Permit Support Document (66) CITY OF TIGARD III , � PLUMBING PERMIT
a COMMUNITY DEVELOPMENT �'� ? b` � �� Permit#: PLM2018-00094
T f c;A I<.i) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 y a ( ' Date Issued: 03/08/2018
j i Parcel: 2S110AD11000
Jurisdiction: Tigard
Site address: 10993 SW ANNAND HILL CT
Project: Annand Heights Subdivision: ANNAND HEIGHTS Lot: 12
Project Description: Irrigation Backflow. 3/26/18:REPRINT to change address.
Contractor: CONTOUR LANDSCAPING Owner: WINDWOOD CONSTRUCTION INC
12485 SW TOOZE RD 12655 SW NORTH DAKOTA ST
SHERWOOD, OR 97140 PORTLAND, OR 97223
PHONE: 503-682-1302 PHONE:
FAX: 503-682-1302
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 03/08/2018 $31.27
Specifics: 1 12%State Surcharge- 03/08/2018 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 03/08/2018 $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:
A% ` Permittee Signature: /1C^�Jil
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.
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10993 SW ANNAND HILL CT, TIGARD, April 6, 2018 at 9:36:12 AM
OR, 97224
Record Type: Record ID:
Residential - Plumbing PLM2018-00094
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
1 " Febco backflow device model 850 ser#56056 Approved with test report.
Violation Summary:
Inspector Contractor