Permit (39) CITY OF TIGARD PLUMBING PERMIT
111 ' ' COMMUNITY DEVELOPMENT Permit#: PLM2019-00250
Ti(;A R p 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2019
Parcel: 2S106DA12200
Jurisdiction: Tigard
Site address: 16551 SW SNOWDALE ST
Project: Speed Subdivision: RIVER TERRACE EAST Lot: 122
Project Description: Backflow preventer for landscape irrigation.
Contractor: DENNIS SEVEN DEES LANDSCAPING Owner: SPEED, KRISTEN&PAUL
7355 SE JOHNSON CREEK BLVD 16551 SW SNOWDALE ST
PORTLAND, OR 97206 BEAVERTON, OR 97007
PHONE: 503-777-7777 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 06/17/2019 $31.27
Specifics: 1 12%State Surcharge- 06/17/2019 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 06/17/2019 $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 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:
SCC 40.�G�/`
GlvVl
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
Site Utilities RECEIVED FOR OFFICE USE ON)L�Y.'/C [^�
City of Tigard Received O' /7 / ��OC� / (/62JV
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: (� `
■ Phone: 503.718.2439 Fax: 503.598.196JUN 13 2019 Date/By:Plan view Other Permit No.:
T I(,n R p Inspection Line: 503.639.4175 Date Ready/By: Jur s: ® See Page 2 for
Internet: www.tigard-or.gov _CITY OF TIGf1RD Notified/Method: Supplemental Information
®
,OF ILDING DIVISION i v z'
❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ®Other:Landscaping New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION = Site utilities:
Job site address:16551 SW Snowdale Street Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Beaverton,OR 97007
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Kristen Speed 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 31.27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
install backflow preventer
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 1 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 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
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Dennis'7 Dees Landscaping,Inc. Water piping/DWV 56.29
Address: 7355 SE Johnson Creek Blvd. Other: 25.02
Portland,OR 97206
City/State/ZIP: Subtotal 31.27503.777.7777 fax 503.777.2399
Phone:( ) garyt@dennis7dees.com Minimum permit fee: $72.50 72.50
CCB Lic.:
lcb:5009 plumbing Iic:05LIBDl metro:1478 Plan review (25%of permit fee) 0
State surcharge(12%of permit fee) 8.70
Authorized signature: ;/' ip� TOTAL PERMIT FEE 81.20
Print name: 'r i1( of
Date: //� C -)C This permit application expires if a permit is not obtained within 180 days
Y I� l 1 q ����,,II fl la- after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Pennhs\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)