Permit n CITY OF TIGARD PLUMBING PERMIT
1111. COMMUNITY DEVELOPMENT Permit#: PLM2o13 00377
TI C3 AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2013
Parcel: 2S109DA16400
Jurisdiction: Tigard
Site address: 15352 SW OAKMONT PL
Project: Arlington Heights No.3,Lot 83 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 83
Project Description: Backflow for irrigation.
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
P
PHONE: 503-387-7577
PHONE: 503-692-5945
FAX: 503-692-0768
FEES
• Quantity Description Date Amount
1 ea Backflow Preventer 10/28/2013 $31.27
Specifics: 1 12%State Surcharge- 10/28/2013 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 10/28/2013 $41.23
Plumbing
Class of Work: ALT
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:
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.
Plumbing Permit Application RECEIVED
Building Fixtures OCT 2 3 2013 rout OFFIC:L t'si: ONLY
•
City of Tigard Received
1111 a 13125 SW Hall Blvd.,Tigard,OR 9Jjd/ Da' ° l0 ',,d / •' Permit Na.: / . 01
C Phone: 503.718.2439 Fax: 5033 1 6Q OFTICARp Plan Review
r 1 G.n tt 17 Inspctnon Line: 503.639.4175
BUILDING DIVISION � y• B Juris: Permit No.! Ms ��-ua I ��
Internet: www.tigard-or.gov Ready/By: )uric: 1 ® See Page 2 for
Notified/Method: j Supplemental Information
TYPE OF WORK
FEE* SCHEDULE
❑Demolition New construction emolition For special informarloe use checklist
❑Addition/alteration/replacement Description 1 Qty. I Ea. I Total
❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath
•
312.70
® 1-and 2-family dwelling ❑ Commercial/mdustial Sit(2)bath 437.78
•
❑Accessory building ❑Mules-farnity SFR(3)bath 500.32
❑Master builder ❑O Each additional bath/kitchen 25.02
Other.
• JOB SITE INFO MATRON ANq Site sprinkler( sq.ft.) Page 2
r Kin fV �TI� Site utilities:
Job site address:( 6-t 5- •os t) Catch basin or area drain
( !Gl _�/?'lC�h_'i �(C(( � � 18.76
City/State/ZIP: / i C+lL ,L C`JZ () `7 d-Q. Drywall,leach line,or trench drain r 18.76
SuitdbldgJapt no.: 1 l Project name: Footing drain(no.linear ft.:_) Page 2
I 1 ri of he)-� F/..") Manufactured home utilities 50.03
Cross.street/directions to job site:
Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear R: ) Page 2
Subdivision: ('] Water service(no.linear R.: ) I Page 2
1 ). /l plc2 ti-h ik- 1/1 j f Lot no.:fi3 Fixture or Item:
Tax map/parcel no.: CG 5-5- , 7 Baelrflow preventer x 31.27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Landscape Irrigation Back Flow Device Clothes washer 25.02
Dishwasher 25.02
,Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER , ❑ TENArcr Expansion tank 12.51
:came:Stone Bridge Homes NW LLC Fixture/sewercap 25.02
Address:4230 Galewood Street Suite 100 Floor drain/floor sink/hub 25.02
City/Staten P:Lake Oswego,OR 97035 Garbage disposal 25,02
Phone:( ) Hose bib 25.02
Fax:( ) Ice maker
12.51
® APPLICANT ® CONTACT PERSON Interceptor/grease nap 25.02
Business name:Landscape Oregon,Inc. _Medical gas(value:S_) Page 2
Contact name:Ellen Sparrow
-P I2.51
Address:P.O.Box 2386 Roof drain(commercial) 12.51
-
City/State/ZIP:Tualatin,OR 97062 Sink/basin/lavatory 25.02
Solar units(potable water) 62.54
Phone:(503)692-5945 ( Fax::(503-)692-0768 TUb/showtar'showerpan 12.51
E-mail:ellen@landscapeoregon-com Urinal 25.02
CONTRACTOR Water closet 25.02
-
Business name:Landscape Oregon,Inc Water heater 37.52
Address:P.O.Box 2386
Water piping/DWV 56.29
Other 25.02
City/State/ZIP:Tualatin,OR 97062
Subtotal 31.27
Phone:(503)692-5945 Fax:(503)692-0768 , _ Minimum permit fee: 572.50_ 72.50
CCB Lic.:LCB 7804 Plumbing Lic.no.: Plan review(25%of permit fee)
Authorized signature: ' - State surcharge(12%of permit fee) 8.70
6,7) eL �c z`' TOTAL PERMIT FEE 81.20
Thts permit a
Print name:Ellen Sparrow '
Dace:% r j `1(1 application explrea.Ha permit Is not obtained within 180 days
after It has been accepted as complete.
`Fee methodology set by Tri-County Building Industry Service Board.
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Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15352 SW OAKMONT PL, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
2013-11-25 (null)
PLM2013-00377
PASS - No C of O
1" wilkins mod350
Violation Summary:
Inspector Contractor