Permit CITY OF TIGARD PLUMBING PERMIT
°�` COMMUNITY DEVELOPMENT Permit #: PLM2010 -00307
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/19/2011
Parcel: 2S109AB16400
Jurisdiction: Tigard
Site address: 14071 SW ALPINE CREST WAY
Project: Alpine View Lot 45 Subdivision: ALPINE VIEW Lot: 45
Project Description: Irrigation backflow
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 01/19/2011 $31.27
Specifics: 1 12% State Surcharge - 01/19/2011 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 01/19/2011 $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 if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N. • a ion :.ter. 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. questions to OU = call •. 503.232.1987 or 1.800.332.2344.
Issu•. By: Permittee„Signature: � `�
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.
I
Plumbing: Permit Application
Building Fixtures FOR OFFICE USE ONLY .
Received Permit No x®73 0 7
City of Tigar 1 � 1 Received 6/��//( rl"L� (f /Q
y 13125: S,W Hnl Blvd., Tigard, OR 97223 SEp V 9 2 l Plan Review ,r�J J a o M rs`
Other Permit N /Q
lig
G Phone: 50 1639.4171 Fax: 503 Dntc/By:
TIGARD Inspection Line: 503.639:4175 TIGA �atel egdylBy: luiis ® See Page 2 for
Internet www tlgard -or gov CITY 'F t : fred%Methad: 77 Supplemental Information
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Demolition For special Information use checklist
® New construction Description I Qty. I Ea: I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2_ famil'y,dwellings.(includes „IOO $. for _each utility connection)
lia grft. 511 4ta r y r M1 0i j;"? SFR (1) bath I 312,70
Ell and•2- family dwelling ❑ Commercial/industrial
SFR, (2)batli 437.78
SFR.(3) bath 500,32
❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02
❑ Master- builder 0 Other: Fire'sprinkler ( sq. ft.). Page .2
?A> ±* o o1 7ytl,_� 14, t q o (9 A Site utilities:
Catch basin or area drain 18.76
Job site address: 14071 SW Alpine Crest Way
Drywell, leach line, or trench drain 18.76
City / State/ZIP: 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 connector 18.76
Sanitary sewer (no. linear ft.: _J Page 2
Stoim.sewer (no. linear ft.: ) Page 2
. Water service (no.linear.•f1.: ) Page 2
Subdivision: Alpine View I Lot no.: 45 Fixture .or- -item:
Tax,rriap /parcel no.: Backflow:Preventer 1 31.27
Va n.sc wr g s fnt, u YJ u „ z . , lr Backwater valve 12:51
:�l•s -rc� O F, ' :�; e� � Clothes washer 25.02
5611•k- fif.n4 ) Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
, M Ear :ansion tank I 12,51
t. 4a ti + o s t tt 4 ?sa"r .`41 Miit:0 t s _ p
rw s . , . Fixture/sewer cap 25.02
Name: West Hills Development
Floor drain/floor-sink/hub 25,02
Address: 735 SW 158 Aye Garbage disposal 25.02
City/State/ZIP: Beaverton,OR'97006 (•lose bib 25.02
Phone:'(503)641 -7342 Fax: (503)641 -7661 )ce,maker, 12.51
.' ` ,�,. r 4 I• tl Elt�j, > " kcr, .� = 0 -�. „ ' ' �0., jy if . Interceptor /grease trap 25.02
`f.6 "a ak ��� lTl..lr4n x, 'u a 's
Medical gas (value: $ ) Page 2
Business name:'West Hills Development - ]2 5l
Primer
Contnct.name:.Angie Cook Roof drain (commercial) 12.51
Address: 735 SW 158t 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@arborhomes.com _ 25.02
: , 71• Water'closet
2 x:, . n o 1 ` � *. s`K.�;�' ..s "a'� 37.5
"'����,��_,. � r . � y,:- ..�. Water (tenter
Business name: Trauemark'Landscape Water piping/DWV 56.29
Address: 19088 S. Redlanil:Rd. Other. 25.02
City /State/ZIP: Oregon.City, OR 07045 Subtotal
Phone (503) 631 -3893 Fax: (503) 631 -4737 Minimum permit fee: $72.50 2,2 ..5
Plan review (25 %n of permit fee)
CCB;Lic. :.1'1 67 w /51 // PlumbingLic. no.: 70
Authorized signature:
State surcharge (12% of permit fee) l'.
` // i-h LU TOTAL PERMIT FEE j 9,, v2c1
D ate: 8/27/10 This�permit.application expires IPa permit ianal obtained within ISO days
Print name: Steve Ellis after it has been accepted as complete,
"Fcc.incthodology sct by Tri- County Building Industry Service Board.
1: lauilding \PermitstPLMU- PermitApp.doc 10/01/09 440- 1616T(10/O2/COM/WE•a)