Permit •
•
q CITY OF TIGARD `�A is,. f ' 4' PLUMBING PERMIT
3.1a ( 3cc
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00036
T f G AR D; 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/04/2013
Parcel: 2S109DA17000
Jurisdiction: Tigard
Site address: 15425 SW SUMMERVIEW DR
Project: Arlington Heights No. 3, Lot 99 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 99
Project Description: (1) backflow preventer 2/4/13 REPRINT to correct class of work 3/6/13 REPRINT permit to correct description
Contractor: LANDSCAPE OREGON, INC. Owner: STONE BRIDGE HOMES NW
PO BOX 2386 4230 GALEWOOD ST, SUITE 100
TUALATIN, OR 97062 LAKE OSWEGO, OR 97035
P
PHONE: 503 - 387 -7577
HONE: 503 - 692 -5945
FAX: 503 - 692 -0768
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 02/04/2013 $31.27
Specifics: 1 12% State Surcharge - 02/04/2013 $8.70
Plumbing
Type of Use SF 41 ea Minimum Fee Adjustment - 02/04/2013 $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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Q
Issued By: �( // 6 � Permittee Signature: 1l y ppoo -
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.
•
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CITY OF TIGARD REVISED PLUMBING PERMIT
n
a COMMUNITY DEVELOPMENT ' ( 3 . $ Permit #: PLM2013 -00036
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/04/2013
Parcel: 2S109DA17000
Jurisdiction: Tigard
Site address: 15425 SW SUMMERVIEW DR
Project: Arlington Heights No. 3, Lot 99 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 99
Project Description: (1) backflow preventer 2/4/13 REPRINT to correct class of work
Contractor: LANDSCAPE OREGON, INC. Owner: STONE BRIDGE HOMES NW
PO BOX 2386 4230 GALEWOOD ST, SUITE 100
• TUALATIN, OR 97062 LAKE OSWEGO, OR 97035
PHONE: 503 - 692 -5945 PHONE: 503 - 387 -7577
FAX: 503 - 692 -0768
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 02/04/2013 $31.27
Specifics: 1 12% State Surcharge - 02/04/2013 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment - 02/04/2013 $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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: , �n „ Permittee Signature: OX-) I PP1 ,/) ,n�S
.2)14,0)21 Call 503.639.4175 by 7:00 a.m. for the next available inspection date. C~` r /'U
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.
q
•
CITY OF TIGARD PLUMBING PERMIT
0 - COMMUNITY DEVELOPMENT Permit #: PLM2013 -00036
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/04/2013
Parcel: 2S 109DA 17000
Jurisdiction: Tigard
•
• Site address: 15425 SW SUMMERVIEW DR
Project: Arlington Heights No. 3, Lot 99 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 99
Project Description: (1) backflow preventer
Contractor: LANDSCAPE OREGON, INC. Owner: STONE BRIDGE HOMES NW -
PO BOX 2386 4230 GALEWOOD ST, SUITE 100
TUALATIN, OR 97062 LAKE OSWEGO, OR 97035
P
PHONE: 503 - 387 -7577
PHONE: 503 - 692 -5945
FAX: 503 - 692 -0768
FEES
Quantity Description Date Amount
• 1 ea Backflow Preventer 02/04/2013 $31.27
Specifics: 1 12% State Surcharge - 02/04/2013 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment - 02/04/2013 $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: Du P p L C4 1-101q
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.
Plumbing Permit Applicati
Building Fixtures DE CEIVED FOR OFFICE USE ONLY
City of Tigard PCB 4 2013 rs a/ 4 / 3 Permit No.:PUq A01 3- v0() 3,
I a 13125 SW Hell Blvd., Tigard, OR 97223 Plan Rc vicw '
Phone: 503.718.2439 Fax: 503.5 D ate. B S' : I Other Permit Ns.:
• T I G ARD inspection line: 503.639.41', 5 OF TIGARD Date Ready/By: 1 /• ' El Sec Page 2 for
Interne_ www.tigard -cr.gov BI IILDING DIVISION NatiLedlMethcd: yo Supplemental Information
. ,. -_.. - - :C �` :1 - t ,.i ;: pl >; . _ _ _ _ - _
_� ... .. __ TYPE _OF:i WQ _ :.:'... r & - 1. - - - -
..�.,,..;, :: .._.. :�_ n. ,._ :...;.. - -_......RK�. -- - :�.ir_. ` ; :�' -: :IIi;.- * : : =�- _- -
r.. :. :J�o._� .0 :i �'5.. �. r: ,..., ...z.:. r� ". dL i e. •..i,_ep:. .a = _cw : �_ _. ,. � _.� zc a._ +`5�.�.'Ss�'t - =-�..
® New construction ❑ Demolition _ For special information use checklist
Description ) Qty. I Ea. I Total
❑ Addition/alteration/replacement . ❑ Other: New 1- 2- family dwellings (includes 100 R for each utility conuetion)
n ' a rs,_ j _ =; - 'I;CA'�GOBY OF:CONS'RLiCI'i0 "it _- r'=a -_' SFR (I) barb 1 312.70
0 1- cad 2- family dwelling 0 Commercial/industrial
SFR (2) bath 437.78
❑ Accessory building ❑ Multi- family SFR (')bah 500.32
Each additional bath/kitchen 25.02
❑ Master builder
: � . Mas „r builder
_ Other: Fire sprinkler(' ) g
_ r sc. ft Page 2
�s= e _`a _ 7 _.iWI.;
O$ 1TEk11T'OR11 it77f?N�ie 6• ,C
,.�P[ilc i :�i,�-;;= rs=.��... .. y _ ATTQNt 'r''RVW Siteen7ities:
Job site address: fs f as .- LLmmC iJi e.�w 1)2 Catch basin or area drain 18.7b
City/State/ZIP: Drywall, leach line, or trench dram 18.76
Footing drain (no. linear ft: _ ) Page 2
Suite/bldg./apt. no.: 1 Project Warne: n /
/Tr / I f l ! Y) l Manufactured borne utilities 50.03
Cross street/directions to job site Manholes 18.76
�? e'zf 6 e'I CL.. 1 9 . u1r 'Tx. i. Cyr' Li ‘ ei-L-• O/ 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: i 1' �ln� 74-1.1.1 / l f ( I 'Lot no.��
I� E u" Fixture or item: •
Tax map /parcel no.: !(s 4; Backllow preventer I x 31.27 1 31 .27
r i ., _
•.iii i= yh g . - i , - <!• - ,.: ,._ . _src
: :is Backwater valve 12.51
1
. I :.I lt;i.,..eL3i, i1: ;r.r.
._. " 'SI ESQtl 0 T- OE :V a :( Ak.- ,, ; _ , I 2 s; W
.s "• r ° c e ; ,, :., -, :. = ....:..... �_ :. e .' . Ii ,x l "c:- ,.,._ : : :: i� .dUl .. ::[II FY Clothes washer 25.02
Landscape Irrigation Back Flow Device Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
_
�.r..- iri : ' - R, 1:_ .
OJ RT) a*sii L' :c. r - ; f, :tr. - _
Expansion tank • 12,51
.: � ?:k: - : . .. r •= _ • -_ ....,,.ail:,., :r 3 I L I r..:•.,.,, :Itf 7.?' a .n `, c =. _ -. d j
Name: Stone Bridge Homes Ate' LLC Fixture'sewer cap 25.02
Address: 4230 Galewood Street Suite 100 Floordrain/floorsink/hub 25.02
Garbage disposal . 25.02
City/State /ZIP: Lake Oswego, OR 97035 Hose bib • 25.02
Phone: ( ) Fax: ( ) a Ice maker 12.5]
f,
: i �
l li�. : s ,i,� .. i�p� .:I p 14i .,,:�, •�:. j t Ia1aa 2
I 5.02
- : : : :..� :� i;',;�'� "si� -,.., � �• :, � c. N - � , ., � z � - , , � ._ � .,.: Ali? :.
ss name: Landscape Oregon, Medical gas (value: S ) Page 2
Business
Primer • 12.51
Contact name: Ellen Sparrow
Roof drain (commercial) 12.51
Address: P.O. Box 2386
Sink/basinilavatory 25.02
City/State/ZIP: Tualatin, OR 97062 Solar units (potable water) 62.54
Phone: (503) 692 -5945 Fax: : (503 -) 692 -0768 Tub/shower/sbowerptm I2.5]
E -mail: ellcnta'�.,landscapeoregon.com Urinal 25.02
s s a$' :.- . . : :; a; ['s: :::::':-V..1.1!,2 - Water closet 25.02
;i
•v�<, - 1_2b._-,2,-3,' * " -: . n•i•c<:.;•,t ... tri _ 'CONTRACrOR' a� 0' , Fe %�i
tx1,
1n! _ 1 - ter-- -'1•�r+vii;I : . =_. -_ r.r•.,.., aw,4i;.93. :, �;tf: :.: `Lei :'. - _ .,. :.,. -, Water heater
37.52
Business name: Landscape Oregon, Inc. Water pipingDWV 56.29
Address: P.O. Box 2386 Other 25.02
City /State/ZIP: Tualatin, OR 97062 Subtotal 31.27
Phone: (503) 692 -5945 Fax: (503) 692-0768 Minimum permit fee: S72.50 ` 72.50
CCB Lic.: LCB 7804 Plumbinc Lic. no.: Plan review (25% of permit fee) • a -I- DO / State surcharge (12% of permit fee) 8.70
Authorized signature:,? ,'lL,./L,'u: TOTAL PERMIT FEE 81.20
Print name: Ellen Sparrow + Date.' This permit application t has sr a permit is as not obtained within HID days
after It h been accepted oomplete.
- Fee methodology set by Tri- County Building industri Service Board
1: \Bui4rill0 mitskPLMU• ?e•mi[Ap ?.doe l a' 44 646': 6T(IW02rCOMIWED)
l 89LO Z69 - £09 U e6£T01, £l l0 qe3