Permit e'r.' 'x7/31 PLUMBING PERMIT
V P' CITY OF TIGARD
V
s= COMMUNITY DEVELOPMENT Permit #: PLM2010 -00080
TtGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/18/2010
Parcel: 2S112BD08800
Jurisdiction: Tigard
Site address: 7876 SW WEBBER LN LN
Subdivision: BRITTANY MEADOWS Lot: 24
Project: Brittany Meadows
Project Description: Installation of residential backflow preventer for irrigation.
Owner: FEES
MORRIS WESTLUND Quantity Description Date Amount
16615 MAPLE CIRCLE
LAKE OSWEGO, OR 97034 1 ea Backflow Preventer 03/18/2010 $31.27
PHONE: 503-601-5041 1 12% State Surcharge - 03/18/2010 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 03/18/2010 $41.23
Contractor: Plumbing
SERENITY LANDSCAPES
11606 NE SANDY BLVD
PORTLAND, OR 97220
PHONE: 503 - 516 -8004
FAX:
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 • ification - • er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or • rect questions to O► C : c•lli ; 503.246.6699 or 1.800.332.2344.
Is ed By: 1 / � � AL / Permittee Signature:
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.
Plumbing Permit Application _ ' <,
Building Fixtures
City of Tigard �,A �p $ '613 Date/B Received f $ (0 1.. -�M ,�D.- go
. Permit No.:
q 13125 SW Hall Blvd., Tigard, OIN199'22 Plan Review
0 Phone: 503.639.4171 Fax: 503.598.1960 • Dat e/By: Other Permit No.:
Inspection Line: 503.639.4175 , ',' Date Read /B orri 0 See Page 2 for
f I L. n I. I) Internet: www.ti ard -or. o v , " Ready /By: g
g g Notifi ed/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
t ir New construction ❑ Demolition For special information use checklist
Description 1 Qty. l Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 312.70
14 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION 7 87 t'o Site utilities:
e Catch basin or area drain 18.76
Job site address: i 1 ( .
• Drywell, leach line, or trench drain 18.76
�
City /State /ZIP: „ V CI CA Footing drain (no. linear ft.: _) Page 2
Suite/bldg. /apt. no.: Project name: 1 1-� Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
/';.1 '1x\ 610k9.-(4i LYV G�i SL �! 1 1T01 rt v 1 /L Rain drain connector 18.76
`7v 11v Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: ) Page 2
� � Water service (no. linear ft.: ) Page 2
6 Subdivision: : x ifoa Lot no.: 2,9 Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27 3 t .2.1
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
14 J ∎ t o A- \J vs 4 ✓ k0 1'.5.12 Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name:
Fixture /sewer cap 25.02
Floor drain /floor sink/hub 25.02
Address: Garbage disposal 25.02
City /State /ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
❑ APPLICANT CONTACT PERSON Interceptor /grease trap 25.02
L 1 l S C a �S .
Medical gas (val $ ) Page 2
Business name: j ay es, es, tt-1 vt tnOl
s g, t 1 Primer 12.5
Contact name: v� b c1 Roof drain (commercial) 12.51
Address: `1 Lk U `p L t SInrt 1 13 +) ,� Sink/basin/lavatory 25.02
\-
City /State /ZIP: t) ,. “�
A. � O 0 1 q `7 Z - --g z 0 Solar units (potable water) 62.54
Phone: ( 503) Z S Z 1 S 3z Fax: : ( 503) 2,5 z $Ci 83 Tub /shower /shower pan 12.51
n p Urinal 25.02
E -mail: S� a.1,. 0 S2v ei. 1 V 1 L i"otc C a reS. ALA" Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: wy t A u C a Q �
V Water piping/DWV 56.29
Address: Other: 25.02
S ubtotal
City /State /ZIP: 3 \ .21
Phone: ( ) Fax: )
Minimum permit fee: $72.50 12 • SD
� Plan review (25% of permit fee)
CCB Lic.: ' �-G �2 ,�. Plumbing Lic. no.: State surcharge (12% of permit fee)
Authorized signature: C �� 441LtitAiL._ TOTAL PERMIT FEE 8 1 . Lo
This pe rmit application Print name: Eft lC, D v ��., �, Date: 3111 cation expires if a permit is not obtained within 180 days after it has been accepted as complete.
*Fee methodology set by Tn- County Building Industry Service Board.
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