Permit CITY OF TIGARD PLUMBING PERMIT
Ai
�.. COMMUNITY DEVELOPMENT Permit #: PLM2010 00250
Date Issued: 07/30/2010
:TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S109AB13400
Jurisdiction: Tigard
Site address: 13125 SW STARVIEW DR
Subdivision: Alpine View Lot: 15
Project: Alpine View
Project Description: Residential backflow preventer for irrigation.
Owner: FEES
WEST HILLS DEVELOPMENT Quantity Description Date Amount
735 SW 158TH
BEAVERTON, OR 97006 1 ea Backflow Preventer 07/30/2010 $31.27
PHONE: 503-641-7342 1 12% State Surcharge - 07/30/2010 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 07/30/2010 $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 $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Util' ∎ otification - • er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
direct questions to Ob C : c. Iling 503.246.6699 or 1.800 332.2344.
Issued By: 0 // t Permit ee gnature
Cali 503.639.4175 by 7:00 a.m. for an inspection that bu ness day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures � °; LL ; 4:. o f ` l sE O�LI .' . t ''.. ' :
City of Tigard (` " R e c e i vi c e 4, y l �� ...6 Permit No.: l (,�a0 /D "Y,�a SU
y 3 _ \. Dian Review
6 ,• % Other permit No.:
fit. a ® Phone: .503 63 Inspection Line 503 639 4175 .4171 Fax: 503:598 13125 SW Hall Blvd., Tigard, OR 972 .19 % �. .„Date/By: Hor - o /O^ aver)
. \ • a eady/By tarts: Fa See Page 2 for
TrIGA RD V cp d/M ethod: Supplemental Information
.,,,, t.xes,141.0 Intcmet avavav tigard -or gov 'L
R• �fi -r ...,. g"' itir ri i-rix a t i p ' .. ,Z b"- }'p( Q13D 1 ( i. ,$, 7 "! r f , bre r
4 t; �;% i- 1 � .`iT ( A .. , t. 1-L ''- :loch ,...„... . • . 1. , � ,'tr xss. '.�f � r _ ', . .. s .�1.... . .77.` -'
Dliti� Fors recfa!in ormation use checklist
® New construction ❑ emo _ 9 Description Qty. Ea. Total
❑ Addition/alteration/replacement ❑ Other: • New 1- 2- family. dwellings (includes 100 ft. for each utility connection)
a te, i r ;b s r yiZi c u _ � `,�r <'�- <� `�' SFR (1) bath I I 312.70
n e...3;�} -i �.. f 4' -c i t� .h�'iY��'l {Ii �t`�G� tY- ri�'ti1.:r r`: �0..., � � ,'. �a.. _.3?: 'ohx ',
❑ Commercial/industrial SFR (2) bath 437.78
® 1 -and - faintly dwelling SFR (3) bath 500.32
❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02
❑ Master builder ,,.... Other: Fire sprinkler ( sq. ft.) I Page 2
,2,,,,' 117 :1 . ..o Ali' �ls § `i � 11 F . 'it ac a ( 'F"='t Site utilities:
_ „1,
Catch basin or area drain 18.76
Job site address:
13125 SW Starview Dr
Dryavcll, leach line, or trench drain 18.76
City /State/ZIP: Tigard OR 97224 Footing dram (no. linear ft.: ___) Page 2
Suite /bldg. /apt. no.: I 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 ft.: Page 2
Stone sewer (no. linear ft.: _) Page 2
Water service (no. linear ft,: ) Page 2
Subdivision: Alpine View I Lot no.: 15 Fixture or item:
Backflow preventer 1 31.27
Tax map /parcel no.:
atirr --.ta r•o, +°ri rg;5 ,' , 7 r9"' "=S,t'9°"'.tY�S Backwater valve 12.51
�j t °-r .D_,GS -e -V IO�! ' �:e ar X `;: Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
,,S;'y .. •• s a V t --� y °a7�c. 17 II My i� s'rs ; • ''^' Expansion tank 12.51
Y .? 4 � i, :�.���t � n � i�l,l� �.. � �:�'.5�'i a>- .�r�.M- ,- �- 2i _h
Fixture/sewer cap 25.02
Name: West Hills Development
Floordrain/floor sink/hub 25.02
. Address: 735 SW 158' Ave Garbage disposal 25.02
City /State/ZIP: Beaverton OR 97006 !-lose bib 25.02
Phone: (503)641 -7342 Fax: (503)641 -7661 Ice maker 12.51
: ; ., y � f a { v t � '' r 0 sr " 17 ; o j t'c 1 p '{ Interceptor /grease trap 25.02
b+a s i�ttii{.:J ?4'°.'1' � 1 ;+ b i�L) C/ y A����sk. , � ,t w� swr"i_ . r� . �!+�-- ..S� �:R.. �,. �..;,....
Medical gas (value: $ ) Page 2
Business name: West Hills Development -
Primer 12.51
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.com 25.02
r;m ,~ V Water closet
Wntcr heater 37.52
Business name: Trademark Landscape Water piping/DWV 56.29
Address: 19088 S. Redland. Rd. Other: 25.02
City /State/ZIP: Oregon City, OR 97045 Subtotal
( )
Phone: (503) 631-3893 Fax: 503 631 -4737 Minimum permit fee: $72.50 7A .
Plan review (25% of permit fee) --&- CCB Lic.;
5 67Q Plumbing Lic. no.; Siatc surcharge (12 %ofpcnnit fee) �d
Authorized signoturc:
TOTAL PERMIT FEE 87 . az
D 6/4/10 This permit application expires If a permit is not obtained within 180 days
Print name: Steve Ellis after it. been accepted ns complete.
•Fee methodology set by Tri- County Building Industry Service Board.
1. 10uiidinOU 'crmits'PLAIU- PcnnitApp.doc 10/01 440- 1616T(10/O2/COM/wEn)