Permit C ITY OF TIGARD PLUMBING PERMIT
� � !
t DEVELOPMENT SERVICES PERMIT #: PLM2%%00151 6 -
:. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2510 6
PARCEL: 2S10 4/24/2006
SITE ADDRESS: 13277 SW SUMMIT RIDGE ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT: 129 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 Description Date Amount
4230 SW GALWOOD ST. STE. 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 5 - 246 -669 0 1- 800 - 332 -2344.
Issued y: ifV(L /lrc..el_ki Permittee Signature
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.
uilding Fixtures
Plumbing Permit AppL'o!'" f. EV\I FOR OFFICE USE ONLY
City of Tigard
Received ® / // Permit No.: �L //�rolo - GL��s�
4 �d
13125 SW Hall Blvd., Tigard, OR 97223 '/, Date/By: TT/!
Plan Date/By:
Review Other Permit No.: •
Phone: 503.639.4171 Fax: 503.598.1960 I ` •' - :'\
t .. " r'' {'! ( _ or
24 Hour Inspection Line: 503.639.4175 , .at c •: �., Date ReadyBy:
Internet www.ci.tigard.or.us Cl� F T -= * Notified/Method: 1 1 S 121 u at 2 o form
�( O pple mSee P :ta t f ati°n
G pIVISInN '.f?L'Fi".'SCHEDULE'
...:.. . :....... •.:;.r:. .::.: - ... , :.. a use klisr
.. ::. • tr uction ❑Demo ' - • For special inform Pion chec -
N ew construction Description ( Qty. I Ea. I Total
0 ddition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) ,
• .. '. .. .':; 'CAT
) bath 249.20
and 2- family dwelling
..... -< •. . EC '
• .... SFR (l
\ ... •...,. .... ...: _.:... SFR (2) bath 350.00
I� 1:1 Commercial/industrial
SFR (3) bath 399.00
❑ Accessory building ❑ Multi-family
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other: Fire sprinkler L sq. ft.) Page 2
T� Oki
..... �d>a .. s •.- TZO4:;�� . , ••. •
,:.:.. . _ sue t,t;rtt
Job site address: i 32•77 �` ,..c tun W
• r ( �. � Catch basin or area drain [ 16.60
q �/ Dtywell, leach line, or wench drain 16.60
City /State/ZIP: - 7 - 11 L1�1liL 6 / ?. 2 / Footing drain (no. linear R.: ) Page 2
Suite/bldg./apt. no.: Project namecL_Th m (i 12-1-1-t Fi Manufactured home utilities 110.00
Cross street/directions to job site: (p SS19 M anholes :6.60 J
tti ,2( i' 6 e c L ie Rain drain connector
16.60 I
CJ Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: -) Page 2 i
Water service (no. linear ft.: ) 1 I Page 2
Subdivision,' ,� ,- j J Lotno./ -�
j1� / t'G � Fixture or item
Tax map /parcel no.: 69 _S A Absorption valve 16.60 _
'
:... . . 2 ,DES'CRO , - _. Backflow preventer / Page )7 , S
1
. i .. ! t7 ! /', ' .mil cif' . ; ,i_I ' 16.60
I �. /?Ct'. Ll./ �J. err 't / • .,. r t - ,.. Backwater valve • Clothes washer I 16.60
' Dishwasher 16.60
P]RQ .. .• Ejectors/sump omm
;• • NAIVT...:' . � ; ' 16.60
i . �> t + e:. um �•rl l- f rt7 E -S � i..CExpansion tank 16.60
Name: ,I�r.'/: r l7/_;; � .: r ��
Address: L - - / • 1 3 i= .S _ _ (_: = •, ( C r`: Lt t •c •C
Fixture/sewer cap 16.60
Floor drain/floor Sirilc/}tub 16.60
City/state/ZIP : L /< L - c . i. t i e ?c, c) k.. 4 1 . 7 /= .1 !E..;
Garbage disposal 16.60
Phone: ( ) Fax: ( ) Ho bib 1 6.60
1
C ONTACT' . rERS0N . ... ; .
I
• •
, .. . .' .. •AY . � ... : - • i .. ... ce maker
l
Business name: ,:; .-e _cif ' .; ( Interceptor /grease trap 16.60
Contact name: ; ' ;,/) SS? :./ P -! 7.-. V Medical gas (value: $ )
Page 2
Address:
Primer l 6.60
* ) C .0 .S �« I Y t. I ( 16.60
• l � S. f' /Sl'1 � • � :U Roof drain (commercial)
City/State/ZIP: { /1. t ( . - 1 7� �= ` \ 16.60
�- S / lavatory
! 4/...;.:2 < Ci F� ax:_ •' -) c .i. . - C '% % .1, 16.60
Phone: (9.'3) L' - S _ I F : ( Tub /shower /shower pan
E -mail: Urinal 16.60
-
aercoset
•:..' .:. ...:...:.... ..• _,:, .. ... .. 660
...... . . Water heater 1 .
Business name: /1.1 .r1i1s( 41. .c'_. ore' iii;ri d : /;C
f Other:
Address: / (JC. a f.I [ t1. /(. ✓�'U Subtotal
City/State/ZIP: 71ta -€2 - t' �OsZ J(.)& L
Minimum permit fee: $72.50
Phone: ea (CQrQ ,,S-9--/...c Fax: 5C 3) ��a - 0 7(r� g Residential backflow minimum permit fee: $36.25 3 (c-•
Plan review (25% of permit fee)
CCB Lic.: ,K) Plumbing Lic. no.:
State surcharge (8% of permit f ee) ,71 . �(<.`. -
Authorized signa(p L 6� 1 �,� ,, ��7�(,1 TOTAL PERMIT FEE 3�9, /.S
.� \ This permit application expires if a permit is not obtained , :thin
I Print name+ `l en ��(,L/'�+ ,.. �' _/ I - 0(0 I 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Boarc
i:\ nuitding wermits\PLMF- PennitApp.doc I?/05 440- 4616T(10/02/COM/tWE8)
I' 139L0- 269 -EOS Uai ei0 =60 90 t Jdd
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006 -00151
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 412412006
Phone: (503) 639 -4171 A ii
Inspection Requests (24 Hrs.): (503) 639 -4175 `: _..
INSPECTION WORKSHEET FOR DATE: 4/25/2006 TIME: 7:00AM PAGE: 21
SITE ADDRESS: 13277 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT #: 129 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 3
DESCRIPTION: Baeldlovt prevention device for residential irrigation.
OWNER: DON MORISSETTE COMMUNITIES, PHONE #: 503 - 387 -75313
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503 -692 - 5945
Inspection Request Scheduled For: Date: 4/25/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 0213654 -01 503 - 692 -5945 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /hul fk Date: l r! / S JhY Phone #: (503) 718-