Permit (184) r ,
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CITY OF TIGARD PLUMBING PERMIT
2 COMMUNITY DEVELOPMENT Permit#: PLM2018 00038
T1GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/25/2018
Parcel: 2S104AB00100
Site address: 11999 SW REDBERRY CT Jurisdiction: Tigard
Project: Riverside Homes Subdivision: PROGRESS LANDING
Project Description: Backflow preventer for water quality facility. Lot:
Contractor: TRUSCAPES INC
Owner: RIVERSIDE HOMES LLC
21600 NW AMBERWOOD DR. 17933 NW EVERGREEN PKWY STE 370
HILLSBORO, OR 97124 BEAVERTON, OR 97006
PHONE: 503-969-2144 PHONE:
FAX: 503-531-9216
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 01/25/2018 $31.27
Specifics: 1 12%State Surcharge- 01/25/2018
Plumbing $8.70
Type of Use: SF 41 ea Minimum Fee Adjustment- 01/25/2018 $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:
Permittee Signature: _ `
-
Call 503.639.4175 by 7:00 a.m,for the next available inspec ion 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 i '
Building Fixtures '
FOR OFFICE I;SE ON1.1'
City of Tigard 14iN 2,a /...,,tt Received
II 41 13125 SW Hall Blvd.,Tigard,OR 97223 ,,JAW/By: y
.j/t r - Permit No.: /1 ��tiie= Phone: 503.718.2439 Fax: 503.598.1960 - ' ')y a )•. Y '� nRevie ®"G.L
Inspection Line: 503.639.4175 Other Permit No.:
TIC�nRI� '^�
Internet: www.tigard-or.gov F , '' + heady/By Juris: Supplemental See Page 2 for
. : Nohfied/Method:
'� � ' 4 i A# : F �,r � � - Information
OWNew construction ❑Demolition For specialinformationinformation use checklist
❑Addition/alteration/replacement Description I Qty. I Ea. I Total
❑Other:
New 1-2-family dwellings(includes 100 ft.for each utility connection)
' s s r SFR(1)bath 3 2.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath500.32
❑Master builder 5 Other: 51,I VIA(il l I" EEach additional bath/kitchen25.02
WC: §, • Fire sprinkler( sq.ft.) Page 2
4 a .1 " z; ,t .
�.� Site utilities:
Job site address: ' Catch basin or area drain
'N /� j , 1, '. : .
City/State/ZIP: Drywell,leach line,or trench drain ,
T-, 4✓P1✓ci ).)-)-3Suite/bldg./apt.no.: I Project name: /� Footing drain(no.linear ft.: ) Page
/ +L'- /S. j, j Manufactured home utilities j 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
Subdivision: Water service(no.linear ft.:_) Page 2
Lot no.: Fixture or item:
Tax map/parcel no Backflow preventer 31.27 -7
i 7-
'I �z� a -(.1111 l`t, , r -"� � .
y •,. Backwater valve
5 �`, Clothes washerIIIIII 25.02
Lam\1� v • (1.�.
\ (A'Vtat-0\A\ i 1,,i c_4‘1, i 1 1' Dishwasher
I
Drinking fountain 25.02
Ejectors/sump I
twtit r3 2 .4. ',' aia 14 t t,.Y :Expansion tank 12.51
Name: 7 1 V t.v c,'‘.L 1, I r yt--vt,� Fixture/sewer cap 25.02
Address: ('�1 y��� t1tl z. s1 Floor drain/floor sink/hub I
't Pc--1(1 w Garbage disposal 25.02
City/State/ZIP:
Phone:( �(j 1 - Hose bib25.02
5fl, ) 3 )1 y, Fax ( )
Ice maker 12.51
� `` � t 11 �i ,. - : t
� � Interceptor/grease trap 25 1
Business name: Medical gas(value:$ ) Page 2
12.51
Contact name: Primer
Address: Roof drain(commercial) 12.51
City/State/ZIP:
Sink/basin/lavatory 25.02
Solar units(potable water) 62.54
Phone:( ) I Fax::( ) Tub/shower/shower pan 12.51
E-mail: h - ,) Urinal 25.02
.. , ::, Water closet 25.02
Business name: r-ti.5 L L S Water heater 37.52
Address: .2(4,.2(4,00� �0 NN( �n`Ao Waterpiping/DWV 56.29
gq� �� Other: 25.02
K
City/State/ZIP: u.,930+2U1 oz. Ii[ J L
7" �'T Subtotal R%.47
Phone:q(5) 93t,12,1 le Fax:( ) Minimum permit fee: $72.50
CCB Lic.: !�� "
1RtQ'� Plumbing Lic.no.: Plan review (25%of permit fee) ---
Authorized signature: State surcharge(12%of permit fee)
'''.\5
)� TOTAL PERMIT FEE 8 j
Print name: \5 kc /\ C-1 y,,)Lt'1 Date: I I Z t-1 / 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-PerntitApp,doc 10/01/09 440-4616T(10/02/COM/WEB)