Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00223
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/02/2013
Parcel: 1 S 133CA07200
Jurisdiction: Tigard
Site address: 11302 SW HALLMARK TER
Project: Barrows Road Estates Subdivision: BARROWS ROAD ESTATES Lot: 21
Project Description: Irrigation backflow device for 6 unit SFA building.
Site addresses include: 11302, 11316, 11320, 11334, 11340 & 11352.
Contractor: R & R NURSERY AND LANDSCAPE Owner: HALLMARK TERRACE LLC
PO BOX 393 18318 SE ABERNETHY LN
EAGLE CREEK, OR 97022 MILWAUKIE, OR 97267
PHONE: 503 - 630 -7975 PHONE:
FAX: 503 - 630 -7955
FEES
Quantity Description Date Amount
1 ea Beddow Preventer 07/02/2013 $31.27
Specifics: 1 12% State Surcharge - 07/02/2013 $8.70
Plumbing -
Type of Use: SFA 41 ea Minimum Fee Adjustment - 07/02/2013 $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: Permittee Signature:
Q/(f 4}7 �'�77fJN
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.
Jul 01 13 09:18a R & R Nursery and Landsca 503 -630 -7955 p.1
I# ' _ CEI
1 A I bin . Permit A t o il t
' e Utilities FOR U.I FI F. l"SI. c) \1.,
JUL 01 2013 Received Permit Na.:��0 /3 -Dona
City of Tigard Datei 9
" ■ 13125 SW hall Blvd., Tigard, OR 9 Plan Review Other Permit No.:
Phone: 503.718.2439 Fax: 503. TIGI`t DatelBy.
lnspectionLine:503. 639.4175 B UILDINGDIVISIO ! Date1eeadymy: - I l� ®SecPaee2for orm arion
f
T1GnRD Internet: wew. CJU LJIIV DIVISION 1 1 �PNe
TYPE OF WORK FEE* SCHEDULE
❑ Demolition For special infornuetion use checklist
VA New construction Description I Qty. I Ea i Total
❑ Addition/alteration/replacement ❑ Other. New 1 -2- family dwellings (includes 100 fl. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
SFR (2) bath 437.78
❑ 1- and 2- family dwelling ❑ Cut
omercial/tndustnal 437.78
- SFR (3) bath .
E:1 Accessory building Multi-family Each additional bath/kitchen 25.02
ID Master builder ❑ Outer Fire sprinkler (_-_ sq. it.)
Page 2 ■
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: it-3'0a. 11�lrhw.k- TE{ re.. �' Drywell, leach line, or trench drain [8.76 l
City/State/ZIP: ,' 4 Q , ` k 1 t la 3 Footing drain (no. linear R: �) Page 2
- Sui dg7ap . o.:_3 . __ _ Project name: ' _ Manufactured home utilities 50.03
Cress street/directions to job site: M c„a ES7A-7-E- Manholes 18.76
` � -rJ f , 9 Rain drain connector 18.76
�� /w/ 7r5 �� 1/� �`� `� Sanitary sewer (no. linear ft.: _� Page 2
��� !.L I � J O /.11 �� T !TD' S Storm sewer (no. linear ft.: 1 page 2
// 352,//3V0 //3020 //3/ b Water service (no. linear ft • ) Page 2
Subdivision:
//.5,e 02 l Lot no.: Fixture or item:
Backflow preventer 1 31.27 :'3l. )1
Tax map /parcel no.: 12.51
Backwater valve
DESCRIPTION OF WORK Clothes washer 25.02
-.. . ' t• . v't'. • ■ . - __ 1, 14 • it3 Dishwasher 25.02
Drinking fountain
25.02
Ejectors/sump 25.02
T
1$ PROPERTY OWNER Expansion tank 12.51
� �
Fixture/sewer elsewer cap
Name: ( US 0 Lt Remo., Floor drain/floor sink/hub 25.02
Address: +g3 i g ilhe f r L0A.3..... Garbage disposal 25.02
City/State/ZIP: niiwQG b Z tom. 9 7C W Hose bib 25.02
Phone: (5 ( (A 7i_- Fax: (503 ) (e3 - 37 q3 Ice maker 1251
DI APPLICANT ` S. CONTACT PERSON Interceptor /grease trap 25.02
n ' �� Medical gas (value: $ ) Page 2
(
Business name: 2 t A. Ld \. . Prime 12.51
Contact name:��} 05 ?.�- y f4r)
Roof drain (commercial) 12.51 •
Address: "3 Q Z 0 .,„ 3q3 Sink/basin/lavatory 25.02
City/State/ZIP: �r�l� (Aga.L . 02. -l7O ;-).).-- Solar units (potable mater) 62.54
Tub/shower /shower pan 12.51
Phone: 5C3) 1030 ° 1 Y, Far:: )630 9S 5 25.02
Urinal
E -mail: 3el..124 �s ; -- Ir- yltd . 1:2"11/N- Water closet 25.02
CONTRA OR Water heater 37.52
Business name: ! � � n , Ge,;_ Water piping/DWV 56.29
s
Addr s: O 2,01.. 313 ` Other: 25.02
Subtotal �l _Z'{
City/State/ZIP: 66.. ( . ( t 9:3--
Minimum permit fee: $72.50
Phone: (2) �3 - 7� S Fax: 6 , 3 ) ( -7� Ss Plan review (25% of permit fee)
CCB Lie.: oz Lx„11, Ye. ISS Plumbing Lic. no.: rge (12% of permit fee) $,7D
Authorized signature: y/30 State surcharge
PERMIT FEE 4 2 E 1 JD
/ ^ , Date:
J This permit appl expires if a permit is not obtained within 180 days
[Print name :a1 -: .4,2, -( 7 / �3 after it has been accepted as complete.
\ \\ *Fee methodology set by Tri -County Building Industry Service 7
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