Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2010 -00345
T t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/22/2010
Parcel: 1S135CA09500
Jurisdiction: Tigard
Site address: 11448 SW 96TH AVE
Subdivision: SOLERA Lot: 4
Project: Solera
Project Description: Backflow for irrigation.
Owner: FEES
GREENBURG TERRACE LLC Quantity Description Date Amount
735 SW 158TH #180
BEAVERTON, OR 97006 1 ea Backflow Preventer 10/22/2010 $31.27
PHONE: 503-332-7167 1 12% State Surcharge - 10/22/2010 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 10/22/2010 $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:
Class of Work: 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. y
Issued By: Permittee Signature: //
LL ✓���i r ter:' /6% / (/
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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.
•
Plumbi Per mit Application , FOR OFFICE I_ SF, o�1,ti
Building Fixtures
061\1 '
" ca o r Pcmtit rm.: V •.a D - .3
City of Tigard Q, Horde
� � � ti Other Permit No.: V ,� i 0 ciJo - " "
N • 1 h i25 SW .811 Blvd., Tigard, OR 97223 i See Page 2 for
Phone: 503.639.4171 Fax: 503598.1960 �i Supplemental Information
Itapection lane 503.639.4175 0 - , � , "
. i �' ^ `�� Int ww or go r i FEE' SCHEDULE
'1 YPE OF WORK Dl For daf I ernmdoa use dtet -klrst Total
❑ Demoltttott e
Descri.tloo
0 Add construction N 1- 2-famil dwellia • (includes 100 h utility connection)
0 Other. 312.70
❑ Add itionialteratioalre placement 312.70
CATEGORY OF CONSTRUCTION SFR (2) bath
❑ Commercial/industri SFR(3) bath 500.32
❑ 1 • and 2-family dwelling
buildin 0 Multi- family Each additional bath/kitchen ME IIIIIIII
❑ Master bu g ❑ Other: 25.02 Fire sprinkler Cf_____ sV• ft �� ME
❑aster builder LOCATION ��
• JOB SITE INFORMATION AND ,•.. :. .
�a>r� Dgrndl, leach line, or trench drain • 111.76
Job site address: \ ((..‘1. S W
Footing drain (no. linear ft.: J 50.03
City/State/ZIP: e1b1d Jap r true Manufactured home utilities
SuitdbldgJapt. no.: Project name: r MN
site: 18.76
Cross street/directions to job Rain drain connector
Sanitary sewer (no. linear ft.:
Paget Ems
Water service (no. linear IL: j
Lot no.: Fixture or item:
Subdivision: 1o,Y • gad pnventer
NUM
Tax map/parcel no.: 25.02
DESCRIPTION OF WORK 25.02
Dishwasher 25.02
Drinking fountain 25.02
•
Ejectors/sump ��
TENAAI T r 2_°.02
�` PROPERTY OWNER Fixturelsewa cap � 25.02
Floor drainifloorsiolJ MI 25.02 MN
IIIIIIII
5k.-1. + sink/hub ,: t S s ', { 't Garbage disposal 25.02
/address: 3 0e 1 tit , Hose bib
P ( l '1 / " S • J • v, �! r Ice maker
b (s (; ) �2 • 25.02
Fax: 6 intercepto /8r easetrap r
Phone: (• �� s _ 0 CONT PER SON r
0 A>>uC �M MIN
Cons ens name: Sink /ba5in/ drain l all 25.02
Contact name: Sinklavatory
• .. Solar units (potable water) � �� MINI
Phone: 25.02
Far:: ( ) _
Phone: ( ) 25.02
E-mail: _
CONTRA . 11111111=11 Water p1p1n8/D�' 25.02
�� ' Other.
• d • e a .,N/0
Address: 7, dye tit fee: S72.s0 7 2., A
Minimum pcm ag. City/State/ZIP: ` � .A. Plan review (25% of permitfee)
t • 0
8 • Fax: (S G I-
Phone: (S v , —
`�� 3 CD-161‘ L PER�117 FEE 1.
• � a Tit L not obtained vritb to it i0 days
Authorized sigltatu� TOTAL
This permit application t is Pu as complete
Date: ZQ /v offerit as been unit' Bud d
•Fee,ayt,cdotoar set by Tri- County Budding industry Service Boar
Priattttam� L. --
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Z L£Ltr l£9 -£05 spue7 vewepali d69 :90 01. 2100