The URL can be used to link to this page

Permit CITY OF TIGARD PLUMBING PERMIT ° COMMUNITY DEVELOPMENT Permit #: PLM2013 -00252 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/23/2013 TIGARD Parcel: 2S109DA19100 Jurisdiction: Tigard Site address: 12613 SW CANYONRIDGE CT Project: Arlington Heights No. 3, Lot 120 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 120 Project Description: Irrigation backflow device. Contractor: LANDSCAPE OREGON, INC. Owner: STONE BRIDGE HOMES PO BOX 2386 4230 GALEWOOD ST, SUITE 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 07/23/2013 $31.27 Specifics: 1 12% State Surcharge - 07/23/2013 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment - 07/23/2013 $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: i. L11,41 7) ,.. k. 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. Plumbineermit Application Building Fixtures RECEIVEr FOR OFti'rcr. USE ONLY City of Tigard Received 1 N a 1 3125 SW Hall Blvd., Tigard, OR 97223 JUL 22 2013 ' 7A-5 i3 Permit � �7 - oa ash Phone: 503.718.2439 Fax: 503.598.1960 Plan Review DamiB Date/By: Other Permit N r 1 I t. A RD Inspection Line: 503.639 CITY OF TIGARD s� oa a3 3 Internet: www.tigard- or. gov Notified/Method: Imu : : -. Information N to y/B ea TYPE of WO RRUIterING DIUISIO Iris, ....ti I Supplemental ,.. - , ...... .,. eta for - FEE *'SCHEDULE' ._.. ® New construction ❑ Demolition For special information use checklist - Description 1 Cam. I Ea. I Total ❑ Addition /alteration/replacement ❑ Other. New 1. 2-family dwellings (includes I OD ft. for each utility connection) " :. CATEGORY OF CONSTRUCTION s .: SFR (1) bath 312.70 • ® 1- and 2- family dwelling 1:I Commercial /industrial SFR (2) bath 437.78 ❑ Accessory building SFR (3) bath 500.32 ❑ Multi- family - _ ❑ M aster builder . Each additional bath/kitchen 25.02 . ❑ Other: Fire sprinkler ( sq. ft.) Page 2 • , •, -., . • JOB. SITE' INFORMATION AND. LOCATION : „ • . -.. .... Site utilities: Job site address: (, . 1 3 C i �+� Catch basin or area drain 18.76 - c'1 f d l c,e� tT - City/State/ZIP: ' c y Drywell, leach line, or trench drain 18.76 TIC ��t ;t. c 2 17 a Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: /4- t K q101.) 1 (-, Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 LC 111 [TLC PI) I/I 1...0111-E-' Rain drain connector 18.76 ' _ Sanitary sewer (no. linear ft.: _ ) Page 2 1 Stone sewer (no. linear ft.: _ ) Page 2 Water service (no. linear ft.: _ ) Page 2 Subdivision: AI- 1 r1,1C //-01.1 1+0_ ‘2(IL./S Lot no.: ! 40 Fixture or Item: Tax map /parcel no.: L, s s A. -7 Bacidlow preventer x 31.27 31.27 f DESCRIPTION VtiURIC ' c at valve 12.51 i - B kw er al Landscape Irrigation Back Flow Device Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ® PROPERTY •.OWNER'' ©- TENANT .. . : •, Expansion tank _ 12.51 Name: Stone Bridge Homes NW LLC FirtturUsewercap 25.02 Address: 4230 Galewood Street Suite 100 Floor drain/floor sinklhub - 25.02 Garbage disposal 25.02 City / State/ZIP: Lake Oswego, OR 97035 Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 ,. , :® i�P ;' E'CONI'ttACT PERSON ImerceptodgreaseUaP 25.02 Business name: Landscape Oregon, Inc. Medical gas (value: $ : ) Page 2 Contact name: Ellen Sparrow - Primer - 12.51 Roof drain (commercial) 12.51 Address: P.O. Box 2386 Sink/basin/lavatory 25.02 City/State/ZIP: Tualatin, OR 97062 - Solar units (potable water) 62.54 Phone: (503) 692 -5945 Fax: : (503 -) 692 -0768 T .b/shower /shower pan 12.51 E - mail: eUen@Jaodscapeoregon.com Urinal 25.02 Water closet 2 5.02 - Water heater 37.52 Business name: Landscape Oregon, Inc, Water i to WV p p P� 56.29 Address: P.O. Box 2386 Other: 25.02 Ci / State/ZIP: Tualatin, OR 97062 Subtotal 31.27 hone: (503) 692 -5945 Fax: (503) 692 -0768 Minimum permit fee: $72.50 ' 72.50 CCB Lit.. LCB 7804 Plan review (25% of permit fee) Plumbing Lic. no.: ... _ l • State surcharge (12% of permit fee) 8.70 Authorized signatur % ) L'i 1 ,OcL 4 Lt,' TOTAL PERMIT FEE I 81.20 Print name: Ellen Sparrow D � - ' vim This permit application espires. a permit is not obtained within 180 days ` v /'P / after it bas been if accepted as Complete. *Fee methodology set by Tri-County Building industry Service Board. i Building 'Pamits\PLMU- PamitApp.doc 10'01/09 440 4 616T(1D/O2/COM•wEB) E abed 89LOZ69EOS 'DuI uo6ar0 adepspue-h NV6l LO £tOZ ZZ lnf