Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2010 -00139
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/29/2010
Parcel: 2S109AB13200
Jurisdiction: Tigard
Site address: 14274 SW STELLER'S JAY LN
Project: Alpine View Subdivision: Alpine View Lot: 13
Project Description: Residential irrigation backflow device. 12/10/10, Reprint to correct street name spelling.
Contractor: TRADEMARK LANDSCAPES INC Owner: WEST HILLS DEVELOPMENT
P. O. BOX 2410 735 SW 158TH
OREGON CITY, OR 97006 BEAVERTON, OR 97006
PHONE: 503 - 641 -7342
HONE: 503 - 631 -3893
FAX: 503 - 631 -4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 04/29/2010 $31.27
Specifics: 1 12% State Surcharge - 04/29/2010 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 04/29/2010 $41.23
Type of Use SF Plumbing
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 taw. 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 -0090. You may obtain a copy of the rules
or direct que OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued / 4 , /+ Permittee Signature
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
"y9i ' CITY OF TIGAR® PLUMBING PERMIT
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COMMUNITY DEVELOPMENT Permit #: PLM2010 -00139
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 04/29/2010
T 1CrARD' Parcel: 2S 109AB 13200
Jurisdiction: Tigard
Site address: 14274 SW STELLARS JAY TER
Subdivision: Alpine View Lot: 13
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: Ow - ,p, G /
G.9i /d
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. 06
Plumbing Permit Application
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Building Fixtures r i , ,, it i ,„ t * .
44"9134 Raecived
Cit o T a ll 1v APR 2 6 2010 Date/13y: a /d `.ar Permit PL/ JO _ /3
*, „,,„, ,„-sn 13125 SW hall Blvd„ Tigard, 97223 Plan Review
N,?,.. ,a NA, Flintier 503.630,4171 Fax: 503.598,1960 Other Permit No.:
Aacc/p
= f Inspection Lille 503.639,4175 CITY OF TIGARD mile It,etaboiy: o Scu faire 2 fur
r i 1t,n'1 u g g ILDING DIVISIO p
1 ll f Amon Internet: nr p� d t • � n r . ( n k v �gy, I f I� ��f ! I Nati / P f r I6 r Supplemental tnforntlt
31/11 1b���Vfa��l���1�! NEE rJlfflilll ItlII��Ikalla'^.Id11tVd1➢]1 YI����'I` I II� , SW�� Jt 1 t ilt. RED '911111la lLI'��I;I II I * I � ll�tl �I ti Yf eiie lti�ill ia�'idl� ll'�li �Nllti ' td111'III JI
El New construction ❑ Demolition For special irrlbrmution use checklist.
Description 1 Qty, I' Etl. j Total
❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 11, for each utility connection)
ifs'lifilINIIIMBRU :1Ji IIIMIMMEM" ;RSINIAPIIM i HE SFR (1) bath 312.70
Q 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) both 437.78 -
SFR (3) bath 500.32
Q Accessory building ❑ Multi- family Each additional bath/kitchen 25.02
p ❑ �� Mtiss �I t �I er p hu 9 � Epic I ❑ Other ` Fire sprinkler ( sq. ft.)
Page 2
p1911111111V II1r r l 1111 l[��t���iu� il6�aI�1'illlelhl�i�t�1�1111'rl ,0 ... nihiiii LI @Ir�IJlil ar I �I III I !RJR I S_ 1 itiliticy:
! !1 Is @ Id I a, N
,lob site address; 14274 SW STEL !.R'S JAY TERRACE Catch basin or tutu drain 18,76
- Drywell, Icach line, or trench drain 18,76
City /state /Lll': 1'IGARI), OR 97221 Fooling drain (no. linear 1t.: _) Page 2
Suite/bldg. /apt. no.: 1 Project name: Manufactured home utilities 50.03
Cross street /directions to job site: Manholes 18.76
Rain drain connector 18,76
Sanitary sewer (no. linear tt,: ___ ) Page 2
Sturm sewer (no. linear it.: _) Page 2
Water service (no. linear ft,; _) Page 2
Subdivision: ALPINE 'VIEW Lot no,; 13 Fixture or item:
Tax map /parcel no.: r/` r o 1 p ,,{{�I 19 ��';��, p y -a ��p�r �����y�� I *ll I , 13acktlow preventer - 1 31.27 I 31.27
JrJr ■ _, r ' �1 wlril ll>d,� �l,@1,310 a l fl�utV�1 �wIII 11 1, � 11�III . Clot es
25.02
�: III ' I I: �Ir�r j..iM
BACK FLOW PERMIT _____
Dishwasher 25,02
_ Drinking buntnin 25,02
. Ejeciors /sump 25.02
111w4vl a ,ut lut y l i t 1 a ° 6 ° V Expan tank 12.51 wl>� E E irl�j�iI Ill tv�l I � � >JTltT ! Expa
. ` k
Name: WEST HILLS DEVELOPMENT Fixture/sewer cap 25,02
1
-- •-- Floor drain /floor sink /hub 25.02
Address: 735 SW 158Th AVL _Garbage diapual 25.02
City/State/ZIP: BEAVERTON, OR 97006 _ Hose bib 25.02
Phone: (503)641 - 7342 p �� Fax: (503)641 -7661 Ice matter 12.51
' I t' I i lk y Stun d I' l.11 ,,� I �i �l� , �� , '4' t k t o I • i II II I Interceptor /grease trap 25.02
n I.in[,i :,,td I !tll6u 11e a of 1 � 1 t :I i YII' I:E I 'mu u IIF m 1 IInt II iy li.. f I ' I I. � ' !
Business name: WEST LULLS DEVELOPMENT Medical gas (value: $�) Page 2
Primer 12.51
Contact name: MIR RAM 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) 62.54
Phone: (503) 726 -7033 1 Fax:: (503) 641 -7661 Tub /shower /shower pan 12.51
Urinal 25.02
E -mail mwilsun @urborhomes.com
ut ty J� Q � q 1�I I m� I { F� o y AN wl , ! I
f 11 oaf l ref 'f . i i1dIL119W61iWIa�11�ltIINf41 . i.,,. I , f `.F h 1 f I j Water closet 25.02
. l Water heater 37.52_
Business nzune: TRADEMARK Water piping/DWV 56.29
Address: P.O. BOX 2410 Other: 25.02
City /State/ZiP: OREGON CiTY, OR 97045 Subtotal 31.27
Phone, (503) 631 -3893 Fax; (503) 631 -4737
Minimum permit fee: 572.50 72.5
Plan review (25n /o of permit fcc)
CCB Lie,: 6796 Plumbing Lit. no.: 2383780 �
State surcharge (12/, of permit fee)
Authorized signature: 1 - 0,-)---• TOTAL PERMIT PEE f/, 0 20
Date: 12/23 This permit application expires if a permit Is not obtained within 180 day ^
Print name: Y1112IAM WILSON after It hos been accepted as complete.
_ "Fee methodology set by Tri•County Building Indu,itry Service Board.
4 II.4c16T(10 /n. leapt /Wea)
r 1Hnilding lPermittaLMLI- PermitApp.due InA11 /09