Permit •
CITY OF TIGARD PLUMBING PERMIT
q
is • COMMUNITY DEVELOPMENT Permit #: PLM2012 -00222
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/06/2012
Parcel: 2S110BC10300
Jurisdiction: TIGARD
Site address: 12047 SW CAFFALL LN
Project: Bull Mountain View Estates Lot 1 Subdivision: BULL MOUNTAIN VIEW ESTATES Lot: 1
Project Description: Installation of residential backflow preventer for irrigation.
Contractor: ASHLAND BROTHERS LANDSCAPES Owner: LENNAR NORTHWEST, INC.
2153 MOLALLA HIGHWAY 2103 NE 129TH ST STE 100
WOODBURN, OR 97071 VANCOUVER, WA 98686
PHONE: 503 - 981 -6131 PHONE: 360-258-7900
FAX: 503 - 981 -1058
FEES
Quantity Description . Date Amount
1 ea Backflow Preventer 08/06/2012 $31.27
Specifics: 1 12% State Surcharge - 08/06/2012 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment - 08/06/2012 $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 'cation - • er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-001-1190. You may obtain a copy of the rules
or dir t questions to OU , C by calling 503.232.1987 or 1.800.332.2344. `
Iss ed B
y: �- / Permittee Signature:
C . 1 503.639.4175 by 7:00 a.m. for the next available in pe • 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.
Ashland Brothers Landscap 503- 981 -1058 p.2
Plumbing Permit Application 4 ZECEIVED
Site Utilities • U6 201 FoR Ow USE ONLY
let:
City of Tigard Date/By: 3 ( 0 l 9 To Permit No.: , Lrf /V I 7''ex�x"
II 13125 SW Hall Blvd., Tigard. OR 97223 j' j? OFTIGARD Plan Review
C Phone: 503.718.2439 Fax: 503598 y �� r DatcIBy: Other Permit No.:
Inspection Line: 503.639.4175 (j DIN DIVISION Date ReadyBy: Juris: 0 See Papa 2 for
r I G:1 K D Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE SCHEDULE
® New construction ❑ Demolition For special it:iormation use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 312.70
® 1- and 2- family dwelling SFR (2) bath 437.78
❑ Commercial industrial
SFR (3) bath 500.32
❑ Accessory building ❑ Multi- family
Each additional bathlkitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler (___ sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 12047 SW CAFFALL LN Catch basin or area drain 18.76
Drywslb leach line, or trench drain 18.76
City /State/ZIP: TIGARD OR 47224 - Footing drain (no. linear ft.: ) Page 2
Suite/bldgJapt. no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: BULL MT RD Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: _) i I Page 2
Water service (no. linear ft.: _) _ ( Page 2
Subdivision: BULL MT ESTATES I Lot no.: 1 Fixture or item:
Tax map /parcel no.: Backflow preventer l 31.27 31.27 :
t Backwater valve 12.51
DESCRIPTION OF WORK - •
Clothes washer 25.02
IRRIGATION Dishwasher 25.02
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• Drinking fountain 23.02
Ejectors/sump 23.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: LENNAR HOMES
Fixture/sewer cap 25.02
- Floor drain/loor sink/hub 25.02
Address: 2103 NE 129 STE 100 Garbage disposal 25.02
City/State/ZIP: VANCOUVER WA 98686 Hose bib 25.02
Phone: (360)258 -7900 Fax: (360)258 -7901 Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease nap 25.02
Medical gas (value: S ) Page 2
Business name:
Primer 12.51
Contact name: Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City /St ate /ZIP: Solar units (potable water) 62.54
•
Phone: ( )
Fax: : ( ) Tub/shower /shower pan 12.51 Urinal 25.02
E -mail: Water closet 25.02
CONTRACTOR Water heater 37.52
Business name: ASHLAND BROTHERS LANDSCAPE .
Water piping/DWV 56.29
Address: PO BOX 131) Other: 25.02 ; •
City /State/ZIP: WOODBURN OR 97071 Subtotal 31.27
Phone: (503) 849 - 2531 Fax: (503 - 981 - 1058 Minimum permit fee: $72.50 72.5
Plan review (25% of permit fee) 0
CCB Lic.: LCB; 7174 Plumbing Lic. no.: Stale surcharge (12% of permit fee) 8.7
• Authorized signatur ... TOTAL PERM IT FEE 81.2
The permit application expires if a permit is not obtained nithin IRO days
Paint name: TOM ASHLAND Date: 0)1106/2012 after It has been accepted m complete.
*Fee methodology set by Tri- County Building Industry Service Board.
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