Permit •
CITY TIGARD PLUMBING PERMIT
PERMIT #: PLM2003 -00159
iit� DEVELOPMENT SERVICES DATE ISSUED: 4/29/03
`' �-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12440 SW WINTERVIEW DR PARCEL: 2S1106C -TS015
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 015 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 device.
FEES
Owner:
Description Date Amount
DON MORISSETTE HOMES
4230 GALEWOOD ST #100 [PLUMB] Permit Fee 4/29/03 $36.25
LAKE OSWEGO, OR 97035 [TAX] 8% State Tax 4/29/03 $2.90
Total $39.15
Phone : 503 387 - 7538
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062
REQUIRED INSPECTIONS
Phone : 503 692 - 5945 Sprinkler Final
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 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: AlP/, ,,, _ Permittee Signature: c7r) 0-1242. A
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Apr 29 03 07:49a dan edmonds 503 - 692 -0768 p.2
FOR OFFICE USE ONLY
Pl P ermit Application RecC Plumbing
Date/By: a7 - 3 Permit No.:rt. - m�60o -urc., /5e
D)C �� D arning Approval Sewer
City of Tigard A J Danny: Permit No.:
13125 SW Hall Blvd.
Plan Review Other
Permit No.:
Date/By: Tigard, Oregon 97223 ��- 1 Z 200 Post - Review Land Use
Phone: 503 -639 -4171 Fax: 50 / ;:..'t I a, Date/By: Case No.:
r Ji:
urs. See Page 2 for
Internet: www.ci.tigard.or.11S �� u Y OF TI GAT e I Contact
24 - hour Inspection Request: (d0 IV Name/Method: I Supplemental Information.
' TYPE OF WORK • ' • ' ' • • 'FEE *.SCHEDULE (for special Information use checklist)
D escription L Qty. 1 Fee(ca.) Total
,New construction ❑Demolition • • New - & 2- family dwellings
❑ Addition/alteration/replacement 1 ❑ Other: 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION. SFR (1) bath 249.20
19,1 & 2 Family dwelling [] Commercial/Industrial SFR (2) bath 350.00
❑ Multi S FR (3) bath 399.00
[] Accessory Building y 45.00 -
❑ Master Builder ❑ Other: Each additional bath/kitchen
Fire sprinkler - sq. ft.: Page 2 •
JOB SITE INFORMATION and LOCATION • , Site Utilities . .
Job site address: /cDL f X10 w/!i �'
t�"� �/Z 77�/6'ta ' Catch basin/area drain 16.60
Suite #: Bldg. /Apt. #: Drywell/leach line/trench drain _ 16.60 •
Project Name: 71677) LZ%GCCZ 1 - 0 T is" F ooting drain (no. linear ft.) Page 2
Cross street/Directions job site: Manufactured home utilities 110.00
I1 L L i M • r ••N Manholes 16.60
8 -Ce /s. S la.; /,.) (e
7h itut v- /act'"‘ a Rain drain connector 16.60
2
Sanitary sewer (no. li near ft.) Page
Storm sewer (no. linear ft.) Page 2
Subdivision: 7Z 1pY GC)Gd • Lot #: jS Water service (no. linear ft.) Page 2 _
Tax map /parcel #: , - - : , - ' .; - ' ' -Fbture or - Iten; '. • - -DESCRIPTION OF WORK Absorption valve 16.60
Bae lG-f'1ULo dL0 t C -e f jjY' Backflow preventer i Page 2 4;21, S$
� (� �,,� Backwater valve 16.60
(A�^GtSCGZ J O(, �( �� �y"' " ' ' Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
PROPERTY. OWNER ' - • [ ❑ TENANT . " ' Ejectors/sump , 16.60
S -7 �•m -es• Expansion tank 16.60
Name: DC.� /)') G'Y Fixture /sewer cap 16.60
Address: S'w &a.(1�000c.: 16.60
O tithe Q OR- 9 e-f Floor drain /floor sink/hub 16.60
City /State /Zip: Lo X . y // Garbage disposal
bib 16.60
Fax: H ose b
Phone:
'APPLICANT " ' • . ' ' . I ONTACTPERSON Ice maker 16.60
Interceptor /grease trap 16.60
Name: t 1 161 Nc parre -to , Medical Ras - value: $ Page 2
Address: aoa-e� 0 St-L) rn ray Primer 16.60
City /State/Zip: . ail A- r)Q. g7o 0a- Roof drain (commercial) 16.60
S I tax: SU3 (e)qa - N7t � , Sink/basin/lavatory • I6.60
E -mail: 3 Coc Tub /shower /shower pan - 16.60 , 1
E -mail: Urinal 16.60 ,
• • - CONTRACTOR: • • Water closet 16.60 •
Business Name: L_A-rd Sc tziak: Olete'JOYI Ziir W ater heater 16.60
Address: I L S l-t) I'Y1t�- S-to Other:
City /State /Zip: TU. F
e Cr! twL, 6,e---- y7Oco� Other: I
x , 76 - Plumbing Permit Fees*
Phone;Si�3 (p9oZ 59}5ax:o'Zr- Subtotal S :2 7. 5 5
CCB Lic. #: - 76-0 Li l Plumb. Lic. #: Minimum Permit Fee 572.50 $
Authorized .� f Residential Backflow Minimum Fed 6.2 3 • °� 5
C
Signatur • Date: / id Plan Review (25% of Permit Fee) $
El / State Surcharge (8% of Permit Fee) $ 90 / �/7 S ru TOTAL PERMIT FEE S 3 , i S
(Please print name)
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isom c or
180 days after it has been accepted as complete. riser diagram for plan review. *Fee methodology sct by Trl- County Building Industry Service Board.
- is \Dsts\Permit Forrns\PlmPermitApp.doe 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: - . 39 -4175 MST
INSPECTION DIVISION Business Line: 639 -4171
BUP
Received D.te Reque ed M 4/S P.m BUP
Location [ `t . A-...11
- .1. r , 1 uite MEC
Contact Person Ph ( ) (a 9a-57(7 PLM 3 -60
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: U ' j),‘,/,/,1,
Final
PASS PART FAIL
PLUMBING
Post & Beam J \
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan te F
. . r :
trob • SS •ART FAIL
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 Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE E Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line �
ADA Date . �T /) 3 Inspector Ext •
Approach/Sidewalk , / P
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL