Permit CITY OF TIGARD PLUMBING PERMIT
'1 * COMMUNITY DEVELOPMENT Permit#: PLM2014-00235
T I G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/17/2014
Parcel: 1 S136AA07900
Jurisdiction: Tigard
Site address: 7050 SW LOCUST ST
Project: Ventura Estates,Lot 1 Subdivision: VENTURA ESTATES Lot: 1
Project Description: Installation of residential backflow preventer for irrigation
Contractor: LANDSCAPE SERVICES CO Owner: DANIEL MACNAUGHTON INC
PO BOX 1623 3802 SW MARTINS LN
CLACKAMAS, OR 97015 PORTLAND,OR 97239
PHONE: 503-656-6890 PHONE: 503-318-3470
FAX: 503-656-4096
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 07/17/2014 $31.27
Specifics:, 1 12%State Surcharge- 07/17/2014 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 07/17/2014 $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 ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. • .1. obtain a copy of the rules
or direct q ions to OU r 50 32.1987 or 1.800.332.2344.
/_Issue 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
Building Fixtures I ()I. ()I 1 1( I I •I 1 1\1 1
Received Arzy �
� City of Tigard - � Permit No.: �� I�.3�
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Review ,�
Phone: 503.718.2439 Fax: 503.598.1960 may. Other Permit No.: /45 rt l.� g 70,q
Inspection Line: 503.639.4175 Date Ready/By: Juris: 1 H See Page e 2 for i` 1 I' Internet: www.tigard-or.gov ov Notified/Method- Supplemental Inf
ormation
TYPE OF WORK FEE* SCHEDULE
New construction ❑Demolition For special information use checklist
Description I Qty. 1 Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
-
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other. Fire sprinkler( sq.ft.) _ Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 705-0 51,1 L o t e s Catch basin or area drain 18.76-
City/StaterzIP: -rj (,IY' l� d/Z q 7619.3 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I (roject name: 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 ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 1 12.51
31.27
DESCRIPTION OF WORK Backwater valve t
Clothes washer 25.02
J r s-t!I 1 r r l�Ct r/O✓l back 1/'J do a1ii
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
q` Fixture/sewer cap 25.02
Name: 4,
D u vl G )UQ 091 O.1 Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:(503 ) 3/ - 3 N7.0 Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:
Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: (A h dst4 re_ Se Y v i ee S Ca Water piping/DWV 56.29
Address: Pr D t ga x 1 ii,A 3 Other: 25.02
City/State/ZIP: 614L4, 4 5> 0 K `1 74/5 Subtotal
(/ Minimum permit fee: $72.50 �
Phone:(5/3 ) b S _ 90 Fax:(23 ) OS -yo q
8 i.C+g Lic.: Plan review (25%of permit fee)
L G 5 7 3 A 2f'1`� Phtmbing-bic.no.: Z I,2 e5
State surcharge(12%of permit fee) ?.'76
Authorized signature: Mc.fry TOTAL PERMIT FEE i, a-0
Print name:173-SLVJ✓1ridr! Date: 7_/1 This permit application expires if a permit is not obtained within 180 days
� 1 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PmnitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7050 SW LOCUST ST, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00235
George Heimos
3/4" Febco, Model 850, Serial No. HC80955
Violation Summary:
Inspector Contractor