Permit CITY OF TIGARD PLUMBING PERMIT
11111 COMMUNITY DEVELOPMENT Permit #: PLM2011 -00142
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/10/2011
• Parcel: 1S125DA05600
Jurisdiction: Tigard
Site address: 6640 SW ALFRED ST
Project: LUIS Subdivision: KINGS VIEW Lot: 42
Project Description: Backflow preventer for irrigation.
Contractor: ALL OREGON LANDSCAPE INC Owner: LUIS, RICHARD R & CANDACE M
19785 SW CIPOLE RD 19674 NW SUNDERLAND DR
SHERWOOD, OR 97140 HILLSBORO, OR 97124
PHONE: 503 -646 -6426 PHONE:
FAX: 503 -625 -9668
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 05/10/2011 $31.27
Specifics: 1 12% State Surcharge - 05/10/2011 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment - 05/10/2011 $41.23
Plumbing
Class of Work: ALT
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 Notification 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 direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: s_ 5
1/
Call 03.639.4175 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.
MAY - - 2011 02:44 PM AlI Oregon Landscaping 503 625 9668 P. 2
Plumbin Permit AREkation RECEIVE
Building Fixtures 1 �
�
MAY 6 F'OR OFFI I, 11::iE ONLY'
Cl 0 a 2011 Received ��
n 13125 25 SW Hall HpA Blvlv d., Tigard,OR 97223 n Datda /J /� y ,
-- ii Phone; 503.718.2439 Fax; 503,598.19p0ITY OF TIGA Plan Review
Inspection Line. 503.639.4175 Dale /B ; Other • - rmit No.:
L.lC.nrti P ww •
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Internet: igurd•or,gov DING DIVISIO 1i • �� El �a
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® New construction 0 Demolition For s, nclal i urination use checklist
Q Addition/alteration/replacement Description • . Ea. Total
❑ Other:
CAPEGf3R °Y„ New 1 2 -famit dwellin_.s (includes 100 ft. for each unlit connection)
'OF C01!YS'1R JCT1ON: :. ''''` SFR (I) bath
® I• and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 47.78
437.78
0 Accessory building 0 Multi- family SFR (3) bath 500.32
❑ Master builder Each additional bath/kitchen 25.02
(] Other; Fire sprinkler ( sq. ft.) Page 2
;IOB SITE' INFORMATION ANU :CiOCATiON Site utilities:
lob site address: 6640 SW Alfred Street Catch basin or area drain 18.76
City /State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft,; ___) page 2
Suite/bldg. /apt. no.: Project name:
r Manufaoturcd home utilities 50.03
Cross street/directions to job site: SW 69" Avenue 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.; _„Z Page 2
Subdivision; Lot no.: Fixture or Item; _
Tax map /parcel no.: Baekflow preventer 1 31,27 31.27
iyigCRihito Ap iikiiiie : Backwater valve � 12,51 •
Install backflow prevention device Clothes washer 25.02
_Dishwasher 25.02
-_ „_ - _Drinking fountain 25.02
Ejectors /sump
25,02
• ® .PROPERTY OWNER' • []' TENANT. Expansion tank
12.51
Name: Richard and Candace Luis Fixture /sewer cap 25.02
Address: 6640 SW Alfred Street Floor drain /floor sit>k /hub 25.02
--. Garbage disposal 25.02
City /State/ZIP: Tigard, OR 97223
Hose bib 25.02
Phone: (503)746 4823 Fax: ( ) ice maker III 25,02
APPI 1CANT 0 CONTACT PERSON Interceptor /grease trap 25,02
Business name: All Oregon Landscaping, Inc, Medical gas (value $) Page 2
Contact name: Craig Prunty Primer 12,51
Roof drain (commercial) 12,51
Address: 19785 SW Cipole Road Sink/basin/lavatory 25.02
City /State /ZIP: Sherwood, OR 97140 Solar units (potable water) 62,54
Phone: (503) 646.6426 Pax:: (503) 625-9668 Tub/shower/shower pan MI 12.51
E -mail: eraig@alloregon.com Urinal 25 02
r closet COiV�';RAICTCIIt:; 5.02
' .• Water heater 37.52
Business name: All Oregon Landscaping, Inc Water piping/DWV 56.29
Address: 19785 SW Cipole Road Other 25,02
City /State/ZIP: Sherwood, OR 97140 Subtotal EN
Phone: (503) 646 -6426 Fan: (503) 625-9666 Minimum permit fee: $72.50 72.50
CCB Lie.; 6667 Plumbing Lie. no.: Plan review (25% of permit fee) 0
Authorized signature; j 4111/0 State surcharge (12% of permit fee) 8,70
,1, A��f,i4 TOTAL PERMIT FEE 81,20
Print name: Craig Prunty if •r Date, 5-6-2011 7 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
' methodology aei by Tri- County Building Industry Service Board,
\ Buildingpermits \PLMuJ- permltAap.aoc iotoia9 440- 4616T(I0 10ZICOMWEB)