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Permit
CITY OF TIGARD PLUMBING PERMIT a . COMMUNITY DEVELOPMENT Permit #: PLM2010 -00360 T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/02/2010 Parcel: 2S109DA17700 Jurisdiction: TIGARD Site address: 15305 SW SUMMERVIEW DR Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 106 Project: Arlington Heights No. 3, Lot 106 Project Description: Backflow for irrigation. Owner: FEES STONE BRIDGE HOMES Quantity Description Date Amount 16869 SW 65TH AVE #505 LAKE OSWEGO, OR 97035 1 ea Backflow Preventer 11/02/2010 $31.27 PHONE: 503 387 -7577 1 12% State Surcharge - 11/02/2010 $8.70 Plumbing 41 ea Minimum Fee Adjustment - 11/02/2010 $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 :11.332.2344. _ sc & 9„43tier : 0_ , , 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. • Plumbing Permit Application Building Fixtures RECEDE 1 FOR OFFICE USE ONLY City of Tigard ived v 13125 SW HallBlvd., Tigard, OR 97223 NOV V 1 2 010 Dac Rece �B y: 1 Permit i „,„ . .. pow Ja _ ( 0 Plan Review Phone: 503.639.4171 Fax: 503.598.1 Q Date/By: Other ,ST�fJ ct7 S I IGA RD Inspection Line: 503 ti OF TIGA Date Read �B y: r Interne :: www.tigard-or.gov pp .: I11tOl1VG Dl:VISlQA on cd/Me od• - alp Supplemental Information • - :?; TYP& OF WORK: :r; 1 ..; •-:• • : " : ' - - - FEE* <SCHEALTLE S? . ..7 1 .". , E New construction ❑ Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total ❑ Addition /alterationlreplacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) • '' C. TEGORY= ©F;:CON .` : ;:;=•- 5" SFR (I) bath 31230 ® 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 ❑ Accessory building ❑ Multi- family 5FR (3) bath 500.32 Each additional bath:kitchen 25.02 ❑ Master builder .. Other: Fire sprinkler sq. ) , g ;IOB _SITE 1N i% 1D : .`: _.. Site utilities: s Page Job site address:] 5 3 C) Ste. ,5 ili rn t:? j• i F,�r 0 F3 match basin or area drain 18,'6 City /State/ZIP: j i C Lfs'lt4_ i /� f 7 ,'3-4. Dtya'ell, leach line, or trench drain 18.76 1 Footing drain (no. linear ft.: ) Pagc 2 • Suitebldg.apt. no.: 1 Project aall1 -K / I U f z yy {..c <-4_, kt� J � f - Manufactured home utilities • 50.03 Cross street/directions to job site: Manholes • 18.76 �-cu p, e _e P ,'-ec, 249 7 t,C_) z1" Rain drain connector 18.76 C% r T'e ,1 7� e--t_ D 0._ -=- ...S S/.t.r�, rr^o-C-T i c'.4.0 Sanitary sewer (no. linear ft : �� Page 2 . Storm sewer (no. linear ft.: _) Pagc 2 � Water service (no. linear ft.: ) Page 2 Subdivision: r J if i i n f a 1 /k t y Jt Lot no.:/ U Fixture or item: Tax map/parcel no.: (,el j r" /1-( Backflow preventer x 31.27 31.27 e.: ....:...: � ;:.: - DESCRIPTION. .' ...,.. _ . ... • _ ... . • Clothes washer 25.C2 Landscape Irrigation Baekflow Device Dishwasher 25.02 Drinking fountain 25.02 I Ejectors/sump r 25.02 , . ;. -,. - . = Expansion ,..:..- ..:-�PROPERTS': . 03'1^4ER - . , :'. ',, _';' ❑��TENAN•C_' � Expan 12.5! - tank • Name: StoneBridge Homes NW LLC Fixture/sewer ca 25.02 Floor drainlfoor sink/hub 25.02 Address: 16864 SW 65` Ave 0505 Garbage disposal 25.02 City/State/ZIP: Lake Oswego, OR 97035 Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 APPLIC.YNT..... _; . . - - . , ®.. CO_VTiCC`P �ERSO�1 �`.. ' , I trap 25.02 Business name: Landscape Oregon, Inc Medical gas (value 5 ) Page 2 Contact name: Ellen Sparrow Prirncr 12.5] Roof drain (commercial) 12.51 Address: 12200 SW Myslony Road Sink/basin/lavatory 25.02 City /State2Q': Tualatin, OR 97062 Solar units (potable water) 62.54 Phone: (503) 692 -5945 I Fax: : (503) 692-0768 Tub/shower /shower pan 12.51 E -mail: ellenglandscapeoregon.com Urinal 25.02 . ... :.., Water closet -CQNTRACTR : :.= 11 P. _ : , ,. ., _ ..._. ,. .:• F. F . .. � -: • : . :.. ..:.:. ...: .• Water heater 37.52 Business name: Landscape Oregon, Inc. Water piping/DWY' 56.29 Address: 12200 SW Myslony Road Other: 25.02 City/State/ZIP: Tualatin, OR 97062 Subtotal 31.27 Phone: (503) 692 -5945 Fax: (503) 692 -0768 Minimum permit fee: S72.50 72.50 CCB Lic.: 7804 Plumbing Lic. no.: Plan review (2.5% of permit fee) State surcharge (12% of permit fee) 8.70 Authorized signature "/ • L. L/) C/2- - TOTAL PERMIT FEE 81.20 Print name: Ellen Sparrow Date: f l -/ -- i} - Q�C ; This permit appllcaden expiro if a permit is not obtained within 180 days a lter it has been accepted as complete. 'Fee methodolo;y se: by Tn -Counry Building lndtatry Service Board. F/��� /�V� TO G /,f���Jpk},J�l 1:lauildi.,glPerruit, PLMU-PernitApp.dx 01/0 44C-0616T(10/omiCOM/WEB) £ 89L0 Z69 Ue113 e5Z:90 01. 1,0 AoN