Permit rd
CITY TIGARD PLUMBING PERMIT
I4c DEVELOPMENT SERVICES PERMIT #: PLM2003 -00494
1,L c � I 11 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/19/03
SITE ADDRESS: 12265 SW WHISTLER'S LN PARCEL: 2S103CC -11000
SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5
BLOCK: LOT: 057 JURISDICTION: TIG
CLASS OF WORK: ALT 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: Installation of residential irrigation backflow device.
FEES
Owner:
Description Date Amount
DON MORRISETTE HOMES
5000 SW MEADOWS RD [PLUMB] Permit Fee 9/19/03 $36.25
SUITE 151 [TAX] 8% State Tax 9/19/03 $2.90
LAKE OSWEGO, OR 97035 Total $39.15
Phone :
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone RP /Backflow Preventer
hone : 503 - 692 - 5945
Final Inspection
Reg #: PLM 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
7 /
Issued By: �� - Permittee Signature: 'J f/7/ n1
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
cep 7 03 1 2 : 07p dan edmonds 5 0 3 - 6 9 2 - 0 7 6 8 p . 1
I I 7 -': 1 . li
...-- 1 FOR OFFICE USE ONLY
Plumbing Per 1 cation
DaterBy: 1 ?i,7 6/ .- 3 4.VY - Pett - AO 1 /9
C
i
\ 1 fl-*r. Planning Approval "
Date/By: Sewer
City oi Tgar9
Pennit No.:
13125 svir 'Hall Blvd c,c,‘) ., PM Review °ther t ,,afoo.2 -dd 07 7 0
a
Ti o 97223 o' c49_,.., DatelEly: -
Post-Review Permit
Land Use
Phone: 503-639-4171 Fan 5k3: -(9u - • ,-- •, DatedBy: Case No.:
Internet Iwww_citigard.01 A AG 0` _ 41 Omelet -;" 4 El See Page 2 for
24-hour Inspection Requ810-30-639-4175 --- - Name/Method: lemental Information.
. --_.-... . , ! OF WORK: • -:- ..- - • ::::::7 -; '., - iliedidinforination lise7cheeldlit --- :- 2
DIVew ;construction . El Demolition Description Qty. Fee(ea.) Total
- ■ - • • .. .. .
D Addition/alterationfreplacement I 1:1 O t h er: :-. ; r." . : ' ::... ;., ' s '. •
..., * •.. 45:: taithiiks 100 for iiielt staTitY'eninectinn):: " : - • : ' :. •
, 1 : : ^,'.CATEGORY0E-CONSTRUCTION-:.1-, .....,...:,--: - - - - ' - -- -
SFR (1) bath 249.20
IIII■11 I & 2-Family dwelling 0 Commercial/Industrial SFR (2) bath • 350.00 ,
[]Accessory Building 0 Multi SFR (3) bath 399.00
0 Mast4 Builder 0 Other: Each adddicinal bath/kitchen 45.00
- . -•"--- " 4013 srrEiNiFoRmknorrialitzocAnoir _:-.1::?7.=;-•.: Fire sprinlder - sq. ft.: Page 2 ,
Job site address: j.a4 i.e g - co: WitiStiers al e .. -:-- ' ,.. .'c* 1.-:•. , .:•_:.- - ...: - :'..F-- - ,. 2 ._ : - -,-; •. ` 1
Suite #: I I Bldg./Apt.#: Catch basin/ area drain- - 16.60 i
,_ Drywell/leach linehreach drain 1
Project Iklarne: LA: kti st.ler4 t..1)411-1c lor -,..-'7 Footing drain (no. linear ft.) • 16.60
Page 2
Cross street/Dire' cticms to job site: Manufactured home utilities 110.00
•
.-S-c-t 0 ( Sr Ave-- Manholes 16.60
Rain drain connedsr 16.60
Sanitary sewer (on. linear R.) - Page 2
Subdivision: Witati 0..)cuLk..) I Lot #: ..7 Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft.) - Page 2
Tax maii/parcel #:
. 1 -..: - ...*::::=.: : : : -2 , ,- - f=;::;; ---:---::::.? - -: ' ' .-- • i
r.:f • : -.- ' -_ ,,-.- ..- * *... - ; . 7. 1 !.''. ---- - .-- ' ' '" - - - - • , ' - I • - -
Absorytion valve 16.60 i
Lal7C-i-c Cc --s 1 1.2-7 CM., Baddlow prevent= i Page 2 .r?. S
B 7c-ga(J eLz.v(c e. • _ Badtwater valve 16.60
I • Clothes washer 16.60
I ., Dishwasher
Drinking fountain 16.60 16.60
1511ROPERTVOWNER::::: --' .11 0:113NAPfl"-.3z:„.:6Y-
Ejector/sump 16.60
.... .
Name: csI bine) erlari SS c-7 fitrril e.-.S - Expansion tmk • 16.60
Ad : 4' ..)..30 N.CLu &ce.t..e.weezi., 44-c0-1- _Fimurelsewer cap 16.60
•
CitY/StiterZiP: Lo-ke. osw...kfcgo 0 itce-7avi Floor drainfRoor sinkihub 16.60
Garbage disposal
Phone: I IZ - 16.60
: Hose bib 16.60 ,
7-1i6. .r. - CONTAC1 Ice maker 16.60 ,
Name: 7/r) ■Xislee., Interceptor/pease trap 16.60
_
Addresi: /).D-DO S Le.) In Ligi CALI RD Medical gas - value S Page 2
City/StitterLip:TUO-U4 6 /q- 4 9 7.614.Q., Primer 16.60
Roof drain (commercial) 16.6D
Phone:.fge L.9a - 59Y6 I Fax:3 - 409a - 674 1> Sink/basin/lavatory 16.60
E-mail:I Tub/shower/shower pan . 16.60
:;-..-- •-...,-_.,.:-... - 7:: : -:: - '.;;..;. Urinal 16.60
Bu-Sines Name: Leviiets eap2_ t.»reires-n _,-)c . Water closet 16.60
Water beater 16.60
Addres:/.10.00 40., fhtiSlany RD
CitY/Stitte/ZiPM.allawl., Oft- 9 9 0 6 Other
Phonc03 (pcja - 6 Fax:563 ifei a -(174 7: : ..: - VerialtFeie • :- ._ ".,'.
CCB Lic. #: 7 go cf Plumb. Lic.#: - - subtotd $
A.uthorized Arminian' Permit Fee S72-50 S _,
signature --J-ea--1.-4-ere-e_,B3ate: 'a q - 1 7 - c)--3 Residential Baekflow Minim F - -<.1r•fP- _
Plan Review (25% of Permit Fee) $
E l I . ..geet_f State Surclialge (8% of Permit Fee) S
(Please print name) TOTAL PERMIT FEE $ 3'. 1 .5
Notice: 4is permit application expires if a perntit is-not obtained within AB mew commercial handbags respire 2 sets of plans with Isometric or
NO days after it has been accepted os complete. - rise- diagram for plan rederv.
• *Fee methodology set by Tri-County Building Industry Service Board.
CITY OF TIGARD 24 -Hour •
BUILDING Inspection Line: (503) 639 -4175 MST 3 - a O
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
d
Received Date Requested / � O AM PM BUP
Location / ? -(2 5 LO d.<-d- LL Suite s-7 MEC
Contact Person (f R Ph ( ) a 8 c?- e? .37 - Oc 5
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler •
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING •
Post & Beam
Under Slab
Rough -In c �
Water Servi 1
Sanitary Sewe
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Othe ,
�!,
PART FAIL
HANICAL
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 Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date ! 6 6 A 3 Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site. .
PASS PART FAIL