Permit •
CITY OF TIGARD PLUMBING PERMIT
71 1 ' °. COMM UNITY DEVELOPMENT Permit #: PLM2013 00196 •
.1' I c X R. - 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/20/2013
Parcel: 1S134CB00500
Jurisdiction: Tigard
Site address: 12185 SW SUMMER ST
Project: Wilbur Subdivision: SUMMER HILLS PARK Lot: 3
Project Description: Install irrigation backflow device.
Contractor: ALL OREGON LANDSCAPING INC Owner: WILBUR, ERIK J & JOANNA C
19785 SW CIPOLE RD 12185 SW SUMMER ST
SHERWOOD, OR 97140 TIGARD, OR 97223
P
PHONE: 971- 295 -3256
HONE: 503 - 646 -6426
FAX: 503 - 625 -9668
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 06/20/2013 $31.27
Specifics: 1 12% State Surcharge - 06/20/2013 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment - 06/20/2013 $41.23
Plumbing
Class of Work: OTR
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
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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: /
•
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.
JUN -19 -2013 01:27 PM All Oregon Landscaping 503 625 9668 P. 2
Plumbin Perm A lication
Site Utilities RECEIVED role („... i i.: I Si.: t►N1.1
's' -1d0/9
City of Tigard Received .24 /3 4 C � ParmitNo�Uygoi3
a 13125 SW Hall Blvd., Tigard, OR 97 N 19 2013 Plan Review
Phone: 503,718.2439 Fax: 503.598.1960 A D Date/8 : Other Permit No.:
Inspection Line: 503.634,4175 CITY OFTIGARD Date Ready/By: � See Page 2 for
1 . i `. n t:l > Internet; www.tigard- or.gov � n. �`.. _,y Notlfled/Method: g g r _.. j Supplemental Information
?tea '" ;. �l' �. h lf,4 - i e:- '� a . 7 - Fai fari..i&[d)
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❑ New construction Demolition For special Info us is
Descn,Gan Su. Ea, Total
0 Addition/alteration/replacement 0 Other: New 1- 2- family dwellln: a (includes 100 ft. for each utili connection
4- p r ° SFR(1) 312.70
Eg 1- and 2- fbmily dwelling ❑ Commercial /industrial
SFR (2) bath 437,78
SFR (3) bath 500.32
fl Accessory building 0 Multi- family Each additional barh/kltchen 25.02
❑ Master builder 0 Other: Fire sprinkler (_ sq. fL) Page 2
w 1 t >k, s 7 1/ lfrii ,g _ Site otllltiee:
- - �- Catch basin or area drain 18.76
Job site address: 12185 SW Summer Street Drywall, leach line, or trench drain 18.76
City /State21P: Tigard, OR 97223 Footing drain (no. linear ft,: , ) Page 2
Suitc/bldg. /apt. no.: Project name: Manufactured home utilities 50.03 -
Cross street/directions to job site: SW 121" Avenue 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: Lot no.: Fixture or Item:
Tax map /parcel no.: ' Backflow preventer 31.27 31.17
,. = Backwater valve 12,51
�Rr "' a k � ai � a et tyg-
"9?..._� ��r= �. Clothes washer 25.02
Install new automatic irrigation system. Install one backflow device. Dishwasher ■ 25.02
Drinking fountain 25.02 M.
Ejectors/sump 25.02
ansion tan k 12.51
■
. ;. _ t x ton tank
.,. r i �. �.. R E
... �,... 25.02
F' sewer cap
Name: Erik Wilbur
Floor drain/floor sink/hub 25.02
Address: 12185 8W Summer Street Garbage disposal 25.02
City / State/ZIP: Tigard, OR 97223 Hose bib 11111 25.02
Phone: (971)295 -3256 Fax ( ) Ice maker ■ 12.51
y a e i~ I' ,� , - , ,' , Interceptor /grease trap 25.02
Business name Oregon Oron Landscaping, Inc. Medical gas (value: $ _ ) Page 2
Primer 12.51
Contact name: Carl Liebhardt Roof drain (commercial) 12.51
Address: 19785 SW Cipole Road Sink/basin/lavetory 25.02
City /State /ZIP: Sherwood, OR 97140 Solar units (potable water) 62.54
Phone: (503) 646 -6426 I Fax: : (503) 625 -9668 Tub /shower /shower pan 12.51
Urinal 25.02
E -mail carl@alloregon.com _ _
Urinal
j 25.02
Water c oset
pp, Sao r 9 i ,i�r < 1 ate'
F^ :r, r , . ._., �, ._ - = ... Water heater NM 37.52
Business name: All Oregon Landscaping, Inc. Water piping/DWV WEI
Address: 19785 SW Cipole Road Other: 25.02 ME
City /State/ZIP: Sherwood, OR 97140 Subtotal
Phone: (503) 646 -6426 Fax: (503) 625 -9668 Minimum permit fix: 572.50
' ' I Plan review (25% of permit fee) �j'
tr CCBLie.: 10 �i i Plumbing Lie no. Co 1 State suroherge(12%of permit fee) MiTpjl /
Authorized signature: ..4 , Fi� 6e -J ' ., /3 TOTAL PERMIT FEE ram v/
1_ ,
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Print name: t q • Q,. o f f p Date: 4.,.- -r Q - i; This permit application expires if a permit is not obtained within 80 days
'VI r after it has been accepted as complete.
' "Pee methodology set by Tri- County Building Industry Service Board.
1; 1auildingWermltelrLMU •PmnitApp.doc 101/09 440-4616T(10IO2ICOM/WEB)
JUN -19 -2013 01:26 PM All Oregon Landscaping 503 625 9668 P. 1
® ALL OREGON LANDSCAPING, INC.
' OJT "Landscaping At Its Best"
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19785 SW Clpoie Road
Sherwood, OR 97140
I A Nito)SCA I'I'NG Office: 503.646.6426 Fax: 503.625.9668
Webslte: www.alloregon.com
Oregon Construction Contractors Board No. 194221
Oregon Landscaping Contractor's Board License No. 6667
fax
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