Permit `�'r;;� � CITY OF TIGARD PLUMBING PERMIT
ih
COMMUNITY DEVELOPMENT Permit #: PLM2010 -00137
i!; Date Issued: 04/29/2010
L1GAAD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S109AB12300
Jurisdiction: Tigard
Site address: 14248 SW ALPINE CREST WAY
Subdivision: ALPINE VIEW Lot: 4
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: 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.
APR -26 -2010 MON 09:50 AM FAX NO, P. 04
Plumbing Permit Application
RECEIV . r r- I .. r 1�.� e • Building Fixtures �i 7, ` I.1 c i ' ' 1 1 y � / , r 1 ,
'twel �t1 Tigard RocciveFl
l a.f. City of PerIrl tNo
ty APR 2 6 20111 Dntc/B, 10 9 /D -- �Li`I�Oi 00 /�
�"r vi 13125 SW Hall Blvd., Tigard,OR 97223 Plan RCVIC /
III 4.,, Phone; 503.639.4171 Fax: 503,598,1960 a j��ntclBv: Other Permit No.:
Inspection Line: 503,639,1.175 CITY OF TIGA
t l' a' A IY'D P ,Q�..� Ro /B s see Pn = for
I� �a?yttx imam: www.1igurd- ar,gov to ILDING DIV IS IDQII`11;acVMcdlod: Supplerucntal Information
l 11111l1IlR1Ii 111011 JLIU NIER MV4E. f 11:1 1 f lal 1H11 11919: ,1 11lr11:111i1110II MENE M io , ' 11 I,L i i i':1!!1' q l'A:1,1 I: in
0 New consnclion 0 Demolition For special Wormation use checklist.
Description 1 Qty-___J Ea. j •lblal
0 Addition /alteration /replacement 0 Other: t411�1� 1 1 I Np���fq�ill��gl8 New I- 2-family dwellings (includes 100 f[, for each utility connection)
El 1 11i A .'1 11,.: ��111111 �� �f Bdahwl l+f���,�111, 0' i W 1 dI 11111fl� ��i�flll111111111 lkil 11 — SFR (I) natal 312.70 r
® 1- and 2- family dwelling 0 Commercial /industrial SFR (2) hflth 437.78
-- SFR (3) bath 500.32
Q Accessory' building 0 Multi- family _
Each additional bath /kitchen 25.02
�j��{ ���I� +I f d e �, � I [ { � j � O � th i e + r, �} l f4i � } {�� � � � I j�1 II Fire sprinkler ( sq. ft) Page 2
I I�IAiI11111W1➢1�ILlkllltltl� l�lt:9111SiIF��artll uhlil��dl <v ilnlNliti�A�ilRlll r�IH t1u� 1111-�IPoNII1j j tl��li�`� Si[eutilities:
.lob site address: 14248 SW ALPINE CREST WAY Catch basin or area drain 18,76
Drywell, leach line, or tren h drain 18.76
Cary /State /ZIP: TiGA1tD, OR 97224 Footing drain (nn, linear ft.: )
Page 2
Suite /bldg. /apt, no.: Project name: Manufactured home utilities 50,03
-
Cross street/directions to job silt; Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear iL; ) Pagc 2
Storm sewer (no, linear IL:. 1 Pagc 2
Water service (no. linear IL: ) Page 2
Subdivision: ALPINE ViEW Lol no.: 4
Fixture nr item:
IINN Tax ma ^ /pareel g ill 1 + pl y a��� -o( ` l I Ir pW��mp� mN ��p�y�ryp Ip�' 1� 13ttekllnw preventer 1 31.27 31,27
i l j l l III{I11111IAII�II�I IIIrlti, idltNfaldllllllY�g11 1�IIP -ail 'D U,p lf fill 4'Uillrylyild�111�1n1111 IY•ll lip Clothes ervalve 25,02
BACK FLOW PERMIT _ Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
1,11 11iIlltt I_ MEM I l�,Ua��rksHNldlIIIIlRl`LII>'91LiMES11l 11lE111 Expansion tank 12.51
Name: WEST I11LLS DEVELOPMENT Fixture /sewer cup 25.02
- Floor drain /floor sink /hub 25.02
Address: 735 SW 558TH AVE Garbage disposal 25.02
City /State /ZIP: BEAVERTON, OR 97006 Hose bib 25,02
Phone: (503)641 -7342 g � yi{ plplp ^Fax: (503)641-7661 Ice maker 12.51
��II` Ill V I
7,1,, im ill��i1999rLeJ C ,uiwiall�ya�Ju j��1LfJ9 f �`�� �'`4Il frig rP ltyll'I1[Lll B,` I�•a •� l �llf ll Interceptor /grease trap 25.02
Business name: WEST HILLS DEVELOPMENT Medical gas (value; w Page 2
— Pruner 12.51
Contact name: MiRIAM WILSON —
Roof drain (commercial) 12,51
Address: 735 SW 158 AVENUE 25.02
SinldUasin /luvuwry
City /StatcIZiP. BEAV1 RTON, OR 97006 Solar units (potable water) 62.54
Phase: (503) 726 -7033 Fax:: (503) 641 -7661 Tub /shower /shower pan 12.51
Urinal 25.02
E -mail: mwilson jarhorhomes.com
�p Op 44 44 Water clo9et 25.02
II'
i �I W � I ''. . F I l ih j �; ,li4 Water heater 37.52
Business name: TRADEMARK LANDSCAPE Water piping/DWV 56.29
Address: P.O. BOX 2410 Other: 25.02
city/state /ZiP: OREGON L'1'1'V, OR 97045 Subtotal — 31.27
Phone: (503) 631 -3093 Fax: (503) 631 -4737 Minimum permit fee: 572.50 72,5
Plan review (25% of permit fee)
CCB Lic.: 6796 Plumbing Lie. no.: 2383780
Slate surcharge (12% of permit fee) F,70
Authorized signitwre: - TOTAL PERMIT FliFi ei,
This p ermit application expires if n permit i5 sat obtained within 180 dnya
Print name: MIRIAM WILSON Date: 1:53 hoer it has been necepled as complete.
*fee methodology set by Tri- Caunty Building Industry service Board.
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