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Permit z . . ' ' ,- CITY OF TIGARD PLUMBING PERMIT t Permit #: PLM2009 -00321 .c COMMUNITY DEVELOPMENT Date Issued: 11/04/2009 1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 T 1 GRAD Parcel: 2S 109AC04900 Jurisdiction: Tigard Site address: 14612 SW 133RD AVE Subdivision: WILSON RIDGE NO. 2 Lot: 17 Project: Wilson Ridge 2 Project Description: Irrigation backflow device. Owner: FEES STONE BRIDGE HOMES NW LLC Quantity Description Date Amount BY VENTURE PROPERTIES INC, 4230 SW 1 ea Backflow Preventer 11/04/2009 $31.27 GALEWOOD ST #100 1 12% State Surcharge - 11/04/2009 $8.70 PHONE: Plumbing 41 ea Minimum Fee Adjustment - 11/04/2009 $41.23 Plumbing Contractor: LANDSCAPE OREGON, INC. 12200 SW MYSLONY RD. TUALATIN, OR 97062 PHONE: 503 - 692 -5945 FAX: 503 - 692 -0768 Type of Use: SF Class of Work: OTR 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: X5214—le` Permittee Signature: ©tij "9 /.e ,f-i ,e 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. YLumbin Permit A lication RECEIVED Building Fixtures NOV 0 3 2009 FOR OFFICE USE ONLY II _ City of Tigard R ved ece' • • 13125 SW Hall Blvd., Tigard, OR 97223 nn �/ Da e/ y: 4 �'�� Permit t L C ?hone: 503.639.4171 Fa: 5 03.598.1966.01 I T OF TIGARD Pin. Review o?O/ -(�03� TIGARD D:t'; _ . Otte: Perttit t Y '7� �� p�//J�f Inspection Line: 503.639.4175 BUILDING DIVISIO • 1 w•w.ttgard- or.gov D 7 7Jr/ L' ace el &eady.By: /� V See Page 2 for Internet www.tigard-or.gov (y TYPE OF WORK ' Supplemental Information • ® New construction i FEE* .SCHEDi7 E Q Demolition Far s ormatdon use checklist D Addition , 'alteration /replace Dcscr tton � ty Ea. ❑Other: Total New 1- 2- family dwellings (includes I00 PL for each utility connection) GATEGORY•OF CONSTRUCIIOY �1- and 2-family = SFR (1) barb 249.20 atttil dwelling ❑ Commercial/industrial SFR (2) bath ❑ Accessory building 350.p0 1:1 Multi-family -� I SFR (3) bath 399.00 ❑ Master builder Each additional 'oath/kitchen ❑ Olher: 45 00 JUB SITE LNFORA1AT10N AND LOCATION Fire sprinkler ( sq. ft.) ?age 2 A Site utilities lob site address: /El &/ � . `0 % _, 3� rt . Ace__ Catch basin or area drain I - j City /State /ZIP: Ti e,CG,t CL 16.60 I C' 7 � a Drwvell, leach line, or tren d ra n Suite /bldg. /apt. no.: j i 16.60 Proect name: - 1!1 , (. 1 7 Footin drain (no. im ear It-: �� Page Cross street/directions to job site: (`-� I P e 2 Manufactured home utilities I 1 10.00 err _ Manholes f ; &• '� 81_01 )�L / I I 16.60 16.60 R ain drain connector Sanitary sewer (no. linear R.: ) Page 2 7 . Storm sewer (no. linear ft.: 1 Subdivision: j IS L r�, 3 ��C. /� 7 R Water service ! Page 2 J' L ( Lot no.: ■ % I (no. iinea: R: �� .:_l_ Tax map /parcelno: 6 SS /44, Fixtureor DESCRIPliCiN OF 'WORK' - Absorption valve ' 16.50 Landsca a r' + Baccllow reven p Irrigation Backflow Device p ter x Page 2 1 Backwater valve 16.60 Clothes washer I 1 16.60 Dishwasher 1 16.60 ! PROPERTY, OWNER I ... Drinking fountain 16.60 • O: TENANT Name: Stone Bridge Homes LLC Ejectors/sump 16.60 Address: 16869 SW 65 Ave 4505 Expansion tank 16.60 Ciry /StateJZIP: Lake Oswego, OR 97035 = l dr sewer caa I 16.60 Floor drain floor sink: nub 16.60 Phone: ( ) . rate: ( ) Garbage d � 16.60 : Landscape e O r e Business name ( Q CONT ACT PERSON Hose bib 16.60 : Landscape Oregon, Inc ice maker 16.60 Interceptor/grease tor; C P Seale trap 16 60 1 Contact name: Ellen Sparrow Address: 12200 SW Myslouy Road I Medics] gas (value: 5 ) Page 2 Primer 16.60 City,'State /ZlP: Tualatin, OR 97062 Roof drain (commercial) 16.60+ Phone; (503) 692 -5945 I Fax: - (503 -) 692 -0768 Stnk/basi Jlavatory 16.60 ,' E -mail: ellen Tub /sh /shower pan Urinal ' 16.60 I CONTRACTOR ` _ + 16.60 • Business name Landscape/Oregon, ater closet i 15.60 P regon Inc r Water heater Address: 12200 SW Myslany Road 16.50 I I Other: City/State /ZIP: Tualatin, OR 97062 I Subto }AI - � 5 L t hone: (503) 692 -5945 _ Fax: (503 -) 692.SptiS O7 'vtirimt m permit fre 53 .5 , Residential backtlow CCB Lic.: 7804 minimum permit fee: �3 .25 ' Plumbing L'... �{? g t^ no.: 11 I Plan review (25% of permit fee) ?, - Authorized signature• - � n � State surcharge (I2% of permit fee) Print name: Ellen Sparrow / / I TOTAL ?cRbflT FEF Date: / f - 3 ..09 i This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. , 4 ,,2 O *Fee m ustry Service . set by Tri- County Building Eldrd. i SuildiahY ff :rmits•PL'.- PertthAn.dec 12/27•'06 , 440.46 r 57: ox vonw JEB) ' o f "r [..d 99L0 Z69 - £09 I- eL� 06 60 £0 ^oN