt f - t a (�.6 I Lot no.;ra - Water service (no. linear ft.: Page 2
Tax map /parcel no.: to - s A- 7 Absorption or
n n valve Absorptalve 16.60
' Backflow preventer / Page 2 DESCRIPTION OF WORK . $'
• �� .. , S
/ _c.4.4 / ..;,, ( , 4) f '. / rr, 4 (Aoyl b !'/t f 7 - i01.Q / e ; ' Backwater valve 1 6.60
Clothes washer 1 6.60
Dishwasher 1 6.60
I PROPERTY. OWNER .. * I . .p .TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Cif Y'/)Cy -i 5 s i i / tr J Expansion tank • 16.60
Address: 1.-.7 3 L' S I_L_t G - Gc I C. (LA.) U Oct. Fixture/sewer cap 16.60
City/State/ZIP:LCA_ / C C 0 1 i j CIO 0k- q L).3 5 Floor drain /floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
APPLICANT . CONTACT PERSON Hose bib 16.60
Ice maker 16.60
business name: L `7 a e ci - p - . 0 ,,,....,. /( _ ; ,,,, .f„., Interceptor /grease trap 16.60
Contact name: y) ,S f - 7 - 6 -- tC i Medical gas (value: $ ) Page 2
Address: / -.D.C) U SLi) /In ` 1 . 1/W11 Primer . 16.60 • City/State/ZIP: ( , 0 2 • 76(4+, Roof drain (commercial) 16.60
Phone: (50:3) (G• C/ -,S%(. j5 Fax:: (503) &, Y ,...R - 61 7(c -S' Sink/basin / lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal I 16.60
• CONTRACTOR Water closet f 16.60
. .
Business name: / seat .i. 07?^ e70 z.,■ C, Water heater 16.60
Address: /' a.,oc S /-C) nn 1.S4614,t11 11-4 Other: I Subtotal
City/State/ZIP: 7r 1 J U,;(2,.. '
Minimum permit fee: $72.50
Phone: (50.3) &Q a "9/t Fax: 603) (09,;? - Or 7C E Residential backflow minimum permit fee: $36.25 3 �- •
Plan review (25% of permit fee)
CCB Lic.: 7 �( Plumbing Lic. no.: State surcharge / u� of fee) �f
Urchar ( 8.0 o. p r it -e - x 90
Authorized signs t�� .4� 7
i C �/ / /2 I TOTAL PERMIT FEE / ,S e`! ( Print nam 1'(-� DatG This permit application expires if a permit is not obtained .t thin
180 days after it has been accepted as complete.
'Fee methodology set by Tri - County Building Industry Service Board.
P\ Building \Permin\PLMF- PemtitApp.doe t2/0] 440- 4616T( 10/02/COM/WEB)
2' d 89L0- 269 -EOS U eIO =TT SO 20 unC
r
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00236
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/71200
Phone: (503) 639 -4171 ii'h
Inspection Requests (24 Hrs.): (503) 639 -4175 "'r' i `:_..
INSPECTION WORKSHEET FOR DATE: 6/10/2005 TIME: 7:14AM PAGE: 105
SITE ADDRESS: 12928 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 082 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Irrigation backflow.
• OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503- 387 -7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503- 692 -5945
Inspection Request Scheduled For: Date: 6/10 /2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 008870-02 503-692-5945 N
Corrections /Comments /Instructions:
11) I .. 0 w - , - I
-- 7Y (76/2---/ 0
riPP
C i
■
Ili PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
16- ' ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / , 7 Date: / #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005.00235
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/10/2005 TIME: 7 :14AM PAGE: 106
SITE ADDRESS: 12928 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 082 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Irrigation bacldlow.
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 - 387 -7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503-692-5945
Inspection Request Scheduled For: Date: 6/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RP /backflow preventer 00887001 503 -692 -5945 N
Corrections /Comments /Instructions:
SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-