Permit r
CITY TIGARD PLUMBING PERMIT
r , l %, DEVELOPMENT SERVICES PERMIT #: PLM2003 -00634
! I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/22/03
SITE ADDRESS: 12345 SW THORNWOOD DR PARCEL: 2S110BC -04900
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 020 JURISDICTION: TIG
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
Remarks: Install irrigation backflow preventer.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES
4230 GALEWOOD ST [PLUMB] Permit Fee 12/22/03 $36.25
STE 100 [TAX] 8% State 12/22/03 $2.90
LAKE OSWEGO, OR 97035 Total $39.15
Phone : 503 387 - 7538
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062
REQUIRED INSPECTIONS
Phone RP /Backflow Preventer
hone : 503 692 5945
Final Inspection
Reg #: LIC LCB: 7804
PLM ALL PHASES - PLI
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.
Issued By: 4 %.".. f Permittee Signature: / d ! I 1 ) t
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Dec 19 03 11:52a dan edmonds 503 -692 -0768 p.2
". uinbing Permit = FOR OFFICE USE ONLY Application Plumbin�
Date/BY: O ll ?Z Permit No.: L-M 3-a)
i Planning A prova Sewer
City of Tigard Datc/By: Permit No.:
13125 SW Hall Blvd_ °..� Plan Review Other
Tigard, Oregon 97223 C s �. .__ 0 ; ' •'` " Date/By:. Permit No.:
Phone: 503- 639 -4171 Fax: 503 = 598'1960 Post Review Land Use
.�,: i t':
Contact _ Case No.:
Internet: www.ci.tigard.or.us `; lei \j, � i ?J rr.r, �� el � Contact Juris: la See Page 2 for
24 - hour Inspection Request 503 - 639 - 4175 Name/Method: I I Supplemental Information.
..: TYPE OF WORK ' • � - . ... FEE* SCHEDULE (for specialintormaGon'ust: checklist)
New construction [I Demolition Description Qty. Fee(ea.) Total
[] Addition /alteration/replacement ❑Other: ; ::New 1= _ &.2-family:dwellings`
CATEGORY:.OF :CONSTRUCTION - ' = (indudes ft for each utility cond«uon)
I & 2 dwelling C SFR (1) bath 350 "00 249.20
y g SFR (2) bath _ 35
ccessory Building . ❑ Multi - Family SFR (3) bath 399.00
❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00
JOB SITE INFORMATION and .LOCATION .• . Fire sprinkler - sq. ft.: Page 2
Job site address: / 3L(S S i -% They 1.4: oce4, D/iut✓ : ; .;. Site.Ut lines •'.;
Suite #: 1 Bldg./Apt. #: Catch basin/area drain 16.60
DrywelWleach line/trench drain 16.60
Project Name: '%YrvYri i.t: oat LOT al.)
Footing drain (no. linear ft.) Page 2
Cross street/Directions to job site: Manufactured home utilities 110.00
LV Cj- i,l, l 1. Y Manholes 16.60
" `V !L t "'"�` Rain drain connector 16.60
Sanitary sewer (no. linear fL) Page 2
Subdivision: 1 rt i.t oocL, I Lot #: ,2.C' Storm sewer (no_ linear ft.) Page 2
Water service (no. linear ft.) Page 2
Tax map/parcel #: ty SS b (e :
` .... Fiitture'or'. t"
DESCRIPTION OF WORK. :. ' =• :'>.: Absorption valve 16.60
LL?_ndg CQQ L tree -ricer e) GtOi CC 2, Backflow preventer / Page 2 �"' /- 5S
r Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
ROPERTY.OWNER :: I (] TENANT :. •` :`:'::"...' ..: ' .:'"
Ejectors/sump 16.60
Name: Da may /.s.,C.e..1?e. HeiliccS Expansion tank 16.60 _
Address: 4 . 3O , S.1.0 . &-makwO C>...) Fixture/sewer cap 16.60
City /State/Zip: 1,0 -e CAS -wc. J " c� Q 0.3.0 Floor drain/floor sink/hub • 16.60
Garbage disposal _ 16.60
Phone: Fax: Hose bib 16.60
IELAPPLICANT `:.: ` 'ICONTACTPERSON• = - Ice maker 16.60
Name: El ! a Sparre J.) Interceptor /grease trap 16.60
Address: I ��-O 0 CAA) r n. cn 2l) Medical gas - value: S - Page 2
City/State/Zip: nt1� 0 1� °t - o to D- R
Primer 16.60
Roof drain (commercial) 16.60
PhoneS03 (49a.. - S94.5" I Fax: S33 tors a..- 076 g Sink/basin/lavatory 16.60
E -mail: . Tub/shower /shower pan 16.60
' ; Urinal 16.60
Business Name: • • :`_CONTRACTOR . . ' "
Water closet 16.60
�iK(SCV c& � � �'l Water heater 16.60
Address: ID Sup 1'Y11 J i - n� lam. Other
City / State/Zip j1Aa tDt-t 6 R._ q'Zti( - Other.
PhoneSU3 (d? - SQ LI S• Fax3)3 (D - or io k . : . Plutnbin Parnait Fee* . ' ;2 7.S5 . •. ` :, .
CCB Lic. #: - PAIL/ Plumb. Lic. #: Subtotal $
Minimum Permit Fee $72.50 $
Authorized , i S / G � /19 Residential Backflow Minimum Fee $36.25 3 - 42
Siiggn I 4 L'L/LzL) Date P plan Review (25% of Permit Fee) $
C,1 / of /Jar J21 State Surcharge (8% of Permit Fee) $ e2 , 96
//" (Please pant name) TOTAL PERMIT FEE S 39. / S
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or
180 days after it has been accepted as complete. riser diagram for plan review.
- *Fee methodology set by Trl- County Building Industry Service Board.
CITY OF TIGARD 24 -Hour
QUR.DING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 1 9 / % 5V Date Requested — 0 44 / AM PM BUP
Location _-/ Z 2 ) L1 5 bt u Suite MEC
Contact Person � .�.. Ph ( S6-3) Lo 2Z S41 3-00/0_3 5
Contractor c�. /lc Ph ( ) SWR ,
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing i i.. .& ./f ..i %. 4 1. ''•
Insulation
Drywall Nailing
Firewall r � ��� �
Fire Sprinkler ' `d''�'� —` ��
Fire Alarm
Susp'd Ceiling �
Roof yu� -I-n t 1 "re ,- P 1 rku.) of 012,
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower an
PART FAIL
M ANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: D Unable to inspect — no access
Fire Supply Line
ADA (1
Approach/Sidewalk Date 112 L J o L1 Inspector I
Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL