Permit CITY TIGARD PLUMBING PERMIT
PERMIT #: PLM2006 -00157
Z DEVELOPMENT SERVICES DATE ISSUED: 4/25/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109DB - 04200
SITE ADDRESS: 13035 SW SUMMIT RIDGE ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT: 121 JURISDICTION: TIG
Project Description: Backflow preventer for irrigation.
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 STE 100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 4/25/2006 $36.25
[TAX] 8% State Surcha 4/25/2006 $2.90
Phone : 503- 387 -7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
•
Contact # : PRI 503- 692 -5945
FAX 503- 692 -0768
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 -6699 or 1- 800 - 332 -2344.
Issued By: 1 ^ _I Permiftee Signature:
1
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.
P s
Building Fixtures
Plumbing Permit Ap O 1VI
t C-� FOR OFFICE USE ONLY .
City of Tigard ReceipatdBy V - O', 'c 06 Permit NI 1 M a 01 s 1
ved :
13125 SW Hall Blvd., Tigard, OR 97223
Phone: Plan Re view
�
Phone: 503.639.4171 Fax: 503.598.1960 A t , PR 2� �5 ; ,m ; �.��� ''I , I �
. l ,� Date/13y: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 t '..... Date Ready/By: J r : G El See t I I 'or lnlorm uion ■ Internet: www.ci.tigard.or.us �'w Notified/Methad: Supplemen ..
V
'TYP t,. F1:1M"M " : .F E ES' " '
ew construction v 1 1 ' U Demolition For special information use checklist.
L Description I Qty . I Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
.. r ` ; : a` .. :Ct);TEGORY:, r'COP(5'Iii p':'10N':: ` .. ..?!.!:: SFR (1) bath 249,20
►` l- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
•...:....y�.- ;: • `#*S• E INI?ORMATIO D • •y ~• .. Site utilities
Job site address: /3035 ( L) L.L m-6 oatet9e. Catch basin or area drain 16.60
City/State/ZIP: rig 44_4( a A. 47.P-3y _ Drywell, leach line, or trench drain 16.60
L'¢;
Suite/bldgJapt. no.: Project n( fyl,/M /2Q,gG 4 _ j a,/ Footing drain (no. linear ft.: ) Page 2 .
Manufactured home utilities 110.00
Cross street/directions to job site:
/�
p Manholes 16.60
s-Le.) bee. F.' £ "' -mod{,. k ) Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: Page 2
Subdivision:. L.G/'YL t)4 (.,1 R....L ! 4 - I Lot no /c.. f Water service (no. linear lt.: ) Page 2
•
Fixture or Item
Tax map /parcel no.: i S"
valve
`''..`.:: DESCRIP,. ON <'01!` V1/(TXi1C
/ 2 017 S
Absorption 1 •
....... � : .. -.. -' :.ii : . Backflow preventcr Page S
L6 C 1.�'(• : ( - .r.... 9 • -;' ! 57, r , /. 74-7.):-.'.1.:' . J ./) ( 4 - Backwater valve 16.60
(( Clothes washer I 16.60
Dishwasher I 16.60
16.60
`y : %` 0.4:i Pi tt'c ,Owlv. . `.i i: : `4 ti l❑. :4 ANT'.. fountain
... .:.
Drinking o
.. Ejecto / mp 16.60
Name: ) j - +/ /-)(. ! _s.,-.: ''' .-L 4 '�� F_� CUM /TILL / Acti E..S L _LP-Expansion tank 16.60
,.
Address: = f' Z c.' LL) L 2< (c' C L` LI e' i Fixture/sewer cap I 16.60
City/ State/ZIP: L.0. / � C.. ( - \ i_ l i C %(• ± (: /&.. /, ) ( 771> Floor drain /floor sink/hub I 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
ose r
. ....'....;1';;::i.:;... H b'b
% APPI,iXC.ANT
. `: ' ' � NTACT YR}V;:.:‘'-.:•••:! : .: 7. :; 16.60
. ..: .
•:..:.:. . -. ..::::•;'; �: �:. "'_ : , \ :CO...,, C SO' Ice maker
Business name: Lel /^ : rC, /3 !;/ r ci!: ` r . , /''; ___. Interceptor /grease trap 16.60 j •
r t
Contact name: ✓ ',1 :f.:/' J /'� , Nay ; : .- ^ , L • Medical gas (value: $ ) Page 2
Address: 1 ) .7 ()C U.) /-YI tj ; I(tl'' 0.0 Primer 1 16.60
City/State/ZIP:'fl(&.t a t-1. . C ita- ' J • -:-:-... , '' :' • Roof drain (commercial) 16.60
Phone: (Sc'3) rL C/, - = - . Fax:: (._ ) L -' : - / .:. � .
Sink/basin /lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
a er closet t
-� dON 'C'POIt•� 1660
Business name:L(7 7 ' (zip ( �' jT 47/ z7 t Water heater 16.60
Address: ;' . , - C / C : a ( / / / fl1 !. I 1.5. u`I Other: I
City/State/ZIP: ;i-)� U - :J._ Subtotal
Ci
ty «G � Minimum permit fee: $7230
Phone: 64 3) ( S 5i ( Fax: (�O3) (r, 9) - 0 r] (n g• Residential backflow minimum permit fee: $36.25 3 C o • J S
3
CCB Lie.: 7 3 (-) L Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee) v.. 90
Authorized signs
C �/� Z " "�%(. TOTAL PERMIT FEE 39. /s
Print nameg`7 en ,.S u��
, a, - i
1 J N aJ � i This permit application expires if a permit is not obtained 'thin
y' (((( 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
i•\ nuilding1PcmiiisrPLMfP •PemutApp.doc : 4L0- .1616r(10/02/COWW88)
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1' 89L0 -269 -COS u a1 13 ebI :LO 90 S2 Jdd
CITY OF TIGARD dais
BUILDING DIVISION PERMIT #: P1.10.00 t3 "+ r�
13,)25 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 41250W;
Phone: (503) 639 -4171 '(I�
Inspection Requests (24 Hrs.): (503) 639 -4175 p:_..
INSPECTION WORKSHEET FOR DATE: 5115/2006 TIME: 7:04AM PAGE: 'i():3
r3o3s
SITE ADDRESS: 4.496n SW SUMMIT ROOF ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE 140. 3 LOT #: 122 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 3
DESCRIPTION: Bauktlow prorrenter for irrigation.
OWNER: DON MORIf SETTE COMMUNITIES LLG, PHONE #: 503-3B1-7638
CONTRACTOR: L ANDSCAPE= OREGON, INC. PHONE #: 50 G92 -69a)
Inspection Request Scheduled For: Date: 5115/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 029825 -01 503 -692 ?i91 i N
Corrections /Comments /Instructions:
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❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1" Date: r i \/6 6 Phone #: (503) 718- 1/4(21/4/