Permit iki CITY OF TIGARD T i
i� . ,; % z ;�,.� ¢I PLUMBING PERMIT
E COMMUNITY DEVELOPMENT Permit a: PLM2013 -00040 •
T [CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/05/2013
Parcel: 1 S125CA11800
Jurisdiction: Tigard
Site address: 9245 SW 74TH AVE
Project: Fasano Subdivision: 2007 -083 PARTITION PLAT Lot: 1
Project Description: (1) backflow preventer 3/6/13 REPRINT permit to correct description
Contractor: ARTISTIC LANDSCAPES Owner: FASANO, JOHN & JOYCE
10670 SW BLACK DIAMOND WAY 9245 SW 74TH AVE
TIGARD, OR 97223 TIGARD, OR 97223
P
PHONE: 503 - 705 -2256
HONE: 503 - 892 -6315
FAX: 503 - 620 -6901
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 02/05/2013 $31.27
Specifics: 1 12% State Surcharge - 02/05/2013 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment - 02/05/2013 $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: !kited— Permittee Signature: a A pp _ ri Oki)
- 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.
c _
.
CITY OF TIGARD PLUMBING PERMIT
•
• COMMUNITY DEVELOPMENT Permit #: PLM2013 -00040
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/05/2013
Parcel: 1 S125CA11800
Jurisdiction: Tigard
Site address: 9245 SW 74TH AVE
Project: Fasano Subdivision: 2007 -083 PARTITION PLAT Lot: 1
Project Description: (1) backflow preventer
Contractor: ARTISTIC LANDSCAPES Owner: FASANO, JOHN & JOYCE
10670 SW BLACK DIAMOND WAY 9245 SW 74TH AVE
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 892 -6315 PHONE: 503-705-2256
FAX: 503 - 620 -6901
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 02/05/2013 $31.27
Specifics: 1 12% State Surcharge - 02/05/2013 $8.70
Plumbing
Type of Use SF 41 ea Minimum Fee Adjustment - 02/05/2013 $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:
Atbidly � /� „ i , Permittee Signature: y,, f ( ,an/ / e;n 77O�
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. IT' r [_
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 Applica COWED
Site Utilities . r( d< , I I n r 4. 1 ,, . i .
FEB 4 "1
City of Tigard Ds e/Br a../ / 3 " its... ./.."dvl3 - ( "op
,, 13125 SW Hall.Blvd, Tigard, Op Cu, , TIGARD Plan Review
ter " Phone: 503.718.2A39 Fax: 503 • 1 ° , g y . Omer Permit No,:
,,;;,,,,,, d � UIL GDNISION Da � 6 e, S.a 2wr
7 I SapD1cm tal reformation
' T YPE Ol? WORK • • FEE, SCHEDULE
►_ • ow c onstruction 0 D emolition For special Worm rlon use checklist
alditian/elter leeernent Description 1 Qty. 1 Er. 1 Total
❑ A
ation/reP ❑ Ott: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY .OF. CONSruu(TIoz SFR (1) bath 312.70
71 1- and 2.fitmily dwelling ❑ CommerciaU ial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessary building ID Multi-family Each additional batbllitchen 25.02
0 Master builder ❑ Other:
Fire Sprinkler (_sot ft) Page 2
JOB• SITE.Ir4FORAfAT[ON• AND'LOCATION ' : Site utilities:
Job site address: 12,45- r " rn AkE, Catch basin or arca dram 18.76
�
l Drywall, learn line, or tr such drain 18.76
City/Stato/ZIP: � l ( ', 27 3 Footing drain (no. linear t1,: _J Page 2
Suite/bldgJapt. no.: iJ I Project name: S i.l n Memufectured home utilities 50.03 - ,
Cross street/directions to Job site: Manholes 18.76
f �
y Si L f W -12 i� kI 9 j Rain drain cmeetor 18.76
1` T �'°� ) w
Sanitary sewer (no. linear it: _) Page 2
Storm sewer (no. linear R: _) Page 2
Waiter service (no, linear 8: __) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backfow preveuter ! 31.27 B1,21
.. ;: DE�SCYtirrlON : Wo104., :. Backwater valve , 12.51
G ice,, Clothes washer 25.02
T-r4 lk T t81� "PrzeAje tan Deft) Dishwasher " 25.02
Drinking fountain 25.02
Ejectots/sump 25.02
;1 PROP`E ;•OWNEk • . 0 TENANT. tmf
Expansion k 12.51
Name: ` Fixture/sewer cap 25.02
t � Floor drain/floor r sink/hub 25.
Address: 92-46 svc) I A ,
lz .n,��, 22 °'g` 25.02
eaCy /sraLeTP
� Ql2 c y3 Hose bib _ 25.02
Phone: ( , g ` s4, Fax: ( ) Ice maker 1231 • y. �.AP'PUC rirr • .' . • • 0 CONTACT PERSON • . • . ' . Interceptor/grease trap 25.02
Business name: I ti 114 r1 aR P£,s _ Medical gas (value: $ ) Page 2
Contact name: 1 •e Pittner 12.51
y „. , g ' •
` r ., Roof drain (commercial) 12.51
Address: 1 o1O �7tA) N, u i 76 b W Sink/basin/lavatory 2542
City/State/ZIP: •- • o e ia-9- Solar units (potable water) 6234
P h o n e : ( 03) c Z • - - LP (5 Fax: : (503) WAD - (, gip 1 Thb /shower / showrr pan _ 12.51
E -mail: , 1 ilG r co YY1 Urinal 25.02
� � , water closet 25.02
:co . •
Business name: • Water heater 37.52
�AfiC d�l Wata piping/DWV 56.29
Address:
25.02
City/State/ZIP: �Dt i M hat4 �- Snblotal 3111
Phone: (Ica) S 19315 Fax: ( (02,p -- (g a 0 L. Minimum permit Sze: $72.50 17,456
. CCB Lie.: _ , : '. g -i Plumbing Lis no.: Plan review (25% of pc n it fee)
State surcharge (12% of permit icc) grii :
Authorized signature: � �
A Air _ ' / _
OkroLeilk me: TOTAL PBRMIT FEE
Print na . ' f �/ n 0 Date: 2 L 13 it aPP son expires it a permit 0 not obtained within Dm days
after tt has been accepted at complete.
'Fee methodology set by Tri.CCauaty Building indunry Service Board
kOlvildiatParmitAPI IIJ- Perrahapp.em mum • 440.e616r(rorovcoaeieuas)
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10670, SW Bladc Diamond Way
Tigard, OR 97223
603- 892.6316 Artistic Landscapes
Fax 503620$901
vnaw.adisticlandacaixopcbccom
Fax
Toc City of Lake Tigard Permits Fronx Sarah Kinsey (gi Artistic Landscapes
Faro 503- 598 -1960 Pagan 3 (induding cover page)
Mona Date: 2-4-13
Re; Plumbing Permit
0 Urgent 0 For Review 0 Please Comment 0 Please Reply 0 Please Recycle
• Comments For submission to your department Please fax permit back to 503 - 620-6901.
Thank You,
Robert & Sarah IGnsey
Artistic Landscapes
•
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