Permit ,„ CITY OF TIGARD PLUMBING PERMIT
111 a COMMUNITY DEVELOPMENT Permit #: PLM2012 -00277
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/24/2012
Parcel: 2S 109AB 12500
Jurisdiction: Tigard
Site address: 14216 SW ALPINE CREST WAY
Project: Alpine View, Lot 6 Subdivision: ALPINE VIEW Lot: 6
Project Description: Installation of residential backflow preventer for irrigation.
Contractor: ASHLAND BROTHERS LANDSCAPES Owner: LENNAR NORTHWEST INC
2153 MOLALLA HIGHWAY 12013 NE 99TH ST #1650
WOODBURN, OR 97071 VANCOUVER, WA 98682
PHONE: 503 - 849 -2531 PHONE:
FAX: 503 - 981 -1058
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 09/24/2012 $31.27
Specifics: 1 12% State Surcharge - 09/24/2012 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment - 09/24/2012 $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 , • . is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notif ion 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 OUNC b c- 503.232.1987 or 1.800.332.2344.
Issued = 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.
Ashland Brothers Landscap 503- 981 -1058 p.1
Plumbing Permit Apulfirop
Site Utilities t"
City of Tigard SEP 2 4 2012 Da B 9 ,4u /.1- Pen*. N.:- s a - c7c 7 7
1 111 - • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit No.:
Inspection Line: 503.639. Date Ready/By:
' Phone: 503.718.2439 Fax: . 4 � • ' DatelBy:
` ° i ���' 1 �' Juni Iii See Page 2 for
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TIGARD Internet: www.tigard- or.gd0 -ft• �1 7':k ��t ,,°[ l' Kotified/Mcthed: I Supplemental Information
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea, 1 Total
❑ Addition/alteration/replacement ❑ Other. New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
SFR (2) bath 437.78
® t- and 2- family dwelling ❑ Commercial/industrial SFR (3) bath 500.32
❑ Accessory building ❑ Multi-family ,
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other.
Fire sprinkler ( sq. ft.) Page 2
/4L1 (p JOB SITE INFORMATION AND LOCATION • Site utilities:
l �(r tre ,4 j Catch basin or area drain 18.76
Job site address: e ' 1 well, leach line, or trench drain 18.76
City/State/ZIP: "Ti 2,4-201 a l_ ' ) Z?..4 Footing drain (no. linear ft.: ) Page 2
Suite/bldg./apt. no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: 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.: _,) Page 2
Subdivision: p,t if/y.. S I Lot no.: j Fixture or item
f Backflow preventer 1 31.27 31.27
Tax map/parcel no.: 12.51
Backwater valve
DESCRIPTION OF WORK Clothes washer 25.02
IRRIGATION Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PR OPERTY OWNER 1 ❑ TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: LENNAR HOMES Floor drain/floor sink/hub 25.02
Address: 2103 NE 129" ST S7'E 100 Garbage disposal 25.02
City /State/ZIP: VANCOUVER WA 98686 Hose bib 25.02
Phone: (360)2.58 7900 Fax: (360)258 -7901 Ice maker 12.51
❑ APPLICANT D CONTACT PERSON Interceptor /grease trap 25.02
Medical gas (value: $ ) Page 2
Business name: Primer 1251
Contact name: Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/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 LANDSCPES _ Waterpiping/DWV 56.29
Address: 2153 MOLALLA RD Other: 25.02
Subtotal 31.27
City/State/ZIP: WOODBURN OR 97071
Minimum permit fee: $7250 72.5C
Phone: (503) 849 -2531 Fax: (503) 981 -1058
Plan review (25% of permit fee) C
i CCB Lie.: LCB; 7174 Plumbin Lig c. no.: _ State surcharge (12% of permit fee) 8.7C
Authorized signature: '`~ TOTAL PERMIT FEE 81.2f
I This permit application expires if a permit is not obtained within 180 days
Print name: Tom Ashland I Date: ,Alt (Z, I after it has been accepted as complete.
*Fee methodology set by Tri- County Building lrrduslry Service Board.
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