Permit / "
C ITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2006 -00298
DEVELOPMENT SERVICES DATE ISSUED: 6/7/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171 PARCEL: 2S109D6 - 04600
SITE ADDRESS: 13139 SW SUMMIT RIDGE ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT: 125 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.
4230 GALEWOOD ST #100 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 6/7/2006 $36.25
[TAX] 8% State Surcha 6/7/2006 $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: �/�) Permittee Signature: 5-0,e, s,
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.
is
..-• '
Duilding Fixtures
Plumbing Permit ApitGEDi E
FOR OFFICE USE ONLY • • •
City of Tigard
..,LUI\I 7 z006
, .,, Received ....
Date/By: ap
Plan Review 1 A‹
Phone: 503.639.4171 Fax: 503598.1 Pemnt NOT : \'''% %. 2 . 606 0 /4 :4 ,11?
13125 SW Hall Blvd., Tigard, OR 972Ao
.2m
rry oF TIGARD z''''''''''`EiAtil." Date/By: Other Permit No.:
24 Hour Inspection Line: 503.639.417V
Date Ready/By:
Internet: www.ci.tigard.or.us BUILDING DIVISIO „-.4-.1,1 li-
NotifiecVMethod:
_ s i ti 0 n
t' ? 91 !: -0 9t t K . I ;. .e".:':L . :.1".:....- .. .......: ,, !.' ' . ........ ,..,..-:../..,...-';.- . • .......... - . , • • -..: • • . .
\I New construction 0 Demolition For special information use checklist.
, Description Qry. Ea. Total
O Addition/alteration/replacement 0 Other: New I- 2-L-tmily dwellings (includes 100 ft. for each utility connection)
rt
'• . ;''''",''.'",:': ..' ....-:i.... - • : :• ". -...: ::? '?/ :;: • :. ''ikTtGeit; :-. OliI 777..77 SFR (1) bath 249.20
NI I- and 2-family dwelling
,\ 0 Commercial/industrial SFR (2) bath
SFR (3) bath 350.00
O Accessory building 0 Multi-family 399.00
• Each additional bath/kitchen 45.00
0 Master builder 0 Other:
I --
Fire sprinkler ( sq. ft.) Page 2
?■ -. 66AijOisi:• ', ' :: ..! . . • '1,..: ' . : .- : ::' • .:•':.:•:. .• Sit - - -
Job site address13 I 3 q S Lt.; SaM 1YLL7 le-LC I 9 e. ‘..c.r Catch basin or area drain T-- 16.601
City/State/ZIP: Tiqa/v.t_ ,C,Ic 7 .P.)-y , Dr/well, leach line, or trench drain L 16.60 I
Suite/bldgJapt. no.: 1 Project licntaiwyt..U g_,..L.C.1- -l(:--ic)----g. Footing drain (no. linear ft.: i ' _ Page 2
Manufactured home utilities 110.00 ,,
Cross street/directions to job site: --
Manholes 16.60
S -u ) 13e i&e.".p-c._ leo Rain drain connector 16.60
1 Sanitary sewer (no. linear ft.: ___) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision:S/bLerni4A_Ct P e Lot noh,)_S Water service (no. linear ft.: ) Page 2
Fixture or Item
Tax map/parcel no.: 60 S 0 / 1-.
Absorption valve 16.60
• •,-,; ! ...'....Y' : :::.,••;,....:!.: . :' : • :.: ,.,.."•?,:•;....•:......•••' : ':,.::::. ::- ." ..' .• ).• .. : . ; 8 ac l ow preventer i Page 2 A7 . s....c
e,:t_ j,-. r. ., ..: .,..;.:, .:--,,-_ , z_ . . Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
••77. '1,.:•',.. i 4,-4;.,.!, titi .•• - ..,,.- - l i t , .. •: v. ..,,,i s ii,, s ; : ,• ; ........... - 7 . 777 . Drinking fountain . 16.60
''..;:j:g;.... • , VP .. .•:,. ..../.‘, • :'!'• .:•::".:•.'i• .:'.. :: .: Ejectors/sump
16.60
Name: b cy., /y),:,- .e ....-; .-...- i- .ger=ziz-_ Lurnmciruti ES LLC.Expansion tank 16.60
Address: 1 - - /,..a .3 C .S 1.1.2 (...: ,. 1 r' e- C..' 0 04 Fixture/scwer cap 16.60
City/State/ZIP:/.. cr_ A;: c, C. c. &.) ,:',1c (.: A.., 'I 7(.2.--, ...., Floor drain/floor sink/huh 16.60 ,
Phone: ( ) Fax: )
Garbage disposal 16.60
Ice maker (
16.60
'::':':.':-•'• .'".::''.....;•••.•••.::.V 1, •..:IrC.!;....:". :,•::.,.',,•!..*::: , •:• tERsopv- . • f.T.••
16.60
business name: L r , i t : el, / 3..,.. .:;./ . Z,'? Interceptor/grease trap I 16.60
...r
Contact name: :-.• . c_ ,.... (ii ;.../. q.t., Medical gas (value: 5 ) Page 2
Address: i l.:;.? D ()c U.) jr) ..; 1 ry,..ii Primer i 16.60
--
_
Roof drain (commercial) 16.60
City/StateJZTP: a _l a t i A C j k
Sink/basin/lavatory 16.60
Phone: (S':) (. (-X.:), - _;-:).:(.• :: I Fax: : (f. :3) C.' ': .; - ' • ..- .:. ..
Tub/shower/shower pan 16.60
E-mail:
1 Urinal 16.60
•
. .• . , . • . . . • - ..
,......,:i$:::: .::: •'....,-;••.,, ,••••:.'..,:,..::: • • :••••••:. ..-' ( .., -...i." . .--:. . ' -.., :. • Water closet I 1660 ..
.60
Business name: / cc ... i'91" ; :L ; , 7,75
. Water heater
Other:
Address: ..'• , r••., (,) /./... ,,! I ,. yi kf fi. -
Subtotal
City/State/ZIP: 7it ,} 04. 9 ..-;,..._
Minimum permit fee: 572.50 3
Phone: ( & ..Lc, ' Fax: 6 4,9;? 696,g{› 1 . Residential backflow minimum permit fee: 536.25 ....5 ce - ....L.S
,
I CCB Lie.: 7 - (....)
...4
/ Plumbing Lic. no.: I Plan review (25% of permit fee)
State surcharge (8% of permit fee) c--2, ?C..
Authorized signa .6. 6.47i _.......6, fia . 2-1--6 7 -4.7 TOTAL PERMIT FEE
'
I Print name e .,. ! I DatC/77 ( 1 This permit application expires if a permit is not obtained - ithin
1 - 180 days after it has been accepted as complete.
'5 methodology set 'oy Tri-Connly Building Indusny Service Board.
i:t By i IdirittkPeriniisSP I .M P-PerntitApp.duc 12:53 445-'6 1 (5Ti I 41/0 VCOM(V EB)
----.
a - d 139L0 -269 -EDS - u 8 j j 3 eTO:LO 90 LO unr
CITY OF TIGARD
' ALI-'IZooG, - p 2q g
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 gu
Inspection Requests (24 Hrs.): (503) 639 -4175 "I�I I
INSPECTION WORKSHEET FOR DATE: 1 A/67 TIME: PAGE:
SITE ADDRESS: 1 3 1 3 7ti1/W1 4N 1 V!/� CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
-2 P1 6 1 itAAN — RYCJ
Corrections /Comments /Instructions:
-9-j
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v Date: / Phone #: (503) 718 Y