Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2011 -00129
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/22/2011
Parcel: 1 S 125DC07800
Jurisdiction: Tigard
Site address: 7009 SW ASH CREEK CT
Project: Ash Creek Estates, Lot 11 Subdivision: ASH CREEK ESTATES Lot: 11
Project Description: Installation of residential backflow preventer for irrigation system.
Contractor: BURNESS LANDSCAPE Owner: ASH CREEK PROPERTIES LLC
9330 SW LEHMAN ST 12655 SW NORTH DAKOTA ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 432 -8525 PHONE:
FAX: 503 - 432 -8525
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 04/22/2011 $31.27
Specifics: 1 12% State Surcharge - 04/22/2011 $8.70
Plumbing
Type of Use: 41 ea Minimum Fee Adjustment - 04/22/2011 $41.23
Plumbing
Class of Work:
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
Utilit ,otification _ :.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 • rect questions to OU by calling 503.232.1987 or 1.800.332.2344.
I- ued By: �{ / It/ PermitteeSigna � I
C Y Ci'L__/
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 compreinTrro the project.
Approved plans are required on the job site at the time of each inspection.
APR -22 -2011 03:39 PM THOMAS. S.BURNESS 5034328525 P_02
Plumb)ng Permit Agolieatlun .
Building Fixtures RECEIVED i , ,,;11111 e I r , , r • cit of Tigard 4 r D�tdBy: y � j- !/ Ptxmlt No„ 'r �ll �� / o'l !
ill
13125BWHe1 Hlvd,,Tlgard,OR 972234 PR 2 2 2011
Phone; 503.7I3.2439 Fax: 503.598.1960
Plan PrmltN rmitNo.;
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( ro � ( il�Y �{ N � I h � I i i k i i SFR (I) bath �,..._ . ,,.,,..,.. ,. ,..�, .,.,,.... . 312.70
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0 1- and 2-family dwelling ❑ Comtncnciai/industrial SFR (2) bath 437.78
• 1] Accessory building SFR (3) bath 500.32
g ❑ multi-flintily
Hach additional hath/kitchen 25.02
i] Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
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Job site address: 7009 SW Ash Creek Ct Catch basin or area drain 18.76
.76
City /State/ZIP: Tigard, OR 97223 Drywall, leach line, or trench drain 15.76
Page 2
Suite/bldg. /apt, no_ - � I Proj of name: Ash Creek Manufactured home utilities„ . _ 50,03 MIN
Cross street/directions to job site: y Manholes 18.76 Mil
Rain drain connector 18.76
- .. .--_ . _ Sanitary sewer (no. linear ft.: ) Page 2
--- ._ - Storm sewer (no. linear ft.: _) Page 2
Water aervioe (no. linear ft.: ) Pegs 2
Subdivision: Ash Creek Lot no.: F iih i r e or Item: mm _
Tax map/parcel no.: g Racictiow prevent 1 31.27
t,r , I ,r +1 l I d. 40 J f ( 4 ,'ii.q' !,. Y 4 �,' 11 r , , r i' 1 '!'",t. h t xd , ., � 1 { i .b , Bask Ater valve 12.91
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;,;,,,' ,. .a7, ra,..' e l,rMhlclr1� rh ,,,, i ,.,.,. +u ll h, ('lotheawasher 25.02
back}law Dishwasher - 25.02
Drinking Ibuntain 25.02
Pjcin Aump 25.02
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0 e• 1 0.6; l '1, •v rr, 6 , ' .0 . t!n,. ',r !l 1 ;'11 , l r h , E.glausluntank 12.51
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Name: Wlndwood Homes Mixture/sower cup 25.02
........... .:,. ..,....- _ ........:...........- _ _ -.....,.,..,.,.- ________ Floor drain/floor sink/hub 25,02
Address: .,...._._ (larbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice makes 12.51
1 { I# 25.02
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l3USi110ti6 name: Malicel g ee (value: $ - ) __,.
Printer 12.51
Comet* name
.. ....._,..._ ...........:._-... ....:_.,....,..,-...,_.....,.......____..... ._.....,...- ...,......,.._.,... - .-..,....,- Roof drain (cianaeercia }) 12.51
Address: Sink/basin/lavatory 25.02
City/Stare/ZIP: Solar units (potable water) 62.54
Phone; ( ) Fax: ; ( ) ruh/ahower /shower pan 12.51
B- lrlail: Urinal 25.02
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I+, r ,i, f „s +IiNt' Water heater 37,52
Business name: Roma 9 - //■1 "�Q7H- 113C--
/ water piping/I./WV 5629
Address: 9330 Other: 25.02
-
City/State/ZIP: Tigard Or 97223 _ Suhtetal
Phone: (503) 432- 8525 -T- --
Fax (503) 432 -8525 „_ - ____ Minimumpeimit ibe; $72.50 'a• 50
CC13 Lie.: 13W4r S J r 1 1/30,, Plumbing Lk. no.: Place review (25% of permit. tme) --�-
State surcharge (12r% of permit fen) : .70
Authorized elgtlatul c r, 4-. J _„ TOTAl.1'l PERMIT IhiN �,��
rrint name: Turn surpass Date: 4-22-11
olu Imoe permit application expires it a penult 1a not abta ted within 18a days
__._...----- _ - - --- - _ r It bee Nunn accepted as complete.
'Fee methodology sat by Tri.County Building laduatry Service Board.
tOmelapt eneitAM.MtI•PennitApp.dna 1 ahnM9 44o.461Nr'(16/02/COM,Wm)