Permit 111 CITY OF TIGARD PLUMBING PERMIT
I COMMUNITY DEVELOPMENT Permit#: PLM2020-00049
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/29/2020
Parcel: 2S101 DD00500
Jurisdiction: Tigard
Site address: 6755 SW SANDBURG ST
Project: Reece Security Subdivision: SALEM FREEWAY SUBDIVISION Lot: 2
Project Description: Installing Backflow preventer for landscape irrigation.
Contractor: CREEKSCAPE DESIGN LLC Owner: REECE HOLDINGS LLC
4305 SW 185TH AVE 25977 SW CANYON CREEK RD, STE E
ALOHA, OR 97078 WILSONVILLE, OR 97070
PHONE: 503-572-5589 PHONE:
FAX: 503-336-0198
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 01/29/2020 $31.27
Specifics: 1 12%State Surcharge- 01/29/2020 $8.70
Plumbing
Type of Use: COM 41 ea Minimum Fee Adjustment- 01/29/2020 $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 les adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090.; You obtain a copy of the rules
or direct questions to OUNC by calling 503.232.198 .
Issued By: Permittee Signature:
v
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 4 FOR OFFICE USE ONLY
City of Tigard JAN I Received l A'1� ,_
202 Date/By:
- 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review _Z /
Phone: 503.718.2439 Fax: 503.598 1.0 + =ra P?it DateBy: ° ��n/L .7
T I G A R D Inspection Line: 503.639.4175 B U s e E J; .,' EE;'`J! i U N Date Ready/By: Juris: Q See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
A New construction El Demolition For special information use checklist
Description _Qty. Ea. Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El1-and 2-family dwelling ❑,Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family -
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: Catch basin or area drain 18.76
,. -. .0 / Drywell,leach line,or trench drain 18.76
City/State/ZIP: ri C.oxyzip a yt.. el sit3
7 2 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: 2C.e.c.. see-iv-try Manufactured home utilities 50.03
Cross street/directions to job site: `'' Manholes 18.76
S1-,i I ZAP, /t 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: 1 Lot no.: , ixtureeritexl:
Tax map/parcel no.: eackflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
- Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER El TENANT Expansion tank 12.51
Name: In Fixture/sewer cap 25.02
�(' _k� ` c t_ Floor drain/floor sink/hub 25.02
Address: 2_S c/ S CANIfJN �1s1'T'�- r4-0 Garbage disposal 25.02
City/State/ZIP:' L.I,L... ,A Ul L-t- OS' / 0-7 h Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: t S - - ,/ Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: VA .'to %. " Roof drain(commercial) 12.51
Address: M1 aS sL.! t tS14 Ate Sink/basin/lavatory 25.02
City/State/ZIP: Al V v� b . 'j Z i' Solar units(potable water) 62.54
Phone:(S D))S12..S V f Fax::( ) Tub/shower/shower pan 12.51
E-mail:3 UM a ego!►CONTRACTOR, ->•f-*r_,r. ,/ . Urinal 25.02
Water closet 25.02
° 1= � Water heater 37.52
Business name: t ;i -4G" ` Y ��. ,�i , LL. Water piping/DWV 56.29
Address: 'f 3 aS 54j f 4S'1-14 Other: 25.02
City/State/ZIP: c4 t,.p- -,r t f ?� '°I-eV Subtotal
Phone:46o3 ) s �C _ s Fax:( )
Minimum permit fee: $72.50
g a. t, Plan review (25%of permit fee)
CCB Lic.: L(' ¢ ' ;(, i" Plumbing Lic.no.:
V State surcharge(12%of permit fee)
Authorized signature: / TOTAL PERMIT FEE
Print name: 1V^w /����L✓ t Date: �2 g ZQ 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\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)