Permit CITY TIGARD PLUMBING PERMIT
PERMIT #: PLM2006 -00150
A.11 DEVELOPMENT HO B r S oE R V SERVICES s39 -4171 DATE ISSUED: 4/24/2006
- 13125 PARCEL: 2S 109DB -04100
SITE ADDRESS: 13009 SW SUMMIT RIDGE ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT: 120 JURISDICTION: TIG
Project Description: Backflow prevention device for residential 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 #100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 4/24/2006 $36.25
[TAX] 8% State Surcharl 4/24/2006 $2.90
Phone : 503 387 - 7538 Total $39.15
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD. REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
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 50 4 69 r - 800 - 332 -2344.
Issued B y, ` it ..."} Permittee Signat re: e: _20 „! rp!
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.
''■
Building Fixture! 9 ED .
Plumbing Permit Ap . cation FOR OFFICE USE ONLY • • .
City of Tigard ,, -:.,<.. ,•_, -..: VOCI1 Received f 6 6
Dae/By: L /..4.0 #1 t 5D
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review o Ay I:OW •
Phone: 503.639.4171 Fax: 503.598.1960 . \
, i .: -i IGN tg;1(1t Date/Byi Other Permit No.:
24- Hour Inspection Line: 503.639.4175 GIT y ■.; Date Ready/By: f t....: 1 El see Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: f to•-• Supplemental Information
:. .k 1 ; 1): 9 1 * 1-, 7; 1G p
4itk.'1;\!::-I'71.1::::":',1;:;1.....?:1'.7.--"1;.:.:7.-.. .3.:•:. 1 ...`' ..h::...iit*".:.1:W61,ii;E:.. ''' • . ' 2... . : ' . . .
)S1 New construction 0 Demolition , For special information use checklist.
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1- 2 dwellings (includes 100 ft. for each utility connection)
St:,::: .00ii..K.:Oit.i.00NO:01014.01!tyt",;.:,::...1: : ;•,...„ ,,, ' ... . s ti:,: SFR (1) bath I 249.20 I
. V4 \ 1 - and 2-family dwelling 0 Commercial/industrial SFR (2) bath 350.00
SFR (3) bath 399.00
0 Accessory building 0 Multi-family
Each additional bath/kitchen • 45.00
0 Master builder 0 Other:
Fire sprinkler ( sq. ft.) Page 2
:•::•...: ti.:.:,..r/:.'1.t.',006.Ki.-4....*A4i;(00t.t00,:.:.'. •.:,'...'..- ..,,:':-... Site utilities •
Job site address: r 3OCK) S411,nit_.;:,..4 ieLiteic:i .4.......r Catch basin or area drain 16.60
I City/State/ZIP: n ei ,J 0 /Cy Ci / .9- c-/ Drell, leach line, or trench drain 16.60
Suite/bldg./apt. no Project name4. (Awl /n (1 ,eta./ '8 i Al) Footing drain (no. linear fl.: ______) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2 .
1
Water service (no. linear ft.: ) Page 2
Subdivision:%S.wyvyk it' /2...t..4 ? e, 1 Lot no.: i ...D..<, - I
Fixture or item
Tax map/parcel no.: 4, S /4- Absorption valve 16.60
. , .. . . ... .. .. . . .. / I Page 2 .; 7
Lz.:4ril _c e ... 41pr' ,- ( fr'" i (/ ra7 /..;7 i■-,, rir ,..:i ei ; , ,:- , Backwater valve 16.60
Clothes washer 16.60
. Dishwasher
. L ....!.... Drinking fountain
,•:,,.-,.;:.!!.... R : '111 . T '. ?: ° R . # -..;.,;'-...::'. • . . .: ' ".....0, • ::; Ii .. tr41 ,... 14 .: ....: ,.. - Ejectors
Name: bine; in c , S• -_-_ .;,- -#. t=.... Cum m Li ruct-i Es LAB' xpansion tank
Address: 1 .---1 4 ,....) . (._.‘ ..S LL .--.,.•-._ (.. (2 C._ C ci c.c L
City/StateJZIP:L.0._ K c. C i,. (. ) c (76 4.:;/?.._, /J..; .--....,
Fixture/sewer cap
Cl9 4 7 ;;: r S913;.......'.::' . 'Y m k r
/ FG lc laro e obra a dgrae 16.60
16.60
16.60
16.60
3
16.60
16.60
Phone: ( ) Fax: ( )
16.60 1
16.60
16.60 .
business name: t d ;-, e itf .,, ...... , -L-.._. ,. c .
Interceptor/grease trap
Contact name: . 7 - -- ,. ..fie) „ Sp c. L ,. ie /.. - L c i )
Medical gas (value: $ ) 16.60
Page 2
Address: i ..)-0( (.1) rn Li S 1 rya.' O_D Primer 16.60
Roof din (commercial) 16.60
City/State/ZIP:IWO i ok_ , -' ey . 7 f . ( (-,.....).__
Sink/basin/lavatory I 16.60
Phone: (Sc' . ...3) tz.:. C/.:-. - ..SVII ; 1 Fax: : L' - ':-
Tub/shower/shower pan 16.60
E-mail: - Urinal 16.60
' . ....:' .;.'::'''..:::...:''...- •••• .6Adiait .-. .:'.. ....? ..'''., .'....I.I.:. • .- -
Water closet 16.60
' .
Business name:LxA j ty , . 0 re 27,,,-) r: Water heater 16.60
Address: / .?„).-00 ,S /0 NI q../ (4 ut gi), Other:
Subtotal
City/State/ZIP: 7itatet_e"),1 j e)... - 470(0 :-;1- Minimum permit fee: $72.50 .
Phone: (5(...-3) (eQ,:,1 _S Fax: . "0..3) 6 g? - e) 70 g ' . Residential backflow minimum permit fee: S36.25 ..5(G: -
CCB Lie.: 7 as.
C...) Plumbing Lie. no.:
Authorized signa _ Le . ..41a..4..4_4/7...0
4 Plan review (25% of permit fee)
State surcharge (8% of permit fee) . 90
Au
TOTAL PERMIT FEE 3q.
I Print nameg,ll ef) ,..c...p,c-zi--xv-E.c) 1 Dat -0.. -4,4 1 This permit application expires if a permit is not obtained s*ithin
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Eloarc
ii\BuildirWermitskPLNIF-PerrnitApp.doc 12/03 440-4616T(10/02/COMAVEB) •
E d 99/.0-269-EOS u al I 3 e99:80 90 172 Jdu .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: I MAW-1101W
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: '1 /.'1)(4i;
Phone: (503) 639 -4171 u-N
Inspection Requests (24 Hrs.): (503) 639 -4175 ''�f (—
INSPECTION WORKSHEET FOR DATE: '1/26/2006 TIME: l'(IOAM PAGE: 1U
SITE ADDRESS: 13009 SW SUMMI f PIDf!. S1 - CLASS OF WORK:
SUBDIVISION: SUMMIT RIDOF NO 3 LOT #: 1)0 TYPE OF USE:
PROJECT NAME: ,31.1MMI C RIDGE. NO. 3
DESCRIPTION: tticidlow prevention wry }vir for residential irrig.tiicn.
OWNER: DON MOORISSE1 1E COMMUNl 1l_: .i, LI.C., PHONE #: {1 013 ::t 1.11• ?:,`P1
CONTRACTOR: 1 ANDSCAF'F OREGON, INC. PHONE #: 03.692 y 3'1?,
Inspection Request Scheduled For: Date: 412 ?//2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3' : i4 Plumbing fine! 028656-01 ! 4; ?; N
Corrections/Comments/Instructions:
(/:-// ./
.PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
L�
Inspector: I let) Date: l 2 6 Phone #: (503) 718- 2 �