Permit q CITY OF TIGARD PLUMBING PERMIT
.t Y
COMMUNITY DEVELOPMENT Permit #: PLM2010 -00158
'41.G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 05/14/2010
Parcel: 2S112BD09100
Jurisdiction: Tigard
Site address: 14738 SW 78TH AVE
Subdivision: BRITTANY MEADOWS Lot: 27
Project: Brittany Meadows
Project Description: Install residential backflow preventer for irrigation
Owner: FEES
ECF DEVELOPMENT COMPANY INC Quantity Description Date Amount
1310 SW 17TH AVE
PORTLAND, OR 97201 1 ea Backflow Preventer 05/14/2010 $31.27
1 12% State Surcharge - 05/14/2010 $8.70
PHONE: Plumbing
41 ea Minimum Fee Adjustment - 05/14/2010 $41.23
Contractor: Plumbing
SERENITY LANDSCAPES
11606 NE SANDY BLVD
PORTLAND, OR 97220
PHONE: 503 - 516 -8004
FAX:
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 sta • within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rul l adopte by the Oregon
Utili otification Cen - . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You m. obtain a copy of the • t es
o direct questions to OUNC ; • 50 .246.6699 or 1.800.332.2344.
sued By: ei■ 1 . ' 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 p
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
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Building Fixtures l r �
tk •e Rcceil�ed
1,1 City of Tigard E i CEIVED p,te/.Bc: ,S Iy /Q Pemvt No algae -420 /
' e, 1 3125 SW Hall Blvd, Tigard, OR 97
` Plan Reciclt rnherr Permit No
C� Phone: 503.639.4171 Fax: 503.598.1960
Date�B��:
,= Inspection Line: 503.639.4175 MAY 1 4 2t1 llateRe B huts: ®See Page 2for
`; I I`G' `•_ -• A,K h i MAY Ready /By:
.'.. Internet: www.tigard- or.gov Notilied'Method: Supplemental Information
• _ • TYPE OF *oR€ITY OF TIG ARD • . • . •• . • .. .- , .. • FEE" SC.'HEDLTLE . '
® New construction ' Ellialaig DIVISION For special information rue dteck/irt
Description Qtt•. Ea. TOtal
❑ Addition /alteration/replacement ❑ Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION.: SFR (1) bath 312.70
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
' ' JOB SITE INFORNIATION AND LOCATION - Site utilities: Job site add
191.3 °SW 78th Catch basin or area drain 18.76
ress: Drywell, leach line, or trench drain 18.76
City/ State/ZIP: Tigard, OR 97224
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: SW 79th 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: Brittany Meadows l Lot no.: 27 Fixture or item: 1
Tax map /parcel no.: Backflow preventer 1 31.27 31.27
DE.S( RIPTION OF WORI> Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
. ❑ PROPERTY OWNER .. I ❑ TENANT . Expansion tank 12.51
Name: Paciflc Lifestyle Homes Fixture /sewer cap 25.02
Address: 11815 NE 99 Street, Suite 1200 Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/ State/ZIP: Vancouver, WA 98682 Hose bib 25.02
Phone: (360)573 -8081 Fax: (360)574 -6401 Ice maker 12.51
❑ APPLIC:ANT - 0 . ❑ CONTACT : PERSON .. Interceptor /grease trap 25.02
Business name: Medical gas (value: $ ) Page 2
Primer 12.51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units (potable water) 62.54
Phone: ( ) I Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
.• . • CONTRACTO ..... • .' '
Water closet
. ` . C . . .• Water heater 37.52
Business name: Serenity Landscapes Water Pm i P� B/D W V 56.29
Address: 11606 NE Sandy Blvd Other: 25.02
City/ State/ZIP: Portland, OR 97220 Subtotal
Phone: (503) 252 -1532 Fax: (503) 252 -5483 Minimum permit fee: $72.50 72.50
CCB Lic.: Plumbing Lic. no.: LCB 8867 Plan review (25% of permit fee)
State surcharge (12% of permit fee) 8.70
Authorized signature: 111111 TOTAL PERMIT FEE 81.20
Print name: Chris Sto Date: 5/14/2010
This permit application expires If a permit is not obtained within 180 days
after It has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board