Permit CITY OF TIGARD PLUMBING PERMIT
I. COMMUNITY DEVELOPMENT Permit #: PLM2010 -00154
Date Issued: 05/12/2010
I GARti 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S109AB14500
Jurisdiction: Tigard
Site address: 13372 SW OUZEL LN
Subdivision: Lot.
Project: Alpine View
Project Description: Installation of backflow preventer for irrigation.
Owner: FEES
WEST HILLS DEVELOPMENT Quantity Description Date Amount
735 SW 158TH AVE
BEAVERTON, OR 97006 1 ea Backflow Preventer 05/12/2010 $31.27
PHONE: 503 641 -7342 1 12% State Surcharge - 05/12/2010 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 05/12/2010 $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: NEW 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 dire uestions • • UNC by calling 503.246.6699 or 1.800.332.2344.
lss d By: `i it Permittee Signature: C y � _,
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.
Plumbing Permit Application
W7 /0' 665
Building Fixtures roll 01 IC11 USE ONLY -
'° r, ±; City of Tigard Received 1 lo .tom/ Permit No.: 4 tW g _60 /5 5e
1,1 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No..
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: n % ® See Page 2 for
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gard -or gov q Iy�� yy9!y Notified/Method / I Supplemental Information
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For special Information use. checklist
® New construction ❑Demolition Description 1 Qty. 1 Ea. 1 Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- famlly.dwellings (includes_ 100 ft. for each utility connection)
x -_ xrh �t_ �r, �� ,� :4 , . SFR(1)bath I 2.70
r . s gli xaX i ill 07: a):i is ar i iaTCA z "- . 4 I 31
kr r: �:..;;cr;+�..i- iFw`z, o 'r if'1✓cSi � L. "�-. x.1 ... G. .. �,.�..:_..._..__.__ -"
J -" 0 Commercial/industrial SFR (2) bath 437.78
® 1 -and 2-family dwelling SFR (3) bath 50032
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) I Page 2
v , - '- �`^f'- �'T 1 ->r. i �=`* •-r.. Site utilities:
Catch basin or area drain 18.76
Job site address: 13372 SW Quzel Lane
Drywell, leach line, or trench drain 18.76
City/State/ZIP: Tigard OR 97224 f Footing drain (no. linear ft .: � Page 2
Suite/bldg. /apt. no.: I Project name: l L p i NI E J1 l_ e. Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: 26 Fixture or item:
Backflowpreventcr I 31.27
Tax map /parcel no.: 12.51
unre _, �., q.0 F • =_. f Backwater valve
.`'..`.' �` �, ,n.�'y; t az ._ Clothes washer 25.02
...■ L., r l hilt ‘ 8 l te) - -- Dishwasher 25.02
3 > . Drinking fountain 25.02
Ejectors/sump ( 25.02
,7T .�. 2.- ..z- -. � � y , p •,max s� ^� c- ir- �^�y�� 3 ci Ex anslontank
12.51
a"' -"k`at iyol 1.,. c�; i1„ n r Y « "_.:tii `f c:Ati 1 �lislfSy.,^Fns ,�k: p
Fixture/sewer cap 25.02
Name: West Hills Development Floor drain/floor sink /hub 25.02
Address: 735 SW 158 Ave Garbage disposal 25.02
City /State/ZIP: Beaverton. OR 97006 l-lose bib 25.02
Phone: (503)641 -7342 Fax: (503)641 -7661 Ice maker 12.51
- -� �- r it - + n tor/ ase at 25.02
.
ry ° ilitri l l�ttjl YFr`111r t , 1M1r 13,0 0 : ,� ' 4 °s Yr .. Intcrcc p trap �r�., ..,_ t, ,rR - �' Page gas (va $ ) e2 g
Business name: West Hills Development - 12 51
Primer
Contact, name: Angie Cook Roof drain (commercial) 12.51
Address: 735 SW 158 Ave. Sink/basin/lavatory 25.02
City /State/ZIP: Beaverton OR 97006 Solar units (potable water) 62.54
Phone: (503) 641 -7342 Fax: : (503) 641 -7661 Tub /shower /shower pan 12.51
Urinal 25.02
E -mail acook(a@arborhomes corn Water closet 25.02
tT 447.s L� x %tr 717 Q . k ltk r:.l ' •9". sl
At zr z. .. ' y ''_.,�,x .. o i >fi t., - / + � ,,. :t s.v Water heater 37.52
Business name: Trademark Landscape Water piping/DWV 56.29
Address: 19088 S. Redland Rd. Other. 25.02
City /State21P: Oregon City, OR 97045 Subtotal
( ) ..50 Phone: (503) 631 -3893 Fax: 503 631 -4737 Minimum permit fee: $72.50 7 A .�
Plan review (25% of permit fee) --e9--- CCB Lic.:,�j3J3 Co Plumbing Lic. no.:
/. ��..C.1'iW State surcharge (12% of permit fee) $. 7
Authorized signature:
` TOTAL PERMIT FEE 0i • AO
This permit application expires if a permit is not obtained within 180 days
Print name: Steve Ellis Date: after It has been accepted ns complete.
"Fee methodology set by Tri- County Building Industry Service Board.
1 \ auildin5U 'crmitAPLMU- PetmitAPP.doe 10/01/09 440- 1616T(1w02/COMAVE0)