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Permit EXPIRED //'2?//o OW- Plumbing Permit Application � E � Fill , Building Fixtures ��-- g FOR OFFICE USE ONLY City of Tigard MAY 2 8 2010 ou ya .S ZP 'VA Permit No/04/1 i-o -DO/ 7Q 11111 v 13125 SW Hall Blvd., Tigard, OR 97223 T� C r� Plan Review .� Q2 0 CI I 1 Of TIGA � : Other Permit ermtNo /S�a P hone: 503.639.4171 Fax: 503.598.1960 h 0/ - 'W O T 1 G A R D Inspection Inc. L 503.639.4175 ate Read tune ® See Page 2 for Internet: www tigard- or.gov BUILDING DI VISIC,PNolife ethod: _ Supplemental Information . , �� x 7 t_ x .: -� 1+`EPl 7° `..i.: z_L i ❑ Demolition. For special information use checklist. ® New construction Description I Qty. I Ea. I Total ❑ Addition/alteratibn/replacement ❑ Other: New I- 2- family dwellings 100 ft. for each utility connection) i" i �, t e�o t � lXoT, �e t . y II �'? (S� I r _ z ' a i SFR (1) bath 312.70 SFR (2) bath 437.78 ® I- and 2- family dwelling ❑ Commercial /industrial SFR (3) bath 500.32 ❑ Accessory building ❑ Multi-family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: 'Fire sprinkler ( sq. ft.) Page 2 .'• ..<'- fi (- •�'a t - 1 - �:ll l,o t to a ,,,`N jN a° s a � r N `k `'tr 2` ..- „7, Site utilities: Job site address: 13348 SW Alpine View Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City /State2IP: Tigard OR 97224 Footing drain (no. linear 11:: ___) Page 2 Suite/bldg. /apt. no.: I - Project'name: ; Manufactured home utilities 50.03 Cross street/directions to job site: _ 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.: 3 1 Fixture or item: Tax map /parcel no.: Backflow preventer f 31.27 g ens ,, -' s(�• ,. - ; -� . , r . , i +T+3 Backwater valve 12.51 ° 'k . '. := i�::. �t ' ` o , ::: - 5.1••` ',.�-''' ' 25.02 Clothes washer Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ;a 77-yy�� ^-= s 0 ,.. -t< •r 4 r� rr- ^- '� Expansion tank 12.51 5 4w" -' .. . ". '. -a a A i /!I�1 ti _� }r rI ' - -fit - ©. � -i`ir s -� - - = Fixture/sewer cap 25.02 Name: West Hills Development Floor drain/floor sink/hub 25.02 Address: 735 SW 158 Ave Garbage disposal 25.02. City/State/ZIP: Beaverton OR 97006 Hose bib 25.02 Phone: (503)641 -7342 Fax: (503)641 -7661 Ice maker 12.51 r , . r I y r x �` `fr o Interceptor/grease ?;, i b � t ,,1 � I'1t r)' , �' r" � } �`� tra p 25.02 Medical gas (value: $ ) Page 2 Business name: West Hills Development - Primer 12.51 Contact name: Angie Cook 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 corn � ry --� Water closet 25.02 ".: '-',1'''... t? a r's . y . 0 ! __: � -' ' 7 Water heater 37.52 Business name: Trademark Landscape Water piping/DWV 56.29 Address: 19088 S. Redland Rd. Other. 25.02 City /State/ZIP: Oregon City, OR 97045 Subtotal Fax: (503) 631-4737 Minimum permit fee: $72.50 �s1- s(7 Phone: (503) 631-3893 ) 631 Plan review (25% of permit fee) CCB Lic.: 11353 Plumbing Lic. no.: State surcharge (12 % of permit fee) g', 7o Authorized signature: 5,4���'�� TOTAL PERMIT FEE A0 • This permit application expires ifa permit is not obtained within 180 days Print name: Steve Ellis Date: after It has been accepted as complete. *Tee methodology set by Tri -Comity Building Industry Service Board. I l: Wilding 1Permio�PLAtU- PermltApp.doe 10/01/09 440 -1t. 16T(1°/02/COAMVaa)