Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2010 -00394
13125 SW H all Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010
TIGARD : Parcel: 2S 109AB 12400
Jurisdiction: Tigard
Site address: 14230 SW ALPINE CREST WAY
Project: Alpine View Subdivision: ALPINE VIEW Lot: 5
Project Description: Backflow preventer for residential irrigation system.
Contractor: TRADEMARK LANDSCAPES INC Owner: WEST HILLS DEVELOPMENT
P. O. BOX 2410 735 SW 158TH
OREGON CITY, OR 97006 BEAVERTON, OR 97006
PHONE: 503 - 641 -7342
HONE: 503 - 631 -3893
FAX: 503 - 631 -4737
FEES
Quantity Description Date Amount
73 Plumbing Permit 12/22/2010 $72.50
Specifics: g 12% State Surcharge 12/22/2010 $8.70
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 Notifi - Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dire .uestions to • NC . -. Ili a 503.232.1987 or 1.800.332.2344.
Issued By: / ' I Permittee Sig
•
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.
Plumbin Perm Applica
Building Fixtures CEIVED FOR OFFICE USE ONLY •
C1 of Tl and 2 2 Received
City g D C C 2010 A As- /0 / A etmit tJo.: G1 Y ,20 /D -
1.
L Re eBy: / _ / 3
M 13 b5, SW Hall Blvd Tigard, OR 97223 Plan Review
C' • Phone: -503 639 4171 Fax: 503.;598 g bate/BY: Other Permit No.:
Inspection Line. 503 639:4175 C�1� OF TIGARD Datc RcadylBy: ions BI Sea Rake '2,for
• ihte
TIGARD met: www.0 ardeor. ov B UILDING DIVISION Nonf ied/Method � I Information
g g Supplements
a y ,% n'�y'.4 4 rc * " „�_ .`1 *6 ' '.0 ,* �i #� ,( ,' F . "� .W �.. C rz ,.. ., �, ` , . y „yla a
��v °SG'•�`I � ..+.�y.�7�.':.. '� �•�, It � :l•J +-°'' ,a. �.: }^'3vt. • ..:Y;.x�'n F , v t., . , _ r�5�.`. ' •r 3} za �UUl�i
® New construction
❑ Demolition Forspecla !Informarron " use checklist
Description I Qty. I Ea: I Total
❑ Additionlalteratian /replacement ❑ Other: . New 1- 2 -fam_ ily.dwcllings.(includes.100 ft. for each utility connection)
.,.Af ca t of 4?Ir, J2x _� ,��� . W au SFR (I) bath I 312.70
® `l- a1r d 2'- family - dwelling ❑ Colimie"rctal/industrial
SFR,(2) ill 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder . ❑ Other: Fire. sprinkler ( sq., ft.) j Page 2 •
pt" f °.1, rjJt. , - zl kll U t,f,`. �.�:.� : 'r Site-utilities:
p. 'a ..
Catch basin or area drain 18.76
Job site address: 14230 SW Alpine Crest Way
Drywell, leach line, or trench drain 18.76
City /State/ZIP: Tigard OR 97224 Footing:druin (no, linear ft.: ) Puget
Suite /bldg. /apt. no :: I Project;name: Manufactured home utilities 50.03
Cross's treet /directions to job site: Manholes 18:76
Rain drain connector 18.76
Sanitary sewer (no.,linear it: - ) Page 2
Storm - sewer (no. linear ft.: _) Page 2
Water service-(no. linear ft,: ) Page 2
Subdivision: Lot no.: 5 Fixture or item:
Tax trap /parcel no.: Backflow preventer 1 31.27 P. 27
,,. Fes; � .,,�.•�.,. ,,,,.,, �,;� r., „-,« , � �°�°o � Bttckwatcrvalvc
12.51
a ° y° S: -,, rA x .Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
. r ° t 1y Ala �tEr �4 �r - Expansion tank 12.31
ig u. ,7 : ,
� '' "'� Fixture/sewer cap 25.02
Name: West Hills. Development
Floor drain/floorsink/hub 25.02
Address:'735 SW'158 Aye Garbage disposal 25.02
City/State/ZIP: Beaverton. OR97006' Hose bib 25.02
Phone, (503)641 -7342 °, Fax: lee.maker 12.51
o f i �., p } c� Est y c i R5Q Interceptor /grease trap 25.02
Medical gas (value: $ ) Page 2
Business- name:'West Hills Development -
Primer 12.51
;COntact.riame :'Angie Coolt 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 12.51
Urinal' 25.02
E -mail acook a arborhomes com
7 � s ti o ar s r �xf:, : r� ® 'r 7 �r u'q " Water°cl0set 25.02
� ' " o` 't 6r , n e ' q( Yli. i�.� ' S- Ji- , id " ^ . .. $ c . 4 , .L;' , :- _," Water heater 37.52
Business name Trademark Landscape I Waterpiping/DWV 56.29
Address: 19688 S. Redland.Rd. O_ they. 25.02
City / State/ZIP Oregon City,.OR.97045 Subtotal
.5
Phone: (503) 631 3893 Fax: (503) 631 -4737
Minimum permit fee: $72.50 7
- Plan review (25 °(0 of permit -fee) -----
CCB Lica 679' Plumbing Lic. no : State surcharge (12% of permit fee) g. 70
Authorized si gn afore:
TOTAL PERMIT FEE ei.ad
Date: 12/20/10 This permit application expires 'l n permit Is not obtained within 180 days
Print name: Steve Ellis after it.has been Accepted as complete.
"Fee methad set by Tri- County Building Industry Service Board.
I:lBuildin enniti\PLMU- PermitApp.doc 1 0/01/09 440 - 16167(9 0/02/COM/wi•D)