Permit II �� CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2011 -00186
Date Issued: 06/14/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S109A613700
Jurisdiction: Tigard
Site address: 13164 SW STARVIEW DR
Project: Alpine View, Lot 18 Subdivision: ALPINE VIEW Lot: 7
Project Description: Residential backflow preventer for irrigation.
Contractor: TRADEMARK LANDSCAPES INC Owner: ALPINE ESTATES LLC
P. 0. BOX 2410 735 SW 158TH AVE
OREGON CITY, OR 97006 BEAVERTON, OR 97006
PHONE: 503 - 631 -3893 PHONE:
FAX: 503 - 631 -4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 06/14/2011 $31.27
Specifics: 1 12% State Surcharge - 06/14/2011 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment - 06/14/2011 $41.23
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 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 estions to C b ling 503.232.1987 or 1.800.332.2344.
Issue By: k b._ iiTt�(GsC Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspect. n 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.
Phithbing. Permit App
Building Fixtures I ow»t ICL USE Q1\LY "
J 1 4 2011 /t/ /( . PnrmitNo.:
Tigard, OR 2
Phone: 503.639.4171, Fax: 5I IF TIGARD Other P No.:
T DIVISION Date Read/y:; SeePage2 tar
Internet: .www,tigardor.gov NottauMetlmi: Supplemental • lntaritntion
'4ew.canstruction
❑ Dmoliti�n For special Inform allan use checklist.
Description I Qty. En. Total
❑ Addltion.ftilleratioiilreplacement 0 Other: Newt- 2- family' dwellings(includes 100 ft. for each utility connection)
SFR(I)bath 31270
1-and.2-family dwelling 0 Commercial/industri1 , SFR (2) bath , 47.78
SFR'(J) bath 500.32
❑ Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑ Mite btil! ❑ Other: Fire sprinkler( sq. ft.) Paget
i< �tr — S ite utilities
- . . . Catch basin or.area drain 18.76
Jobstte.address: •
Drywell, leach linc or trench 'drnin 18.76
City/State/ZIP: Tigard OR 97224
Footing drain (no linear- ft:;.., ) Pne 2
Suitelbldgiapt.no.: Project name: Manufactured home utilities 50.03
Cross streeridirections to job site: Manholes 18.76
- Raih.drain connector 18.76 -
Sanitary se.ve,r(no.ijncn ft: ) Pngt 2
Storin sewer (no. linear fL:__)- Page2
Wateservie(no. 'linear' ft.: ) Page 2
Subdiision: L�t-no: Fixture or item:
T' iii/ip/parcel.no.:' Backflo'/ pre 1 31.27 ' /.
Clot icsIier 25.02
Dishwasher 25 02
Driitking' fountain 25.02
Ejeciors/sump - 25.02.
Epansiontank 121
Nhte:' W.stI1ills:Development , Fixture/sewer cup 2.02
- ‚ . oo daiflo�r sinkub. 2502
Address: '735 SW 158th Ave . ' -
Garbage disposal- 2.02
City/State/ZIP: Beaierton.OR'97006 ‚ Hose bib" 25.02
PhonL (503)641 - 7342 Fax (U3)641 7661 Ice mnLc.r 12 - ?l
lntcri.eptor/gre tse trap 25.02
f
Business name. West }lillsDevclopment- 'Medical gas (value: $ ) Pa 2
Pfimcr 12,51
-Contact nnme:'Angie'C�ok
Roof dra (commercial) 12.51
Address: -735:SW 158th.A , . Sink basin/lavatory- 25.02
City/Sthte/ZIP: Beaverton -OR 97016 , Solar units,(potnble water) 62.54
-Phone:'(503)64I7342 Fax: :'(503)641-7661 Tub/sliower/hosver pan . .12.51
` Urinal 25. 02
'E acook@arborhomes.com -
tiness niime Trademark Landse'npe Water piping/DWV 56.29
',kddress: 19088 S. Reilland Rd. Other. '25.02
'Cit/State/ZIP: bregon Cty, OR 97045 Subtotal
,Phone: (503)631-3893 Fax: (503) -61-4737 Minimum permit fee: $72.50 7• 6)
- Plan review (25%ol'permit fee)
,CCB. . Numbing Lie, no.: -
- - State surcharge (12%�fpennit fec) . 7
Authorized signature: - , - TOTAL PERMIT FEE - g
Ellis Date: This permit spplicntion explm.if a perm is not obtained witbiniSO days
Print •name: Steve
after it has been accepted as complete.
•F methodology s et by Tii•Coiutty Bsuildidg industry Service Board.
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