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Permit CITY OF TIGARD PLUMBING PERMIT 1111 ' COMMUNITY DEVELOPMENT Permit #: PLM2011 -00029 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/26/2011 Parcel: 2S109AB13300 Jurisdiction: Tigard Site address: 14292 SW STELLER'S JAY LN Project: Alpine View, Lot 14 Subdivision: ALPINE VIEW Lot: 14 Project Description: Residential backflow device 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 1 ea Backflow Preventer 01/26/2011 $31.27 Specifics: 1 12% State Surcharge - 01/26/2011 $8.70 Plumbing 41 ea Minimum Fee Adjustment - 01/26/2011 $41.23 Type of Use: SF 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 ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility ification Cen e Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or dir ct questions to OUNY. in. .03.232.1987 or 1.800.332.2344. Issu d By: Permittee Signa i 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= Q1 �u Building Fixtures R - ' F ] FOR O[ 1' c C USE OI1L p+' � ry p , � ♦• pye I eY � City Tigard nereiv<a �� . / �, c ,� v� IN 1}r J I n A Dnte/ay: / ,./..be) // Pemtit No O �- /.20//-(700 9 oC 0 13125 SW Hull Blvd., Tigard, OR 97223 2 6 2011 Plm Review ,, �J Phone: 503,639.4171 Fax: 503.598.1960 Date/By: Other Permit No.1 /� Q'O TIGARD inspection Line: 503.639.4175 CITY O lie y 9D Datc Ready/By: tam- ® See Page 2 for Internet: tvww.tigard- or.gov p Ica n,o d r`t Notified/Method: Supplemental Information .i.- en z' € , „ „ jp1r 0 * t , ' : ,� ,'i a ' '? p � IiiiiW HD � `I? '�� 4 .. Y" '' .4' " F � 0 � .. • , � '.s. hs � ��Y2Y� .. Maat.� <.,.� .. ., e SC^ 5tJx1Y.�:f ... © New construction El Demolition For special Information use checklist. Description I Qty. I En. I Total ❑ Addition/alteration/replacement ❑Other. New 1- 2- family dwellings (includes 100 ft for each utility connection) ^ "�'"`� � �r ' t a 0 t ¢: o l" t , ' SFR (I) both 312.70 ® 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 SFR (3) bath 500.32 Accessory building ❑ Multi - family ❑ A rY g Ench additional bathfkitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 �" I' i �"°` �"� t a O u o >j Site utilities: y tt,��'• ,,n "`"r„�Ir1I of Nlt� aKr �." f y Job site address: 7 7 Catch basin or area drain 18.76 14292 SW Stellers Jay Lane Drywell, leach line, or trench drain 18.76 City/State/ZIP: Tigard OR 97224 Footing drain (no. linear R.: _J 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 It.: Pngc 2 Storm sewer (no. linear ft.: _) Page 2 Water service (no. linear ft.: Pngc 2 Subdivision: Alpine View I Lot no.: 14 Fixture or Item: Tax map /parcel no.: Buckflow preventer 1 31.27 G° .� ,,. - -,9 -� 1+«.r a - Bnckwatervalve 12.51 t : y �;:7?x +zn;.•w'; i a ?;l �D �n9 ..' n _ P -.. ..W 4.ra 1 " 1 "=r'= y1, -a'= ` CloUtcs washer 12.51 Dishwasher 25.02 Drinking fountain 25.02 £jcclors/suntp 25.02 f� t 1 0 of U „ Trt' a ., g tf3 �pl a jt. > Expansion tank 1251 West 7..4, .est Hills Development rl�rr t� � '`� ,. �� f�`�J.. 1 V Fixture/sewer cap 25.02 Name: 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 milker 12.51 Ve∎ -i tt' i ' t�' ill .C.0.-It 4 Intcrceptodgre ttsc trap 25.02 Vi e � 12i,. tr,i � � - .....r Business name: West Hills Development Medical gas (value: $ _) Page 2 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 E -mail: ncooh @arborhomes.com Urinal 25.02 , M # �n -,- Water closet 25.02 art 4- ' ;'4g . r lti � c 'a -; u 2 '. ' ' �2 Water heater 37.52 Business name: Trademark Landscape Water plping/DWV 56.39 Address: 19088 S. Redlaad Rd. Otto. 25.02 City /Stote/ZIP: Oregon City, OR 97045 Subtotal Phone: (503) 631 -3893 Fax: (503) 63I -4737 Minimum permit fee: 572.50 Nun review (25% of permit fee) CCB Lie,: 11353 Plumbing Lic. no.: State surcharge (12% of pcnnit fcc) s Authorized signature: LI -J� TOTAL PERMIT FEE 1.- c ` Print name: Steve Ellis Date: 1/27/11 This permit application expires If n permit Is nut obtained within IOU clays rafter It has been accepted as complete. •Fec methodology set by Tri- County Building Industry Service Board. I. lauildinrPcrnlits V'LAtt3- Pcm1App.dac 10101107 440- 1016T(10/nJCOM/WGa)