Permit (13) CITY OF TIGARD PLUMBING PERMIT
a Permit#: PLM2023-00439
COMMUNITY DEVELOPMENT Date Issued: 10/16/2023
T`GARO 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112CA14700
Jurisdiction: Tigard
Site address: 7788 SW LAYTON LN
Project: Brookside, Lot 7 Subdivision: BROOKSIDE SUBDIVISION Lot: 7
Project Description: Backflow preventer for irrigation.
Contractor: BRAVO LANDSCAPE MAINTENANCE Owner: BLACKWOOD HOMES INC
1153 VANDERBECK LN, OR 97071 PO BOX 4188
TUALATIN, OR 97062
PHONE: 503-951-0208 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 10/16/2023 $31.27
Specifics:
1 12%State Surcharge- 10/16/2023 $8.70
Plumbing
41 ea Minimum Fee Adjustment- 10/16/2023 $41.23
Type of Use: SF
Plumbing
Class of Work: OTR
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: Permittee Signature: ,`
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
Plumbing Permit Application
Building Fixtures I�EGEIVED
City of Tigard naceisy 1(, tl�/a3 SPermitNo.: ni� ' 3 ci
13125 S50 Hall Blvd.,Tigard,OR 97223 Plan Review t [ �T 3 7J
illi S Other Permit No.
Phone: 503.718.2439 Fax: 503.598.1'` !�' 1 6 414 Date/By:
Inspection Line: 503.639.4175 Date Ready/By: l ® See Page 2 for
1 I C;A F.1) Internet: www.tigard-or.gov 1 0 ■ Notrfied/Method: /r' Supplemental Information
❑Demolition For special information use checklist
l'I New consUuction Description Qty. Ea. Total
❑Addition/alteration/replacement ❑Other: New 1-2-famlly dwellings(ntcludes 100 ft.for each utility connection)
(er; ,' SFR(1)bath 312.70
� .,..r 4Ea.78
SFR(2)bath
FA 1-and 2 family dwelling ❑Commercial/industrial SFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional bath/kitchea 37.78
❑Master builder ❑Other Fire sprinkler`_sq.ft.) Page 2
� § �� � ,� §"'�-;r} t ��`l )`o-��;l{1 e E�€r�s�'�if�'aat ..,. w«.� {.� `�SL�. Site utilities:
d d Catch basin or area drain 18.76
Job site address: �,b S� (��1114
1 UI (�( Drywelli leach line,or trench drain 18.76
02
City/State/ZIP: T i( P $) 0 R 91 Z.3)4 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03
1 Manholes 18.76
Cross street/directions to job site: �}? '� (, f0
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Qj�OkiSI.)11v I Lot no.: Fixture or Item:
Backflow preventer / 31.27
Tax map/parcel no.: Backwater valve 12.51
Clothes washer
'04),s
n 1� � � lV° Dishwasher 25.02
25.02
v-�'1 Dig fountain 25.02
Ejectataisamp 25.02
A � � cf E Expansion tank
12.51
25.02.
Fixture/sewer cap
Name: Blackwood Homes, INC
Floor drain floor sink/hub 25.02
Address: PO BOX 4188 Garbage disposal 25.02
City/State/ZIP: Tualatin, OR 97062 Hose bib 25.02
Ice maker 12.51
Phone:( ) Fax ( )
9 Interceptor/grease trap 25.02
tea. '
(j Medical gas(value:S ) Page 2
B 1 ii'SS Ia l'i It',. ,,,. Primer 12.51
Address' JIS • , ' i = Roof drain(commercial) 12.51
«; 63 t'4• State Q ZIP: if -Sink/basin/lavatory 25.02
Phone: FOX: _ Solar units(potable water)
62.54
Tub/shower/shower pan 12.51
1'�11E711 25.02
. '-+^-
- it �. E.
r� � Urinal
�' ����� '` '�"` as: Water closet 25.U2
s s •�� ;; � Y•ft ., 37.52
_ d ., Water heater
7t1'az Water pipinglDWV 56.29
lick QQd H 3rnes Other 25.02
�'Ad r in tom. 6nit Subtotal
(v11 `< tm, t2 ZIP: Minimum permit fee: $72.50
Phone FOX Plan review (25%of p�nit fee)
^Erna State surcharge(12%of permit fee)
_rr__ TOTAL PERMIT FEE TI J73
cThis permit application ePlan Pim if a permit 4 not obtained wtthin 18o days
Print name: � L- {� arte Dat `�(L I *Fee methodology set by Tbeen
Counry Building Industry Service Board.
440.4616T(10/02/COM/W EB)