Permit 4
C ITY OF TIGARD PLUMBING PERMIT
i
AA, DEVELOPMENT SERVICES PERMIT #: PLM2006 -00203
V I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/1112006
PARCEL: 2S 109DB -04500
SITE ADDRESS: 13103 SW SUMMIT RIDGE ST ZONING: R -
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT: 124 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 SW GALEWOOD ST. #100
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 5/11/2006 $36.25
[TAX] 8% State Surcha 5/11/2006 $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: 4a9a) Permittee Signature: 0/46-•
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.
.'i's
u ilding Fixtures f�
Plumbing Permit Appli . CEIVE FOR OFFICE USE ONLY
City of Tigard R eceived
66 Permit No.: 011010D* - 1,4203
13125 SW Hall Blvd., Tigard, OR 97223
g ' � , 2 00 - •' • � Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /�r,., c , \i „y, I c Plan Review
�/ Date Other Permit No.:
24- Hour Inspection Line: 503.639.4175 C ITY O TAG - -. c••I Date Ready/By: �°� - /ei See Page 2 for
Internet: www.ci.tigard.or.us g�t1LDr Notiiied/Mcthod: Su plemental Information
F�1tIV - - .. F' E )E : 'S�FIE'Il�J TE`
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New construction ❑ Demolition P or spec in orrnaflon use chec
Description •ty. Ea. To
❑ Addition /alteration/replacement - ❑ Other: New 1- 2- family dwellings (includes I 00 ft. for each utility connection)
�r' i` . +'.:1: IC ORY;r4F;;CO2YSTRUCi?OIY ? .'' ` ;;yj:, SFR (1) bath 249.20
- 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
a
N"' ..1c. J ''' • • • B ,E •,` I N FURMA1 ONj , .lYfl LOC P[Ot? Site utilities
Job site address: f 3 / (.33 S.4.... S -647'1 An ( IQ to ye_
f eaich basin or area drain 16.60
City/State/ZIP: % / / fi,Le..iL D �� e f Drywell, leach line, or trench drain 16.60
Suitelbldg. /apt. no.: rProject par d 4C/ L / aL/ r
Footing drain (no. linear ft.: ) Page 2
f Manufactured home utilities 110.00
Cross street/directions to job site:
�s �� /! � ) Manholes 16.60
..C. LA.) f�`�` ) � .../0 Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivisions L.LJfl m L/- /..l ct Cf Lot no.: / Water service (no. linear ft.: ) I Page 2
Fixture or item
Tax map /parcel no.: to SS
Absorption valve 16.60 �
--;:'• .. Absor 7 S •. • ,• :.... ; I)ESCCtIP'PIO ; .. -
: ... ..... : . .. . � ,. � .:.; � .. .. .. .. . � .. Backflaw preventer Page 2 a-
L..z r)4' - e.. ("f .. ,' // ( -/. /7 :: 7. 17,.."") re ;'.• /'•/ ,, �rj ; : i r. Backwater valve I 16.60
11 Clothes washer l 16.60
Dishwasher 16.60
Drinking fountain 16.60
,. , : 'IPROPEiR'YL OWNER. :: :.,',;., :0 T..E . ... „
-
a ' Ejectors/sump 16.60
Name: j)/71/-: `^/)f , S L s _S L -L'7Y1 int..i../1.4.0 f •S L..V.Expansion tank 16.60
Address: 1 . f Q 3 C! •S L . t.•.' C_ ( c' c L' Ci c Fixture/sewer cap 16.60
City/State/Z1P:L c . k c . C \ L C 1 c° �%�., C. = /L. 4 1'7 (.%. ` -. Floor drain/floor sink/hub 16.60
Phone: ( ) / Fax: ( ) Garbage disposal 16.60
16.60
•
ose 1
_ . . �:: Imo:: • ..:.:. ,:,;.:.:... :,,.,. ; I ^: .:.:., . .. .."
. . Ice maker ' '" � I k 16.60
Business name: L / - a / . 4 .,_ / :,. /- 'r /j!;} 1 2: Interceptor /grease trap 16.60
Contact name: J) / - >• :• ` �(_ Medical gas (value: $ ) Page 2
Address: / ) l.; C .S (,L) r l'•1 Li a i ( t.j D Primer 16.60
City/State/ZIP:1 - a f , L ! at n. • J C, l a _ • J (. 7 7 Roof drain (commercial) 16.60
f/. '/ �.' , I F , Sink/basin/lavatory 16.60
Phone: (Sc 3) it: - =� / (.�( .3) e • , - •�' , ..:1
Tub /shower /shower pan 16.60
E-mail:
Urinal 16.60
',,: • .:: -..r •:.COIYTIiAC`IURi; ` ':;:: Water l 16.60 •
Business name:Lek Olaf l ( 0() .e. :'i-Y ei; .!T ,,/::/,: ! water heater 16.60
Address: / „.?- - G' G' ti, (.// rr, ..-f . S- i /, `l/1 II P , n Other:
v Subtotal
City/ State/ZIP: 774.1,4,1 1'.440-711. `' (14 �7eNc
--11 )' Minimum permit fee: $72.50
Phone: er.5 3) &4 S 9S. Fax: € ",3) ( c•](p g• Residential backflow minimum permit fee: $36.25 3 �• a
CCB Lie.: 7 �C. Plumbing Lic. no.:
Authorized signs Plan review (25% of permit fee)
/ State surcharge (8% of permit fee) . , yL
. L C�/l � �LCZI� ? TOTAL PERMIT FEE 1 3y. 1 S
Print name.`/ e u . , r 7 c 1 , - - j ' L ) " T • ( , I DaS - / 3 - L) (p This permit application expires if a permit is not obtained "thin
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
is \Building crini,s∎PLMP- PumiIApp.doc 12/03 440- 4616T(10/02ICOM/'.VEB)
2'd 99L0- 289 -E0S wet 13 eIs :90 90 0T ReW
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PlM7l1f1 )7i13
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1112O0f;
Phone: (503) 639 -4171 Ak Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5115/2006 TIME: 7:04AM PAGE: 91
SITE ADDRESS: 13103 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT #: 171 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 3
DESCRIPTION: Batkilow pxcventer for irrigation.
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 -387 -7538
CONTRACTOR: LANDSCAPE OREGON, INC. PHONE #: 503. 692 -5945
Inspection Request Scheduled For: Date: 5/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 029854 -01 503.692.591& N
Corrections /Comments /Instructions: _
"ri5 - �5 / t
6 - - - -
12 I ) . Cs - .-
4 \A A (: j : '/--- .'/ '9 I -
S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
Vc
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: k/C Z
� � Date �v Phone #: (503) 718 -
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