Permit , CITY OF TIGARD PLUMBING PERMIT
IL
C = COMMUNITY DEVELOPMENT Permit #: PLM2010 -00135
T1GARD Date Issued: 04/29/2010
' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 0 4/2 9AB12100
Jurisdiction: Tigard
Site address: 14272 SW ALPINE CREST WAY
Subdivision: ALPINE VIEW Lot: 2
Project: Alpine View
Project Description: Residential irrigation backflow device.
Owner: FEES
WEST HILLS DEVELOPMENT Quantity Description Date Amount
735 SW 158TH
BEAVERTON, OR 97006 1 ea Backflow Preventer 04/29/2010 $31.27
PHONE: 503 641 -7342 1 12% State Surcharge - 04/29/2010 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 04/29/2010 $41.23
Contractor: Plumbing
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 to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: _Z Permittee Signature: AJ ,'/'Li e,9-77U/k/
CaII 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.
APR -26 -2010 MON 09:49 AM FAX NO P. 02 (D
Plumbing Permit AppiicationR
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k , , NI 4' i City of f igard l)dre/tiy: Received z y f7 1% "r Permll Nn.,e 0/O ''D0 // p 13125 SW Hall Blvd., Tignrd,OR 9 72 OF TIG ARD Plan Review
M e Phone: 503,639,4171 Fax: 503.598. Date /By. Other Permit No.;
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Inspection Line: 503.639.4175 B UILDING DIVISION - Data Ready/l y. -: 5d see Page . rnr
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y,. „, ,,7.A.44 Internet: www.Ugard•or,gov Noufiod(MOthod: Supplemental Information
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® Nov construction ❑ Demolition For .special information use checklist
Description 1 Qty. 1 Ea. 1 Total
g��I Addition/alteration/replacement 1:I Other: J ��{ ( i��y� II ill �� New 1- 2- family dwellings (includes 10011. for each utility connection)
�1�U1111�1�Il�i11111111Ili ll11lllp�Iq��uildhlGliaiflE� bi11 E Leo ItliAui�lilU�ll IfII'Ii' 'l1 '1 i i11�)1111]fi" SFR (1) buth 312.70
® 1- and 2- family dwelling, 171 Commercial /industrial SFR (2) bath 437.78
SPR (3) balls 500.32
❑ Accessory building ❑ Multi- I'arnity
Each additional bath /kitchen 25.02
Q Master builder ❑ Other: Fire sprinkler ( sq. 11.) Page 2
ICI 11 I 1 MINI 1;� �� �d��l i ` i J l ' 9iPJ; � , ill J ! 't fll Site "lilies:
Job site address: 14272 SW ALPINE CREST WAY Catch basin or area drain 18.76
Drywell. leach line, or trench drain 16.76
City /Slate /ZIP: TIGARD, OR 97224 Footing drain (no. linear n.: ) Page 2
Suitc /bldg. /apt. no.: Project name: Manufactured home utilities 50.03
Cross strcct/direclions to job site: Manholes 18.76
�- Rain drain connector 18,76
- Sanitary sewer (no. linear It; _) Page 2
- Storm sewer (no. linear it.; ) Page 2
Water service (no. linear 1.; ) Page 2
Lot no.: 2
Subdivision: ALPINE VIEW I r Fixture or item: •
_ _
Tax map /parcel nn.; 3-31 , 146 I 'a. o o Dackflow prevent= 1 31.27 31.27
i' : ti' 1 l 1 .11114121,5111E', .,11r 4 :,, , `i;. I I ' 1p Bacl:watcrvalvc 12.51
I,�L , -rll. . >t l,, III ' :1 �� I : I ��Ih Clothes washer 25.02
BACK. FLOW PERMIT Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02 _1
l i � a { ru 7 p a r�ui oan j s biIpj®PJ d' Expansion tank 12.51
4 J f IIll�I�tlllt �dI11 0I�INIW�+IfaChYl I l .Ill I,Iii f:.!-,I' I�l,I'Iwl� �t i�'QI �IAFJ,ARG1il l•
Name: WEST RILLS DEVELOPMENT fixture /newer cap 25.02
Floor drain /floor sink /hub 25.02
Address: 735 SW 158" AVE - -
dabagc disposal 25.02 .
City /Shale /ZIP: BEAVERTON, OR 97006 l-Iose hip 25.02
--
Phone: (503)641-7342 Fax; (503)641 -7661 ice maker 12.51
rr �y� � + �I� + " " ' a t 9 aa� !�jV 1 lnterceptorlgrcnsctrap 25.02
eft j. illi l I W $alai!' a 1 t�au�Illl liii 7 t Wan �K�tr��la6 Jl k'I.
Business name: WEST HILLS DEVELOPMENT .
Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: MIRIAM WILSON , Roof drain (commercial) 12.51
Address: 735 SW 158" AVENUE - Sink/basin/lavatory 25.02
City /State /ZIP: BEAVERTON, OR 97006 Solar units (potable water) i 62.54
Phone: (503) 726 -7033 Tax:: (503) 641 -7661 Tub /shower /shower pan 12.51
Urinal 25.02
E -mail mwilsoa(a?nrbor•ltomay.cnm �-
�P IW ? ��� i � q Water closet 25.02
��� iI �x.t ii9 �� �. �� , 11�iti�aidy�Aif i�„ � �;1,11i l.1 1- � it �'� I� i'l:Ii' �' ,. W atcr a rtier 37.52
Business name: TRADEMARK LANDSCAPE Water piping/DWV 56.29
Address: P.O. BOX 2410 Other , 25,(12
City /State /Z1P; OREGON CiTY, OR 97045 __. Subtotal 31.27
Phone: (503) 631 -3893 Tux: (503) 631 -4737 Minimum permit fee 872.50 72.5C
/ Plan review (25% of permit fee)
✓ CCB Lin //
: 6796 3 //I Plumbing Lic. no.: 2383780 State surcharge (12° of permit ice) ', ?O
Authorized signatur r /s--, TOTAL PERMIT FEE /, O�
-
Date:
12/23 This permit application expires if a permit is not obtained within 180 dny� -
Print name: MIRIAM WILSON after it tnla lama accepted as complete. �//�
- 'Fee methodology set by Tri- Caunty auitdh,g Industry Servkr (Board.
Lu LliehioPermitslPLMLf- PcrmitApp.doc 10/01/ou 4401616T(10 /O:/C'OWWlm