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Permit INCITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2017-00454 -f-t A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/01/2017 Parcel: 2S111AA11200 Jurisdiction: Tigard Site address: 9060 SW INEZ ST Project: Greensward South,Lot 6 Subdivision: GREENSWARD SOUTH Lot: 6 Project Description: Backflow preventer for irrigation. Contractor: AUSTIN BROWN LANDSCAPE Owner: GP4 LLC PO BOX 14441 PO BOX 1577 PORTLAND, OR 97293 BEAVERTON, OR 97075 PHONE: 503-887-7795 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Backflow Preventer 11/01/2017 $31.27 Specifics: 1 12%State Surcharge- 11/01/2017 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 11/01/2017 $41.23 Class of Work: OTR Plumbing 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: / -ignature: ` z ..„,..."00110,1 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 City of Tigard -oi Ate-pr.mil rri rv. `- ‘,,„t V L1,1 Received (1/1/17 it7,7_, Permit No.:fitiA14026 i 7.11:311541, U 13125 SW Hall Blvd.,Tigard, 1• • ' ' ' Phone: 503.718.2439 Fax: 503.598.1960 7111 Plan Review Date/By: Other Permit No.:(n)7- p, _a:97 7 TI GA RD Inspection Line: 503.639.4175 Nov 1 2017 Date Ready/By: Juris: gi See Page 2 for Internet: www.tigard-or.gov Notified/Method: ' ritp , Supplemental Information TYPE ()F ,OF 1"'GARD, '''. , ' , FEE* SCHEDULE For special information use checklist ONew construction u ri' ''' tiliii SION Description Qty. Ea. j Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 VI-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 El Master builder El Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION , Site utilities: 7(36 0 5. (,) -- Catch basin or area drain 18.76 Job site address: Drywell,leach line,or trench drain 18.76 City/State/ZIP: '1"- 1(...11Q,It_t i 0Q--- 9 7-27`-f Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 6r-e.. it 3w p.r-i) Lc,rfc / Q U 4-1,4- /1 k)E-1-- Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: G12.,.----L.N S C.-J(4 YUD (...,, t.t-i,( Lot no.: (.., Fixture or item: Tax map/parcel no.: Backflow preventer [ 31.27 3 I ,)--) ,,, ,,'''''',,,iwrios„0,40R1, Backwater valve 12.51 . i Clothes washer 25.02 2 pe_i(-ELL,(--) ere-'1e11/4.-iftNic- Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 - --'t3rjoitoptitiVbwisfER t.' 1f'f' ,-, 10 TEi„t'AT'''',.:,' -4" 1, Expansion tank 12.51 Fixture/sewer cap 25.02 Name: S-P-ti(±1(.),,LJ Floor drain/floor sink/hub 25.02 Address: p, 0, /s 7-) Garbage disposal 25.02 City/State/ZIP: "rbastift. - -11,...rb k...J 0 0- _ Hose bib 25.02 Phone:( .,-"3 ) 72 0 _'7L/Li .$ Fax:( ) Ice maker 12.51 la Ailp urepa, 4 4, '-',. - tfoiliAciPpEoNYt- ,,,-4 Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: Contact name: Primer 12.51 Address: IG las 004 Ve.---- Roof drain(commercial) 12.51 5.14,ff Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: ,,,,„,,,,,,,,-;,.., Water closet 25.02 "-"."'""'" Water heater 37.52 Business name: pct,t-5t_t ts.) Bi-eiLL,N...) Lioi,i OScAsi.vc..„ Water piping/DWV 56.29 Address: P 0 6.3)4 / y yY / Other: 25.02 City/State/ZIP: (F)6(2.-T-Lp,/,) 1,' (a. Cf) 29 3 Subtotal 3 /, Phone:(5j. ) 8 8a7 _---.?"?C/7 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: Plumbing Lic.no.: Authorized State surcharge(12%of permit fee) y"-- 70 signature:IZ/ 7,1v,;(7/. TOTAL PERMIT FEE < ).}0 Print name: Dir / L`/r, a.,)/y3 it/24„,) DateDate:/f_/_ /7 ,---7 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Pennits\PLMU-permjtApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: =Qty' Fie(ea)' 'otal ar `F©Oti ,`, 'Permit,Fee: site tilihes $p Footing drain-Pt 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52Va11iatIOn:, remit'Fee: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9060 SW INEZ ST, TIGARD, OR, 97224 November 2, 2017 at 12:19:46 PM Record Type: Record ID: Residential - Plumbing PLM2017-00454 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS - NoCofO Comments: 1 "Wilkins model 350, serial # A642378 Violation Summary: Inspector Contractor