Permit • .,,? '�-' PLUMBING PERMIT
® ;
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00145
.
IGAR 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/9/2008
PARCEL: 2S 110C B -08300
SITE ADDRESS: 12454 SW AUTUMNVIEW ST ZONING: R -7
SUBDIVISION: MOUNTAIN VIEW ESTATES LOT: 008 JURISDICTION: TIG
PROJECT: ACCENT RESIDENTIAL HOMES
Project Description: Installing backflow preventer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ACCENT RESIDENTIAL HOMES
18676 SW BOONES FERRY RD Description Date Amount
TUALATIN, OR 97062 [PLUMB] Permit Fee 4/9/2008 $36.25
[TAX] 12% State Surch 4/9/2008 $4.35
Phone : 503- 691 -1428 Total $40.60
Contractor:
PRO LANDSCAPES OF OREGON INC.
PO BOX 261
ST. PAUL, OR 97137 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 633 -3400
FAX 503- 633 -3401
Reg #: LIC 7326
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these 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.
04/09/2008 09:49 15036333401 PRO LANDSCAPES PAGE 02/03
]Plumbing Permit Application r �
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1 City of Tigard Received
'' ' 4 ' V 13125 SW Nall Blvd., Tigard, OR 97223 APR 9 2008 DateB '/ `► y : ` , Permit No.;
/ Phone: 503.639.4171 Fax: 503.598,1960 Plan Review
,L. 4 1115 Uak /zty: Other Permit No.
� ` Inspection Line: 503.639.4)7S 5
i :� 4 ' " Internet: www.tigard-or.gov CITY OF TIGARD Date Ready/By: hrrsn: 65 Sc e Page 2 for
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SapplemenMl Information
TYPE OF WO:' l ° FEE* SCHEDULE
4 New construction ❑ Demolition For vain! Information use checklist
Description 1 Qty. [ Ea. 1 Total
❑ Addition /alteration /replacement ❑ Other, New 1- 2-family dwellings (includes 10011. Tot each utility connection)
_ . CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
4 l- and 2- family dwelling ❑ Commercialtmduatrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399,00
Q Master builder
Each additional bath/kitchen 45.00
❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: % witm� \ J ) t Catch basin or area drain 16.60
City/State /ZIP: ''r ! , r / 1'�/ Drywcll, leach line, or trench drain 16,60
Suite/bldg. /apt. no.: Project name: 4 . ` /. , i / Footing drain (nn, linter ft,; �) �� Page 2
Cross street/directions lo_ job site: anulherurcd home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no, linear ft.: ) Page 2
Storm sewer (no. linear ft.: __) Page 2
Subdivisitm: �l�W i of nv.:� Water service (no, linear ft.: `) Page 2
Fixture or Item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF . WORK F3ack[low prevcntcr 1 Page 2
.l 111 C/L - £_mite OW Backwatcrvalve 16,60
Clothes washer 16.60
Dishwasher 16,60
PROPERTY OWNER I ❑ TENANT'
Drinking fountain 16.60
Retitle a, � Ex tan k 16" 60
16.60
Name: rt U ,� J
"V -- ` ► Expansion tan
Address: $ i 1 , Get ` � i .e.- ` L 'a. • _ Fixture /sewer cap 16.60
City/State /ZIP: , j L 4 . 1 p ' a 1tij Floor drain/floor sink/hub 16.60
Phone: (93) (ell '''14.2 Fax; ( ) Garbage disposal EMI
IA APPLICANT . 0 CONTACT PERSON Hose bib x6.60
Ice maker 16.60
Business name: 1 1 p i t C� 1 OA tte41j [/I l
� '-- nterc
npior /grease trap 16.60
Contact name: r§11 s -'L .l Medical gas (value: $ ) Page 2
Address: ;QD Six 2.-IYl Primcr 16.60
City /State/ZIP: f .I kill 1 113 Roof drain (commercial) 16.60
Phone: (C17,) 1n',T, ,. -;i.�' DO Fax: ; (�p3) i 32 - i 1, f� 1 Sink/basin/lavatory 16.60
�t! �K -•���� K V Tub/shower/shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet
16.60
Business name: �1... Water heater 16.60
Address: Other: l
City/State/ZIP: Sabtotttl
Minimum permit fcc; $72.50 �!� (�
Phone: ( ) Fax: ( ) Residential baekflow minimum permit fcc: $36,25 .I• %
tic.: '12-. 1» Plumbing Lie. no.: Plan review (25% of permit fee)
r 1 State surcharge (12"%ofperanit fee) i'•lb
Aul.hrnivcd signature: rturc:
i , I �l�l , /L el TOTAL PERMIT FEE . �f7
Print. name: �I W , P1 Date: ` a, DC� Thi application expires if a permit is not obtained within
l 180 days after it has been accepted as complete.
*Fee mrthndoln'v eel by Tri- (pnfv Ruildinv industry Service Anti