Permit PLUMBING PERMIT
CITY OF TIGARD
`, a _ COMMUNITY DEVELOPMENT Permit #: PLM2010 -00183
TtGt\RQ; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/09/2010
Parcel: 2S110BC11000
Jurisdiction: TIGARD
Site address: 12042 SW STRINGER LN
Subdivision: Lot: 0
Project: Bull Mountain View Estates
Project Description: Backflow preventer.
Owner: FEES
WEST HILLS DEVELOPMENT Quantity Description Date Amount
735 SW 158TH AVE
BEAVERTON, OR 97006 1 ea Backflow Preventer 06/09/2010 $31.27
PHONE: 503 - 641 -7342 1 12% State Surcharge - 06/09/2010 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 06/09/2010 $41.23
Contractor: Plumbing
TRADEMARK LANDSCAPES INC
P. O. BOX 2410
OREGON CITY, OR 97006
PHONE: 503 - 631 -3893
FAX: 503 - 631 -4737
Type of Use: SF
Class of Work: ALT 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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: - Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
JUN -07 -2010 MON 03:00 PM FAX NO. P. 02
Plumbing Permit Application RECEIVED
Building Fixtures JUN 0 8 2 � 1Q � - x 4 � 4 = r �� zz o ifr ; � . , .r ..Z , '
47 City of Tigard Rc oive4 6 $ Ponnit No.:
t• 3
.t 13125 SW 1-1a11 Blvd„ Tigard,OR 97223 CITY OF TIGAR Dat&By: 10 �
, I Re
rij M H C � Phone; 503.639.4171 Fax: 503.598.1ILDING DIVISI 0 �rm tnlOyv. iaty 1 8 Other Pcrmlt No,; p'1sT�oIU .. �y �•�(,•yP•a
Inspec Lino: 503.630,4175 Data Ready113y; 7 B! see rage 2 for "`4
9 G
;Ft A let r '-ioix9o. Internet: www.t ur.gov 13otitied/Method; SuppiementullafOrn
��1iIl l�hllf��Hf��111i�f1fl llhllllf�( �fJfiVIII (��IillllfnN�it`l�s:'�IIX' ��fh 11th [�frl�ldl�iJ(�il��l( Illl�(111 1101 l{NI1�{'I�ll�l1Eiliti ��;Mihl�a l �'�r�r��� ElMEN , fri
El New construction ❑ Detnolition For special ittformatiorr use checklist..
Description I Qty, 7 T.a Total
❑ Addition /alteration/replacomenl. ❑ Other: New 1- 2.family dwellings (includes 100 R. for each utility connection)_
������I!1 I�II�I IlJd111i1sii�EQI; y�;�tl�;i�Il����l�Jl�i`' ��Jh�l' i�i��u Jfllflll�llllllJlllhlrllll lJfllJlllillNl1J'�l SFR (1) bat,, 249.20
® 1- and 2- family dwelling [] Commercial/industrial SFR (2) bath 350.00
[] Accessory building ❑ Multi - family
SFR (3) bath 399.00
Each additional bath /kitchen 45.00
0 Master builder [] Other:
1 ANLi,1111 :.0 22fl ; ,0 1111 !u;lifilliSSIBItJNIIIIfINOOMNI Fire Paget _ utilities
iob site addres r. 12042 SW Stringer Lane Catch basin or area drain 16.60 _�
City /State /ZIP: Tigard, 0197224 Drywell, leach line, or trench drain 16.60
Footing drain (nee linear it.: ) Pago 2
Suite/bldg. /apt. no.: I Project name: Bull Mt View Estates
Manufactured home utilities 110.00
Cross street/directions to job site: Bull Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear 1i.: ) Page 2
Storm sewer (no. linear ft.; __) Page 2
Subdivision: Bull Mt View Estates I Lot no.: 8 Wntcr service (no. linear IL: _ ) _l Page
Fixture or item
Tax mop /parcel no.: 2S1. 10130 11000
Absorption valve 16,60
u n b d u �i�e e u ,�t6, a a`
ES ; HIM RRlllflll �fll flf ll�ti� iihmf,�n �� , �� �1, �ih � ��tl (11111111 l llflElllllf11111 `. Declaim presenter 1 Page 2
Back Flow Permit for bacicyard landscape Bacicwater valve 16.60
Clothes washer 16,60
Dishwasher 16.60
.IAIlBf I 8111! ANN l'e `ICI;I MEME lfl NHIll (ltlNEWIIIIJIAIIf➢ i,1fDEZI I f1111IJf11flf1flf11P ectors/suml� 16.60_
Name: West [ills Development Expansion tank 16,60
Address: 73S SW 158 Avenue Fixture /sewer cap 16.60
City /State /ZTP: Beaverton, OR 97006 Floor drain /floor sink/hub R 16,60
Phone: (503)641 -7342 Fax: (503)641 -7661 Garbage disposal 16.60
! Ck ' G110 1/ i; g all! - VIIIf��lllf� f��r 1. Ifitl i N etL ' Il k1 i °u - ll �l � c c nicker 16.60
Business name: West Hills Development interceptor /grease trap 16.60
Contact name: Miriam Wilson Medical gas (value; $ ) Page 2
Address: 735 SW 158`" Avenue Primer 16
City/Stine/ZIP: Beaverton, OR 97006 Roof drain (commercial) 16.0
Sink/basin/lavatory 16.60
Phone: (503) 726 -7033 Fax: : (503) 641 -7661 Tub/shower/shower pan 16.60
- E -mail: mwilson@arborhomes.com Urinal 16.60
I,i
1111118111I.11ARIIK � 1 �;'h �i �,15D,1[11 yc 11I P (IIN1fRMI N NII W tucr closet — 16.60
l3usincss name: Trademark Landscapes Inc Watt' heater 16,60
Address: P.O.1'3nx 2410 Other:
Subtotal
City/State/ZIP: Oregon City, OR 97006 Minimum permit fee: $72.50
Phone: (503) 631 -3893 Tax: (503) 631 -47 Residential backtlow minimum permit fee: $36.25 7a. 50
CCA Lice: 6796 is 3( // .... Plumbing Lie. no.: 2 80 Plan review (25% of permit fee) elrnr State surge (12"%of penult fee) D ^ 7()
Authorized signature n �� ` , TOTAL PERMIT FF 1 V x
Print name: Miriam Wilson Date: 10/21/08 This permit application expires If n permit is not obtained within
180 days otter It has been accepted as complete.
*Fcc methodology set by Tri- County building Industry Service Board.
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