Permit suf CITY OF TIGARD PLUMBING PERMIT
II o COMMUNITY DEVELOPMENT Permit #: PLM2009 -00358
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/23/2009
Parcel: 2S109AB15700
Jurisdiction: Tigard
Site address: 13331 SW ALPINE VIEW DR
Subdivision: ALPINE VIEW Lot: 38
Project: Alpine View
Project Description: Irrigation backflow device.
Owner: FEES
WEST HILLS DEVELOPMENT Quantity Description Date Amount
735 SW 158TH AVE.
BEAVERTON, OR 97006 1 ea Backflow Preventer 12/23/2009 $31.27
PHONE: 503 - 641 7342 1 12% State Surcharge - 12/23/2009 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 12/23/2009 $41.23
Plumbing
Contractor:
TRADEMARK LANDSCAPES INC
P. O. BOX 2410
OREGON CITY, OR 97006
PHONE: 503 - 631 -3893
FAX: 503 -631 -4737
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 ttoo7OU by calling 503.246.6699 or 1.800.332.2344.
Issued By: i 'r/ � Permittee Signature: 0 1 , 4 . / .77O _ /
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day. /v
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.
•DEC -23 -2009 WED 10:55 AM FAX N0, 5036417661 P. 02
riump11I ter nit Review
Applicati l,.
building Fixtures '
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.: City of Tigard DEC d
p c e , g o r� s
M 1 3125 SW Hall Blvd., Tigard, OR 97223
t e DE Dntov: 3 Qom/ ill Parrnil No, •♦ 111 ' Phone: 503.639.4171 Fax 50 3,598.1960 -- . PJ 41 .„,?0, / "�Q -�5�
I'l Inspection
l A It pe c ton Line; 503 .639.4175 �� �( ((0 TIG AR D Date /13v: other Permit Na S /� _ / � O
Internet: www.tigard- ur,gov • ILDING DIVISION 1):'te Ready/By ; �9
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F'ors. eclal it formation use checklist
❑ Addition /u)tnration /replaceruent 0 Other: . Descri Non ��
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® 1 -and 2- family dwelling 0 Commercial /industrial SFR (2) bath
Accessory building ❑ Multi-family i SFR (3) bath
500 437.78 ,32
❑ Master builder
0 Other Each additional bath/kitchen 25.02
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Job site address: 13331 SW ALPINE VIEW DRIVE �Itih I I 1 Slte
Catch basin or area drain 18.76
City/State/71P; TIGARD, OR 97224 Dtywell, leach line, or trench drain
18,76
Suite /bldg. /apt, no.: Project name: Footing drain (no, linear ft.: :) Page 2
6
Cross street/directions to job site: Manufactured home utilities 50.03
Manholes 18 76
Rain drain connector � 8 18.76
_)
Sanitary sower (no. linear II.: _) Page 2
Storm sewer (no. linear H.: :) 111.1 Page 2
Subdivision: ALPINE VIEW Water service (no, linear 11.:._ Pa e 2
Lot no.: 38 Fixture or item: g
Tax map /parcel no.: „IS' oq .
� 1`' 11111' 1`l'`I .57Q c� Buchflow preventer NEM � 1 II :1���1,1V��1'll``llI I IIyI`[I III II III PI I'll P`I L'.!tultatic,�tul i .!,i -111. „ ut,, o runtll lrl''I' I I'l,' I I ' I 1 ' 1 I 4t 1 31.27 31.27
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BACK FLOW PERMIT l z. s I
Cinches washer MI 25,02 NOM
Dishwasher 25.02
Drinking fountain
25.02
,
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r Mil titltim ll �' I'' °,I ° s ti l l l. I I I I I 11 :, ', fi t! ,,ra V I I I I 1 1 11 15(11`1 12.51
till 45,1 1,1 nn, l o, ,L iI.I(cIL11jil,ll:di.i'I 1., � ,,, . 1 Gl il Ild il� 1 Il1I l��llill lll�I�IId 1i�l�Itl,15�.I�.,i i iIil:d I ll ,11,1�11111,IL1,LIlId1, Cxpansinn tank 12,51
Fixture/sewer r cap 2i 02
---~—
Name: WEST HILLS DEVELOPMENT
735 SW 158 AVE Floor drain /floor sink/hub
25.02
City /State /ZIP: BEAVERTON, OR 97006 Garbage disposal 25.02
•
Phone: (503)641 -7342 - Hose bib 25 51 02
'
1 1445``'II r II I I 1 'I,P 1 1'I'1 (rt1 k41l " 1: 111,td'lyl t nl v II 4 Fax: (503)641-7661
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Business name: WEST HILLS DEVELOPMENT Medical gas (value: $ 25.02
) Page 2
Contact Warne: MIRTAM WILSON Primer ME
Address: 735 SW 158 AVENUE Roof drain (commercial) 12.51
City /State /ZIP: BEAVERTON, OR 97006 Sink/basinllavatery 25 02
Solar units (potable water) 62.54
Phone: (503) 726 Fax; : 503 641 -7661 —
( } !Tub/shower/shower pan 12,51
E mwilson ®arborhomes.com
� 11'II' ' t 1'11'1`1 11 nlrI, , Urinal 2
1111 iI� llt' l l lll I' �l I �l�, tl 1l� II 1 1 1 1 1�1 1 < �ll�l�` l� �t . I11 !1 i Itij: ild. . i" ijil` yi�', I' 111yII' �I�11''�I11111II'rI.14`„II dl'1:I,'I,1'11P1,11 ,_,1,.1. I,.,I1 at et 25.02
,I,pIL , I,LI1ll , ,l,ll,l.Itll• d1„1di„ d,11'diI:IPid1�1,:1U1•.11lr,l1. 111511 15...... 1111' 4 111 1 11I 11111 1 1 11 ,1�11ild�ll:,rlIl!1111,l�Illl, 1141411, 111111,, Ij'. 11ti11�lll,,ll�t11li,ll.1.1.Ilj�lylll 25.02
Business name: TRADEMARK LANDSCAPE W er h eat c loser
•
Address: P.O. BOX 2410 1Wutcr plping/DWV 56.29
City/State/ZIP: OREGON CITY, OR 97045 —. Other: _ 25.02
Subtotal 31.27
. Phone; (503) 631 -3893 Fax: (503) 631 -4737 '
Minimum permit fee; $72.50 72.5
CCB Lic,: 6796 Plumbing Lic. no.; 2383780 Plan review (25% of permit fee)
Auchurizedsignaut . �./�./v State surcharge( d%,
Print name: MIRIA — TOTAL PERMIT FEE
•
M WILSON Dale: 12/23 I Thin permit application expires if o permit is out obtained within 180 days ,
after it has been accepted as complete.
*Fee methodology sot by Tri- County Building Industry Service Board.
Lmuildlur \PermhdlrLMu- rermlatpp.do 10/a1/09
i440 (10/0 2/COMAVLDI
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