Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT
Permit #: PLM2012 -00366
T[GAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/18/2012
Parcel: 2S109AB14100
Jurisdiction: Tigard
Site address: 14297 SW ALPINE CREST WAY
Project: Alpine View, Lot 22 Subdivision: ALPINE VIEW Lot: 22
Project Description: Installation of residential backflow preventer for irrigation.
Contractor: TRADEMARK LANDSCAPES INC Owner: DR HORTON INC - PORTLAND
P. O. BOX 2410 ATTN MELISSA TRUNNELL
OREGON CITY, OR 97006 4380 SW MACADAM STE 100
PORTLAND, OR 97239
PHONE: 503 - 222 -4151
HONE: 503 - 631 -3893
FAX: 503 - 631 -4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 12/18/2012 $31.27
Specifics:, 1 12% State Surcharge - 12/18/2012 $8.70
Plumbing
Type of Use SF 41 ea Minimum Fee Adjustment - 12/18/2012 $41.23
Plumbing
Class of Work: OTR
Type of Const: Other
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, • •rk is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit otification Ce - r. 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 • calling 503.232.1987 or 1.800.332.2344.
Is ued By: Permittee Sig ature: `
/ /
Call 503.639.4175 by 7:00 a.m. for the next available inspe '•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.
12/17/2012 17:01 FAX []002/002
Plumbine Permit Applicati0
DECEIVE Ohl - 01zZ_,
Building Fixtures DEC 17 2012
SI City of Tigard IN• n .e d ey iQ ,.� Permit N°.' /.1414;9° / - cam 3
Phone: 503.718.2439 Fax: 5033'
13125 SW Hall Blvd, Tigard, OR • 4 l- h15�1�10 /� /p. �-
4c! DING DIVISION °ice o'er
Irupedion Line: 503.639.4175 1:66 Ready/By L.is B See Pape i ke
Internet: www.tigard or.gov NatifieNMedwd Supplemewfal 1 i 1 erm'd"
TYPE OF WORK FEE* SCHEDULE
New caamuction ❑ Demolition For 'pedal hiformeles au c*eckl Total
® Description 1 Qty. 1
❑ Addition/alteration/replacement ❑ Other. New 1- 2- family dwellings (includes 100 R. for each utility comedian)
CATEGORY OF CONSTRUCTION SFR (I) bath 312.70
® I - and 2- family dwelling ❑ Commercial/industrial
SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building 0 Multi-family Each additional bads/kitchen 25.02
❑ Master builder ❑Ott Fire sprinkler (__ sq. It) _ Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
lob site address: /9 V17 , l f / j I Y C t R a i 5 f &j ' Catch basin or area drain 18.76
r Drywall, leach line, or trench drain 18176
City /SlatdLlP: TIGARD, OR 97224 Footing drain (no. linear ft.: _) Page 2
Suite/bldg./apt. no.: 1 Project name: ALPINE VIEW Manufactured home utibties 50.03
Cross street/directions to job site: SW ALPINE VIEW AND SW ALPINE CREST Manholes 18.76
WAY Rain drain connector 18.76
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. lumen ft.: _) Page 2
Subdivision: ALPINE VIEW l Lot no.: Z� Fhtture or item: f�
Tax map/parcel no.: Badcftow prevents •.( t ,r 31.27
Badrwasa valve �� 12.51
DESCKW ION OF WORK '
Clothes washer 25.02
NEW SINGLE FAMILY RESIDENTIAL Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWN I ❑ mum. Expansion tank 12.51
Name: D.R. HORTON INC. - PORTLAND Famadsewer cep 25.02
Floor drain/floor sink/ hub 25.02
Address: 7380 SW MACADAM AVE, SUITE 1W Gabes disposal 2502
City /Ste rlZIP: PORTLAND, OR 97239 Hose bib 25.02
Phone: (503)222 -4151 I Fax: (503)222 -1304 Ice maker 12-51
❑ APPLICANT ® CONTACT PERSON lasacepwr /grease trap 25.02
Business cute: D.R. HORTON INC. - PORTLAND Medical gas (value: f _ ) Page 2
Primer 12.51
Contact name: GARY CULP Roof drain (commercial) 12.51
Address: SAME Siolc/baci/hwatoey 25.02
City/State/ZIP: Solar units (potable water) 62.54
Phone: ( ) 1 Fax: : ( )
Tub/shower/shower pan 12.51
Urinal 25.02
E -mail: gacdp(a)drhortoo.com
Water closet 1 25.02
CONTRACTOR Water heater 37.52
Business name: TRADEMARK LANDSCAPES, INC Water ng /D3,yV 56.29
Address: PO BOC 2410 Other: 25.02
City /State/ZIP: OREGON CITY, OR 97045 Subtotal
Phone: (503) 631 -3893 Fax: (503) 631-4737 _ Minimum patch Be: 572.50 72.50
Pl n review (25% of permit fee)
CCB Lic.: 6796 :11353 - State surcharge (12% of permit fee) 8.70
Authorized signature: „ ,.. TOTAL PERMIT FEE 81.20
This permit •earies stokes it • permit not *NNW 1.166 M. IN days /_
/
Print name: STEVE ELLIS Date: �� /�? `permit w V N
.teem • Ns bee. auseened Ns template. . eft
"'Fee methodology we by In-Comity Buibb a bedostey Service Dowd.
1∎ Bui1dangTvmiu'Pr],!U- P.tApp.doc I0I01A9 440-4616T( tZWO1COM/N'FB)