Permit NI CITY OF TIGARD PLUMBING PERMIT
s • - COMMUNITY DEVELOPMENT Permit #: PLM2013 -00204
Date Issued: 06/26/2013
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Parcel: 2S109DA16900
Jurisdiction: Tigard
Site address: 15439 SW SUMMERVIEW DR
Project: Arlington Heights No. 3, Lot 98 Subdivision: ARLINGTON HEIGHTS NO 3 Lot: 98
Project Description: Irrigation backflow device for new SF
Contractor: LANDSCAPE OREGON, INC. Owner: STONE BRIDGE HOMES NW LLC
PO BOX 2386 4230 GALEWOOD ST, STE 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 06/26/2013 $31 27
Specifics: 1 12% State Surcharge - 06/26/2013 $8.70
Plumbing
Type of Use SF 41 ea Minimum Fee Adjustment - 06/26/2013 $41.23
Class of Work: OTR
Plumbing
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 questi.. • OUNC by calling 503 232 1987 or 1 800 332.2344.
Issued :y: / Permittee Signatur=• / , ;�
� • • A I L � •y / � � J / C �� l��
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.
- -
Plumbiniz,F Permit Awalicaf
Building Fixtures E'E1VED FOR OFFICE USE ONLY
Cit7i of Tigard I Rexwed
Date/By. 4/Z-5/13 *Vrrtrulit /4°,4//e.2411-7-"doc21)
iii .3125 SW Hall Blvd , Tigrd, OR .972JUN 2 5 2013 Plan Review '
; ! . Phone.: 503.718.2439 Fax 503 598,1967 Dare.13y: Other P e mut 14 /Icr,261/3 -4 0 0 .......<
T 1 GARD
Inspection Line. 503 633 4175 C Ready/7
ITY OF TIGARD 1
Dae B :nare. Ell See Paze 2 for
Internet www.tigard goy ni nm r, Nerrfted/M ediod Supplemental lnformation
'''' ' '' 'k ' ' °:'' : ';' r '-- • • ''''' ° f' ; ''. 'ffl't OF 1:5614k D V ISIQ° ' - - ':--'; ' 1 - i ; :- - ' .."- --: -:. -' . L - - '''' : FEE, ': SCiTEfifiLE'V
0 New constructior. ID Demolition . For special information use checklist
- Description I Qty. I Ea. Total
0 Add: tion/alteration , 0 Other: New 1- 2-family dwellings (includes 100 ft. for each unkry conneation)
7 ': ';'il.: '-'' '' ''' ' ' ' - a :CATEGthei OF CONSTRUCTION , .. -; ... : i ': 3FR (1) bath I 312. 1
E I. and 2-family dwelling 0 Commeniai/industrial SFR (2) bath I 437. 1
SFR (3) bath , 500.32
E Accessory building El Multi-family
Each additional bath/kitchen I 25.02
E Master budder 0 Other: Fire sprinkler ( so. ft.) Page 2
-".:::;': 1 . ,.. 1,• i i;1.1;," : ",..,; ' : ' ,.:, .14 SITE IiNFOR.k... -..0cAntifsT,;:- :.! 7 ' :' l :', Site utilities:
Catch basin or area drain I 18.76
Job te address 1 S 3c) . 5,c u -ojy t eru t cut De _ ,
' Drywell, leach line, or trench drain I 8.76
City/State/ZIP: T er tce 6 g- 9 7 ?-,•- L i -
. Footing drain (no. linear ft.: ) Page 2
-
Suite/bldg./apt. no.: 1 Project nr.m901-yi t y l e t k 7' , Manufactured borne utilities 50.03
Cross street/directions to job site: ge ef:- . P--.0 Manholes .76
Rain drain connector 1 18.76
Sanitary sewer (no liner ft.: ) Page 2
'
Steno sewer (no. linear fr.: _____) Page 2
' Water service (no. linear ft.. ) Page 2 1
Subdivision:14-y f i ri El-e L 9 C, Lot no.: I Fixture or kern:
Tax map/parcel r.o . 6, 513 /9--(fr, ' BacIdlow preventer :: 31,27 31 2
Backwater YON/a 12.51 t
!'s;,; :' , , l .:±,-.; :1?ESCIUP ; 110:11. 7 -Di'. : *01* - -1::;:...' . :::.-.:- : : - ."; - 5: - ., ::: f... ..
' Clothes washer 25.02
Landscape Irrigation Back Flow Device
Dishwasher 25.C2
Drinking fountain 25.C2
Ejectors/sump 25.02
Ilitit".64 .1 :El itg*j■nr.-- 1::'.. ExP's tank 12,51
25.02
Name. Stone Bridge Homes NW LLC , Fixturesewer cap
- Floor draintfloor sinkIhub 25.02
Address: 4230 Galewood Street Suite 100
Garbage disposal 25.02
City/StateiZIP: Lake Oswego, OR 97035 I Hose bib
25.02
Phone: ( ) Fax: ( ) ' Ice maker , 12.51
al.i..:: -:!-, ?::-: ' I': ■ g . Ap,PLILfkkk /axrAcr; pERNit:': interceptor/grease trap I 1 25.02
Medica: gas (value: $ _ ) I Page 2
Business name: Landscape Oregon, Inc.
Primer 12.51 '
Contact name: Ellen Sparrow
Roof drain (commercial) , 12.51 I
Address: P.O. Box 2386 Sinkibasinflavatory ; 25.02 ;
City/State/ZIP: Tualatin, OR 97062 Solar units (potable water) 6234 '
Phone; (503) 692-5945 Fax: : (503-) 692-0768 Tubishowerishowcr an 12.51
Urinal 25.02
E-mail: ellenglandscapeoregon.com ..
2
riP2'P 'I' '.2-; y, ' ii- 'F 4 - • :0, e c i o i .._-: ...: :,=.--• .!.....-"- ' ' }..:-' ' r . Water closet 25.02
-,-,--,,,,,• , . -,_ ,",,1 . ' -". II: „.',, -1 watei h eawr 3'7.52 1
Business name: Landscape Oregon, Inc. water pipinVDWV 36.29 1
Address: P.O. Box 23 86 Other 25.02
City/State/ZIP: Tualatin, OR 97062 Subtotal 31.27
Minimum permit fee: 572.50 72 5C
i Phone: (503) 692-5945 Fax: (503) 692-0768 .
Plan review (25% of permit fee)
CC3 Lic.: LCB 7804 Plumbing Lic, no.:
- , State surcharge (12% of permjt fee.) 8.7C 1 7
Authorized sipaturei,...-4..e..6/2 . TOTAL PERMIT FEE 81.20
Print name Ellen Sparrow Date. bk•Vo:3 Th. permit application expiresif a permit is not obtained within 180 days
after it has beer accepted as complete.
•Fee rneth000logy sct ir, Tr-County Builcinc Incusery Seniice Boaiid
I OR 1 04,,APerra: \PLML-PeranAroa az•c I�'0109 4.12 46 16T( 10:07: COMAYEA■
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