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Permit y a CITY OF TIGARD PLUMBING PERMIT ' 7. 2'''- COMMUNITY DEVELOPMENT Permit #: PLM2010 -00383 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/08/2010 Parcel: 2S112BD08200 Jurisdiction: Tigard Site address: 7881 SW HANSEN LN Project: Brittany Meadows Lot 18 Subdivision: BRITTANY MEADOWS Lot: 18 Project Description: Installation of residential backflow preventer for irrigation. Contractor: SERENITY LANDSCAPES Owner: ECF DEVELOPMENT COMPANY INC 11606 NE SANDY BLVD 1310 SW 17TH AVE PORTLAND, OR 97220 PORTLAND, OR 97201 PHONE: 503 -516 -8004 PHONE. FAX: FEES Quantity Description Date Amount 1 ea Backflow Preventer 12/08/2010 $31.27 Specifics: 1 12% State Surcharge - 12/08/2010 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment - 12/08/2010 $41.23 Plumbing Class of Work: OTR 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 otification -nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or •rect questions to O • .Ili,. 503.232.1987 or 1.800.332.2344. Is ued By: , //i Permittee Signature: ' _1 -// f C _ _ 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. Plumbing Permit Application • Building Fixtures RECEIVED F012 OFFICE USE ONLY Tigard Received of Ti q City 26 City g Date/By: fe- /0 Permit No.: , �lQ OO 7d ® 13125 SW Hall Blvd., Tigard, OR 97223 f r 8 .gQ4 Plan Review O 1 Phone: 503.639.4171 Fax: 503.598.19 1, L Date/By: Other Permit No.: � 0M2! Q ,,,(� /35 Inspection Line: 503.639.4175 1 L(S A It t) C ITY OF TIGARD Date Read By fur is: ®See Page 2 for Internet: www.tigard Notified/Method: Supplemental Information p 7 L�1N. 0- =YTYPE •:OF.:.W _. > ° ° • FEE* SCHEDULE '5 q: Y New construction ❑ Demolition For special information use checklist Description Qty. 1 Ea. 1 Total ❑ Addition/alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) ,CATEGORY OF : ,CON S TRUCTION -r ` :- SFR (1) bath 312.70 ,N1- and 2- family dwelling El Commercial/industrial SFR (2) bath 437.78 El Accessory building SFR (3) bath 500.32 ry g ❑ Multi - family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 • - JOB ^SITE INFORMATION AND LOCATION , t . ' • , Site utilities: Job site address: 7 g g ( S w „50-yl, L,e_ Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City /State /ZIP: 1 1 3 - t ©V' C I - 7 9,9-77 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: 1 Project name: Manufactured home utilities 50.03 Cross street/directions job site: Manholes 18.76 in.) -7e ±3-- S� a-t '�� _ tt Rain drain connector 18.76 l T°�� Sanitary sewer (no. linear ft.: _ ) Page 2 0 /1 n P �� Storm sewer (no. linear ft.: ) Page 2 ( �� Water service (no. linear ft.: ^) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 4 31.27 3 ( t-y"") .. _ _ :_ . • Backwater valve 12.51 ' DESCRIPTION , OF ^WORK , ' ' . g / �� 'J / Clothes washer 25.02 el .cC - , 0 (( re-✓ Dishwasher 25.02 _ • ,/ rr t�l t./�- S 'FP�^•4, -- ! - Drinking fountain 25.02 Ejectors /sump 25.02 <."; PROPERTY OWNER '- w *^ T ; i TENANT Expansion tank 12.51 Name: P�e.-(` 1 �'� S4 `e- L� ie.- . (-4-r n S Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 1 r 8/ 7 A) E 9 9 , 5 +, s 19_ 0 Garbage disposal 25.02 City /State /ZIP: V 0„,c, 0 LA, UPf i I)J &l � g 2 -Z Hose bib 25.02 Phone: (3b0) . 73 - g o g 1 Fax: ( b0) 51 - 6L.(-0 ( Ice maker 12.51 .:,, ; * ® .APPLICANT; ,sj ' '' r _ q a Interceptor/grease tra _.v. _- '� t - � �.�� ® "CONTACT PERSON P 25.02 P / p Medical gas (value: $ ) Page 2 Business name: t r w Y tS . ,, e-, D131 So- e,,,1 - y 1 � � s J � ' ,- Primer 12.51 Contact name: cW r 4'.-LC ++ I f� Roof drain (commercial) 12.51 Address: 1 I b06 i' E SaA -&6' d-J 1 I/ ,( Sink/basin/lavatory 25.02 City /State /ZIP: A2 �•-1 t ©,_ C�' -7 Solar units (potable water) 62.54 Phone: (c ) 3_5z i 53 y Fax:: (50g zS z - 540 3 Tub /shower /shower pan 12.51 E-mail: 11V(6 iil 5B- v ��d �jA°S vl�f Urinal 25.02 �` a Water closet .'''''''''',..;'1"-- 25.02 ' i CONTRACTOR . , f Mr - . w.e: .. Water heater 37.52 Business name: ri _(1`C-ac,� -1-, LG D 01. ; Sc'��' S ` Water piping/DWV 56.29 Address: ( 1606 lit) ,5 CO f od l Other: 25.02 City /State /ZIP: P4-(GQr t /7,,R13 Subtotal Phone: ( Fax: 7......52„---: , L 7 S 713 y` ��c3 ( sue) L g _3 Minimum permit fee: $72.50 Plan review (25% of permit fee) ---- • - L L. 6 8 4 g1,67 Plumbing Lic. no.: 'J l State surcharge (12% of permit fee) g.- Authorized signature - TOTAL PERMIT FEE q ( • LO Print name: 1"lr 4_,` ,„ bt'z 1 ,(06 k- Date: LZ- 7 - Zp le) This permit application expires if a permit is not obtained within 180 days t after it has been accepted as complete. "Fee methodology set by Tri- County Building Industry Service Board. 1: \Building\Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(10 /O2JCOM/WEB)