Permit
CITY OF TIGARD PLUMBING PERMIT
i
COMMUNITY DEVELOPMENT Permit#: PLM2010-00040
r; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/03/2010
Parcel: 2 S 111 DA 13800
Jurisdiction: Tigard
Site address: 8890 SW GREENING LN
Subdivision: Lot: 0
Project: Schneider
Project Description: Install backflow for irrigation.
Owner: FEES
SCHNEIDER, MICHAEL J & TERRI L Quantity Description Date Amount
PO BOX 4017
BEAVERTON, OR 97076 1 ea BackFlow Preventer 02/03/2010 $31.27
1 12% State Surcharge - 02/03/2010 $8.70
PHONE:
Plumbing
41 ea Minimum Fee Adjustment - 0210312010 $41.23
Contractor: Plumbing
ASPEN CREEK LANDSCAPING INC
610 S CENTER ST
NEWBERG, OR 97132
PHONE: 503-538-2636
FAX: 503-538-0136
Type of Use: SF
Class of Work: ALT 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 952-001-0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: r .Y s'
/ l v_ 'r'.. mac`' "~E/'r' c~,i' .f AA's tir _a ,d'`
B 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.b 02 2010 9:21AM Aspen Crek 503- 538 -0136 p.2
Plumbing Permit Application
Building Fixtures RECEIVED 1:1)It 011,l I. , :l: (1.1:,
City of Tigard D � a 3 ! t7 .1.... 'ermit►oPL/1 .20/0 -0009
:� ,; 13125 SW Hall Blvd., Tigard, OR 9712
Phone: 503.639.4171 Fax: 503.598.1 B 0 2 2010 Plan Review
inspection Line: 503.639.4175
Date/By: Re
Oiler Permit No.:
Internet www.tigerd- or.gov OF TIGARD N D Ready/By: 1 ' S See Pena 2 In for
edrMethod � Su � ltseotal Information
''fi'If'��!S�I?'• Ifll s' � - �ia,rel� ��lul 'FIII"'71'�'% trl )' � ' �^p , r � t .. !t e�:la= o �+ �,;� ,
Il �� >�� 1 1 r � I V �. G =m [s�, y � �� � � I�
�1� +,. , lie;., ...z....1.%.11.:'.0...".:2". ��yy � L' u�'771� r .. .t .. _ .1 1 3 u: =,, te!.
V.!,, ' r �; 1. J [t e' J 1 �, ;' �T � i + 4' i• i 's1 !d' �i ,� • il' c 1 i1 1 4 Rr 4.. � ! I
' li��. 'L ltl�_II._Ik�.. - #:^'A'�;.,..L!� �fY9 '
• .•.c ._ + � �,.:�+U{SL7�1� +•;
❑ New construction ❑ Demolition For spedat inJonnahlan use checklist
t
Description I Qty. I Ea I Total
❑ Addition/alteration/replacement ® Other sprinklers _ New 1- 2- family dwellings (includes 100 8. for each utility connection)
s r , y "i' g r`:1`. - i ' 1}7 ' ' : „ ..
} bath
I: . 7' I, ' ", _:ire'I � rQ ; u 1!)1 :41, " :.. sprinklers , iettw'ru �` '> taro 3 In t � ';: � ! SFR (1) 312.70
® 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi - family SFR (3) bath 500.32
❑ Master builder Each additional bath/ldtchen 25.02
❑ O Fire sprinkler ( sq. ft.) Page 2
111 °T' i l5 , lu` : 1 l rbi �'�j `T,1 'i.TTIAq rrlti'a�f FA;RI.C: Site utilities:
,.: t.,ir
I , tel:i; i t ,iii 1 i,L utrr t :_.1t_I r j tar 6'samEBdl ati,..tat. �I
Job site address: 8890 Sw Greening La Catch basin or area drain I8.76
City/State/ZIP: Tigard OR 97224 Drywell, leach line, or trench drain 1 8.76
Footing drain (no. linear ft:_.) Page 2
Suite/bldgJapt no.: I Project name: Schneider Manufactured home utilities 50.03
Cross street/directions to job site: Manholes • 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: Page 2
Water service (no. linear ft.: _J Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow pre venter 1 31.27 31.27
.il
p l , I f Ii ,7p�itltn���4 '���', •'noA i" ,1 , 1?44ti al ,i;!,{siTtitim+!�crir IPt��a'r.� I . Backwater kwater valve 12.51
¢'L�,IYrlira "l
�', l! . 11-2.1t:eSa.HJill hirizzaa :4!?flarele, lIit.i:ati:.1111 ..111a1itllL r. � .II
Clothes washer 25.02
Install Sprinkler system w/ backflow device .N Dishwasher 25.02
Drinking fountain 25.02 -- -
Ejectors/sump 25.02
id- 1 , ie! r.; '?'m ;Ipiu:iAtrlr .t6PM `0.. -t" i} c.}': " '.. 3"--l'i Expansiontlank 12.51
Name: Terri Schneider
Fixture/sewer ceP 25.02
Floor drain/floor sink/hub 25.02
Address: Same Garbage disposal 25.02
City/State/ZIP:
Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
I t & . � + ' ;" 11.:. NY u J i r 1 G mtl
!ll!},
; w : 1 � • •' . X.r 1 J f i u , ' � n , ^ I'j , .,' „ h l i d .:. , , , Intercepmr/grease trap 25.02 ■
Business name: Medical gas (value: S ) Page 2
Primer 12.51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: • Solar units (potable wafer) 62.54
Phone: ( ) I Fax: : ( ) Tub /shower /shower pan 12.51
Urinal 25.02
E-mail:
°'t �F 5�� j' f61!� a ,.. Il � , .HJ ,� d; ��;. W �
(m . -1 lr... ... ' r. . l :�.... ,,,. Water closet 25.02
!`'i +I �l atilt ]r fr: yt-'ill8lit: , tN71Ci',�..i g. .' I . � �': 4 . a�3l s i.
- Water heater 37.52
Business name: Aspen Creek Landscaping Water P 1 nn WV 56.29
Address: PO Box 418 Other: 25.02
City/StateJZIP: Newberg OR 97132 Subtotal
Phone: (503) 625-6888 ( Fax: (503) 625258 Minimum permit fee: 572.50 �i�, 50
-
'� { Plan review (25% of permit fee)
7859 �,(j `?' 6 Plumbing Lic. no.: State surcharge (12% of permit fee) a r 76
etVLic.:
uthorized signature: �,� i,
rJjyc/ l.dll.rA �( �Q M 11 9 TOTAL PERMIT FEE FA odd ,...
I Print name: Date: Z 1 10 This permit application expires ifs permit is not obtained within 180 days
61,4_4_ l r cu. I alter it km been accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board. '
1 Buildieg∎PermiulPLMU -P tthApp.doe 10 /01:09 430 -0616T(10n02 /COMJWEB)