HomeMy WebLinkAboutPermit CITY OF TIGARD PLUMBING PERMIT
IS' COMMUNITY DEVELOPMENT Permit #: PLM2010 -00286
T L GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/27/2010
Parcel: 2S109DA13900
Jurisdiction: TIGARD
Site address: 12685 SW MOUNT VISTA CT
Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 58
Project: Arlington Heights
Project Description: Backflow for irrigation.
Owner: FEES
STONEBRIDGE HOMES NW LLC Quantity Description Date Amount
16869 SW 65TH AVE #505
LAKE OSWEGO, OR 97035 1 ea Backflow Preventer 08/27/2010 $31.27
PHONE: 1 12% State Surcharge - 08/27/2010 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 08/27/2010 $41.23
Contractor: Plumbing
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: 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
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 1411110 Perrnittee 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.
Aug 26 10 11:28a Ellen 503- 692 -0768 p.1
Plumbing Permit Application
Building Fixtures AUG 2 6 2010 FOR OFFICE USE ONLY
a City Of Tigard Received /Q Mr Permit xo.:. PtM9oi0 -ego)-
:: 13125 SW Hall Blvd., Tigard, OR 97123 -
Phone: 503.639.4171 Fax: 503:598.1960 Plan Review
Date./13y: Orha ?errnit No.: •
TI GARI) Inspection Line; 503.639 DateReady/By
Internet: www.tigard- er.gov kris Et See Page] for
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ethod: r g
1 ._ :.. -. � . E . _ O _, - - .. - upp emennl Iaformahon
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• ® New construction
❑ Demolition • For special information use checklist ,
Description 1 Qty. I Ea. 1 Total
Q Additionialterationheplacement I ❑ Other. New 1. 2-family dwellings (includes 100 a. for each utility connection)
:. C¢TEGORY.'OF CONSTRUCTIOY ". SFR(l)bath 1- 312.70 I
® 1- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
Accessory building SFR (3) bath 500.32 l
❑ i g ❑ Multi- femily
Each additional bath/kitchen • 25.02
❑ Master builder 0 Other:
- -.. • Fire sprinkler ( ) Page 2
s.ft.
JOB SITE INFORMATION AND LOCATION , Site utilities:
Job site address: li g 6 O s 1 i "l ck., ,, •' i l < Catch basin or area drain ] 8.76
City!State,rLIP: i / -� Drvwell leach line, or trench drain 18,76
- 1 1 61,1 1 t. G � . • ) o J t r
Footing drain (no. linear R: ) Page 2
Suite./bldg.!apt.no.: Pro j ectna mc:i l iI')I / - t/q 7 1-1:: ;.1, r1 ?.:� Manufactured home utilities 50.03
Cross street/directions to job site: ! " Manholes 18.76
�.
.. i f1 -1.' N ,(r . i P . „ ; it ' ( p ) -. ! _,_ ; . r -i r ; r � :,, r .. . ; r Rain drain connector 18.76
r i y lei %i ' -'..V` /`:, ,., . �.
Sanitary sewer (no. linear ft.:. ) Page 2
Storm sewer (no. linear ft.: ) Page 2
l.- -• J
// 7 is t_ Water service (no. linear ft.: ) Page 2
Subdivision: i- i - 1
-r',i - n hi) 1 IJ r
�. i .;! _� Lot s ,i( Fixture or item: _ i
Tax map /parcel no.: Baccflow preventer x 31.27 31.27
-- DESCRIPTION; OF_ ��'ORK : - Backwater valve
._ -.:_ .. -- : .. . -.. - B 1, val 12.5:
Clothes washer 25.02
Landscape Irrigation Backflow Device
Dishwasher 25.02
Drinking fountain 25.02
Eiectors/sump 25.02
® PROPERTY OWNER ._ - • - Er.tENANT ; -• Expansion tank 12.51
Name: StoneBridgc Domes NW LLC Fixture/sewer cap 25.02
-
Address: 16869 SW 65` Ave #505
Floor drairjfloor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Lake Oswego, OR 97035 Hose bib 25.02
Phone: ( ) Fax: ( ) Ice makes 12.51
'.- El `APPLIC&NT• - - _ i N. CONTAiCI 'PE In ter:eptorrgrease trap 25.02 • Business name: Landscape Oregon, Inc. bfed'.cal gas (value: S ) p 2
Contact name: Ellen Sparrow
Primer 12.51
Roof drain (commercial) • 12.51
Address: 12200 SW Myslony Road S nkrbasin/lavatory 25.02
City /State/ZIP: Tualatin, OR 97062 Solar units (potable water) r 62.54
Phone: (503) 692 -5945 Fax: : (503) 692 -0768 Tub/shower /shower pan 12.51
E- n:ai :: ellen ®Iandscapeoregon.com Urinal 25.02
. etc et
25.02
- Water heater 37.52
Business name: Landscape Oregon, Inc. Water :iping/DWV 56.29
Address: 12200 SW Myslony Road Other: , 25.02
City /State/ZIP: Tualatin, OR 97062 Subtotal i 31.27
Phone: (503) 692 -5945 Fax: (503) 692 -0768 1 Minimum permit fee: 572.50 72.50
CCB Lie.: 7804 Plumbing Lic. no.: Plan renew (25% of permit fee)
/�- . State surcharge (12% of permit fee) 8.70
Authorized signature :. / r
(e. /-h ✓: =- ! - _ TOTAL PERMIT FEE 81.20
Print name: Ellen Sparrow I ` 1 Datg� ; (� v (� ; �� This permit applicatioa ezpires if a permit is not obtained within 180 days
(„01-44/ aRer it has hoes accepted as complete
- C . ,`/��'// _ I 'Fee me;hodotogy set by Tri•Couoty Building Industry Se-vice Bcard.
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