Permit CITY OF TIGARDPLUMBING PERMIT
1111COMMUNITY DEVELOPMENT .4 Permit#: PLM2016-00257
Date Issued: 05/13/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 136AA10900
Jurisdiction: Tigard
Site address: 6695 SW LOCUST ST
Project: Oak Street Estates,Lot 12 Subdivision: OAK STREET ESTATES Lot:
Project Description: Irrigation backflow. 5/26/2016: REPRINTED to correct address.
Contractor: PACIFIC LANDSCAPE SERVICES INC A WASHINGTC Owner: LENNAR NORTHWEST INC
PO BOX 821903 11870 NE 99TH ST, STE 1170
VANCOUVER,WA 98682 VANCOUVER,WA 98682
PHONE: 360-891-0367 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 05/13/2016 $31.27
Specifics: 1 12%State Surcharge- 05/13/2016 $8.70
Plumbing
41 ea Minimum Fee Adjustment- 05/13/2016 $41.23
Type of Use: SF Plumbing
Class of Work: NEW
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: v.�___ Permittee Signature: //1/6—
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.