Permit a CITY OF TIGARD PLUMBING PERMIT
.110‘ s • COMMUNITY DEVELOPMENT Permit #: PLM2010 00150
T 1 G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/06/2010
Parcel: 2S109AB16200
Jurisdiction: Tigard
Site address: 13343 SW PIPIT LN
Subdivision: Alpine View Lot: 43
Project: Alpine View
Project Description: Residential irrigation backflow device.
Owner: FEES
WEST HILLS DEVELOPMENT Quantity Description Date Amount
735 SW 158TH
BEAVERTON, OR 97006 1 ea Backflow Preventer 05/21/2010 $31.27
PHONE: 503 641 -7342 1 12% State Surcharge - 05/21/2010 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 05/21/2010 $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: 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 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 503.246.669 ,;x;'0.332.2344.
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Issued By: / �- Permittee Signature: /
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all 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.
Plumbing Permit Application
Building Fixtures RECEIVE), rolz oI ICE 4 SL ONL
Received
, ' 1 ; I Y City of Tigard M 7 D eceiv e S• ,, // 0 . Nona NoP f fc /O �('�I
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q 13125 SW Hall Blvd Tigtud, OR 97iYlg1Y _ 1 2010 Q 1 Q Plan Review C Other Permit N �A ,J
Phone: 503.639.4171 Fax: 503.598.1960 r / - S
960 DateBy: %ZD�O DODGE 7
T I Inspection Line: 503.639.4175 Date Read /B orris: 1 HI See Page 2 for
c n 1 10 P CITY OF T1GAR1} yd
Internet: v tigard -orgov e
Notified/Method: Supplemental Information
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® N construction ❑ Demolition For p elal' Information use checklist
- Description I Qty. f Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
` x: `4 ' t iiik'il M 1^i°l 1Cc t„!.� it ((_� - `.:'. \- ,..i f 4 SFR (1) bath 312.70
SFR (2) bath 437.78
® 1- and 2- family dwelling ❑ Commercial/industrial SFR (3) bath
500.32
❑ Accessory building ❑ Multi - family Each ndditianol batti/I:itchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft) I Page 2
3 l,gi fi t .., o ;_yll4t`t to it: i ' �, 11 ` i fx , .. Site utilities:
`' Catch basin or area drain 18.76
Job site address: 13343 SW Pipit Lane
Drywell, leach line, or trench drain 18.76
City / State/ZIP: Tigard OR 97224 Footing drain (no. linear fl.: ) 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 sever (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ___) Page 2
Water service (no. linear ft.: ) Pngc 2
Subdivision: I Lot no.: 43 Fixture or Item:
`axmap /parcel no.:
WSW- ` T y�rsy�rc�a Backflow preventcr 1 31.27
w ,,y`�? ar. -czt R itIIGI rt :st x 4o, 4 i; N- 1",+" i Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
E � �: •' ' Ex ansion tank 12,51
t .4ri .�,t its f yr` 1-i`: YI !x3; »tio -. .s lw�.? 4 _ P
,��,;..
• Fixture/sewer cap 25.02
Name: West Hills Development Floor drain/floor sink / hub 25.02
Address: 735 SW 158 Ave Garbage disposal 25.02
City / State/ZIP: Beaverton OR 97006 Hose bib 25.02
Phone: (503)641 -7342 Fax: (503)641 -7661 Ice maker 12.51
-,, i 5 r rr � INT- , ,,. t "� ," ` ii -m l' Interceptor/grease tra 25.02
e4, 4;r h t a,�'* 1 ,,�1 tr,,:..;rie f ,i ,_0 .qr[:s; ,„ r • ,r JnU ...� „....... .... -,, trap .
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 1 2.51
Urinal 25.02
E -mail acook a@arborhomes com
• m r 25.02
; 1, ^xat iY 731 - i "JH; C 0 rt az tic !,, Sa '. Water closet
x +5 ,t ; ' . ' "-' 2' '• � -; --_. � :' 1 .Z".$ 1 ;T " , : t .. r ' .3 '' Water heater 37.52
Business name: Trademark Landscape Water piping/DWV 56.29
Address:.......,., R_dr_ Ra PO 6dX ,,,,y /0 Other. 25.02
City /State/ZIP: Oregon City, OR 97045 Subtotal
631 -4737 Minimum permit fee: $72.50 2 , SD
Phone: (503) 631 -3893 1,6wASC/ijoir -F ax: (503)
Plan review (25% of permit fee)
/ Pl . ; / Plumbing Lic. no;
State surcharge (12% of permit fee) 8', 70
Authorized signature: . TOTAL PERMIT FEE ?i ,AZ)
This permit application expires if n permit is not obtained within 180 days
Print name: Steve Ellis Date: after it has been accepted ns complete.
*Fee methodology set by Tri- County Building Industry Scrvice Board.
1. \ nundingU 'crmiu\PLMU- PermitApp.doc ID/01,09 440- I616T(IOIO2/COMAVE13)