Permit CITY OF TIGARD PLUMBING PERMIT
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tz ,,. COMMUNITY DEVELOPMENT Permit #: PLM2010 00376
TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/18/2010
Parcel: 2S111DB14700
Jurisdiction: Tigard
Site address: 15050 SW 93RD AVE
Project: Lobdell Subdivision: KESSLER ESTATES Lot: 4
Project Description: Installation of residential backflow preventer for irrigation system.
Contractor: ENCHANTED GARDENS LANDSCAPE SERVICES LL( Owner: LOBDELL, TIMOTHY F & CAYLEE H
1980 WILLAMETTE FALLS DR, SUITE 120, PMB 15050 SW 93RD AVE
156 TIGARD, OR 97224
WEST LINN, OR 97068
PHONE: 503 - 650 -2561
PHONE: 971- 533 -9053
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 11/18/2010 $31.27
Specifics: 1 12% State Surcharge - 11/18/2010 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment - 11/18/2010 $41.23
Plumbing
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 i • - spended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility 'cation Center. •ose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or d ct questions to OUNC b .:Ili 1 503.232.1987 or 1.800.332.2344.
ssued By: ■. // Permittee Si... 1 �`
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Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Nov 16 10 08 :52a ENCHANTED GARDENS 503 - 678 -2394 p.1
Plumbing Permit Application
Site Utilities . ,, CEIVE 1; - FOR ' OFFICE USE ONLY .
Received n �
City of Tigard D au /By: ////e/4 J Permit No.: e „Qt
u 13125 SW Hall Blvd., Tigard, OR 9722 v 16 2 Q 10 � `�,
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Plan Rcvicw
Phone: 503.639.4171 Pax: 503598.1960 Dawrlly. other Permit No.:
Inspection Line: 503.639.4175 CIT O F TIGARD Ready/By:
1• I G A R D. Date runs: 12l See page 2 for
. Internet: www.ugard or.gov �T���QQ Notified/Metbod Supplemental Information
TYPE OF :WOW DIVISION FEES SCHEDULE
❑ New construction ❑ Demolition _ For special information use checklist
Description 1 Qty. 1 Ea. j Total
® Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 fi. for each utility connection)
' . . ' • CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
® 1- and 2- family dwelling ❑ Commercial /industrial _ SFR (2) bath 437.78
❑ Accessory building ❑ Multi- family
SFR (3) bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: hire sprinkler ( sq. ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 15050 SW 93 Ave Catch basin or area drain 18.76
City / State/ZIP: Tigard, OR 97224
Drywell, leach line, or trench drain 18.76
Footing drain (no. linear 0.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Lobdell sprinklers Manufactured home utilities 50.03
• Cross street /directions to job site: SW Sattler St Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: _) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parse] no.: Backtlow preventer 1 31.27 31.27
. - DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Sprinkler system installation Fq TETI
dd��ii Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
❑ PROPERTY •OWNER • • ' . ' ❑ TENANT • Expansion tank 12.51
Name: Caylee Lobdell Fixture/sewer cap 25.02
Floor drain /floor sinklhub 25.02
Address: 15050 SW 93rd
Garbage disposal 25.02
City / State/ZIP: Tigard, OR 97224
Hose bib 25.02
Phone: (971)533 -9053 Fax: ( ) lce maker 12.51
• .• ❑ APPLICANT . • • ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Enchanted Gardens Landscape Services LLC Medical gas (value: $ ) Page 2
Contact name: Delia Wallin -Gill Primer 12.51
Roof drain (commercial) 12.51
Address: 1980 Willamette Falls Dr, STE 120, FMB 156 Sink /basin/lavalDry 25.02
City /State/ZIP: West Linn, OR 97068 Solar units (potable water) 62.54
Phonc: (503) 982-3859 Fax: : (503) 678 -2394 Tub /shower /shower pan 12.51
E -mail dwg- enchanted@comcast.net Urinal 25.02
Water closet 25.02
• CONTRACTOR .
Water heater 37.52 _
Business name: Enchanted Gardens Landscape Services LLC Water piping/DWV 56.29
Address: 1980 Willamette Falls Dr, Ste 120, PMB 156 Other: 25.(12
City /State/ZIP: West Linn, OR 97068 Subtotal 31.27
permit fee: $72.50 72.50
Phone: (503) 650-2561 Pax: (503) 678 -2394 - Minimum P
g\���`\
- Plan review (25% of permit fee) 18.13
CCB Lie:: 7857 OLCB 7 \ Plumbing Lic. no.:
State surcharge (12% of permit fee) 8.70
Authorized signature: t z z( " TOTAL PERMIT FEE 99.33
Print name: Delia Wallin - Gill • ate: 11/16/10 ( this permit application expires if a permit is not obtained wi thin 180 days
after it has been accepted as complete.
*Fee methodology set by Tri- County Building Indusvy Service Board.
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