Permit 4 CITY OF TIGARD J 1 6 PLUMBING PERMIT
• COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00132
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/28/2008
PARCEL: 2S 110BA - 04200
SITE ADDRESS: 14330 SW MCFARLAND BLVD ZONING: R -2
SUBDIVISION: SHADOW HILLS LOT: 023 JURISDICTION: TIG
PROJECT: DUNCAN
Project Description: Replacing backflow preventer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
THOMAS & F DUNCAN Description SW MCFARLAND BLVD escription Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 3/28/2008 $36.25
[TAX] 12% State Surch 3/28/2008 $4.35
Phone : 503- 968 -6060 Total $40.60
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 682 -6076
FAX 503- 682 -4975
Reg #: LIC 8079
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: / � Permittee Signature: SP—e � � L,j�iti
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
. 03/28/2008 09:31 5036824975 PROGRASS, INC. PAGE 02/02
Plumbing Permit Application
Building Fixtures MAR 2 8 o ' K) OH;l:lcE I O LV
R eceived p
City of Tigard /By, ' 7 l ate 5/J PcrmitNo.: - OJ / .11, + 13125 Sir Hall Blvd., Tigard, OR 9x2 l v nate OF TIG /1 RD Plan Review
• Phone: 503.639.4171 Fax: 503.5115 1I 1 /1 Other PtrmitNo.:
Inspection Line; 503 �VG D1VI 1Da"
- r! i n r:. t', SI OI I Date Ready/By: )uric; ® See Page 2 for
Internet: www.tigard or.gov NotiBed'Mcthod; Supplemental Information
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❑ New construction • ❑ Demolition For special infonuarton use checklist.
Description .1 Qty. I Ea. I Total
Eivkdditio0/alteratioWreplacewent ❑ Other New 1 - 2- family dwellings (includes 100 R. for each utility connection)
t!,1 1 T f, y ` ' f,. t 7) r 1 l 751i l tr9 � ,,, , 4'a _ j . + y t a r� I il, l .� L S1'R(1)ba 249.20
: .`.x t ..:i ._,. fa:> 'r � 2, t .., 7 Gf Lr lY .:. , S . 1 . <, � ., � ,. 1r
5; and 2- family dwelling ❑ Commercial /industrial I SFR (2) bath I 350.00
El Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
1
r _ n n Fire sprinkler ( sq. R.) Page 2
t .tar iJ 4 : u 4 . 'T , :.
.s .:.,: u. a,. ..a. 7 . , ; �:v-, n s : _.J: 5 , F .r!il\;S)_ r , ;. � +� 7P. u?
.1 ,t., ,. , ; ti i .- - �JJ. Site utilities
I
Job site address. 350 ) / IJ � {,' 1 Catch basin or area drain 16.60 -
City/State/ZIP: ---rl 1 CV 0 R - 7 )-a- Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no, linear ft : _ ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft: ) Page 2
Storm sewer (no. linear ft: _ ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: _ ) Page 2
Fixture or item
Tax map /parcel no
, : ''' .7.. t, ii F J •. r, 1 . _ . , ,, - k --r•.. � ` , r ,: ,.,;,;,-;,..,,,,,.,,,,s,... ., AbSOrpnon aloe I 16.60
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- : _ ',•, ,! Backflow prevented Page 2
(--. " 6 fn,. ,� UvJ ( klaekwater valve 16.60
1 � i rn9 fNC9 i Clothes washer 16.60
pishvasher 16.60
.7.7,;,--,-,, ti r r • t 1 . ,. ' y k -,^. 1 his 11 , x1 j -, , 1: f i , Drinking fountain 16.60
i < :4 f! ,..' .L..w� .� l - '$. . .,,, y.. , - .h ,!:,,,: IY W ',n r . . .r . ,.., . i „ ,.3Yi t e
� > = j ec t ors / sump 16.60
Name: 1.'Yl Do, ✓i C�4 1/1 . expansion tank 16.60
Address: 14 OS0 'd,) hi i11-7Z al, 01 Fixture/sewercap 16.60
City /State/ZIP: -- r(, CI CiAtlk I Dr- e.11 '?- - Floor drain/floor sink/hub 16.60
Phone: ( ) r - t V Fax: ( ) Garbage disposal 16.60
• ly T r Hose bib
i 16.60
1, d ,, t ;: f rl � i , l w i i J , lt \t '� € J, 7 .. -:C ✓Y,N r . 1,'.'
-- x....:�;,s. yL . -> ' x Y Ice maker 16.60
Business name: Cp . .a„.0
interceptor/grease trap 16.60
Contact name: 1 I A- -4 Irn l iA Medical gas (value: S ) Page 2
Address: OCt 5 1) 1`-„t y5 S ,V1-L> i" Re Primer 16.60
City /State/ZIP: W 1 o y1 V` Roof drain (commercial) 16.60
1 � ' , O " 7 SiAlc/basin/lavatory 16.60
Phone: (5 03) (p A,), _. 1 `, (p 21 t.I Fax :: ( )
1414 i 1 q y� Tub/shower /shower pan 16.60
E-mail: - f7)-Q3 ,4 , �-� t'
Urinal 16.60
, ,t •.-,,-,.:5-•!::', ∎tti; ;!','. ,..'.. - .. ?l 4F. :,t? °_-_. :*,:_::V, 1;f, .1i '..q ,; . :! ° ". 1 ,sf l+ J { a ,', :, Watt: closet 16,60
Business name: r .. r t2 Water heater 16.60
`
Address: ' et,4 A -i-,,- _.& Other •
City /State/ZIP: Subtotal
- Minitmun permit fee: $72.50 v /-! -- a-
Phone: ( ) S 3 ( 0' Fax: ( ) Residential backflow minimum permit fee: 33625 v•
CCB Lic.: 10 g 5 F utnbing tic. no.: Plan review (25% of permit fee)
State surcharge (12% of permit fee) I.- -
Authorized signature: /
��f / TOTAL PERMIT FEE ` /�/
I Ptint name: ,�-(� 1 ; ` i • Date: 3 0 c This permit application expires if a permit is not oDtatnedxvltbin
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
r :`.BadngWammlPLMF- PennitApp.tioc 12'Z7'06 440- 9616T(LO!OVCOMNIEB)