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Permit / 7/n ; CV c re. i n CITY OF TIGARD PLUMBING PERMIT 1 1- COMMUNITY DEVELOPMENT Permit #: PLM2011 00244 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/27/2011 Parcel: 2S112CC04501 Jurisdiction: Tigard Site address: 15800 SW 80TH AVE Project: SCHERNER Subdivision: Lot: Project Description: Backflow for irrigation. Contractor: OREGON LANDSCAPE Owner: SCHERNER, JOHN A/ANN P PO BOX 1265 15800 SW 80TH AVE CLACKAMAS, OR 97224 TIGARD, OR 97223 PHONE: 503 - 855 -4976 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Backflow Preventer 07/27/2011 $31.27 Specifics: 1 12% State Surcharge - 07/27/2011 $8.70 Plumbing 41 ea Minimum Fee Adjustment - 07/27/2011 $41.23 Type of Use: SF Plumbing 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. OP Issued By: - mittee Signature: ( /�9 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 PLUMBING PERMIT ' `` COMMUNITY DEVELOPMENT Permit #: PLM2011 -00244 - 11 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/27/2011 Parcel: 2S112CC04501 Jurisdiction: Tigard Site address: 15800 SW 80TH AVE Project: SCHERNER Subdivision: Lot: Project Description: Backflow for irrigation. Contractor: OREGON LANDSCAPE Owner: SCHERNER, JOHN A/ANN P PO BOX 126 15800 SW 80TH AVE CLACKAMAS, OR 97224 TIGARD, OR 97223 PHONE: 503 - 855 -4976 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Backflow Preventer 07/27/2011 $31.27 Specifics: 1 12% State Surcharge - 07/27/2011 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment - 07/27/2011 $41.23 Plumbing 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 -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: "ermittee Signature: f �•" �// - sue_ Call 503. 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. Jul 26 11 08:44a Tony & Kelli Iranshad 503 -558 -9077 p.1 Plumbing Permit Application $\\'5;C) . Building Fixtures FOR OFFICE USE ONLY City of Tigard I � � Received PermitNo.: 13125 SW Hall Blvd., Tigard, OR �' �� ® DateI ' �/� 1" ' pert A011_0o , l-1 M ill tan Rewew f Phone: 503.718.2439 Fax: 503.5 x]460 �� � OtherPernutNo.: telly: Inspection Line: 503.639.4175 , t\ TIGARD < P J i ea : Page 2 for Internet: www.tigard- or.gov V iti Supplemental . .... ..... .. .c un Sup ple • . .. - _ _. . - . . • • . :.;:: - ::: +TYPE: °:- -° G�jti - .k'E)E� CHC1aULE : t .. - 'l t e[ o � • New construction 6w F special in ornration use checklist ❑ ❑ Demolitu P f Description 1 Qty. Ea. I Total ® Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) " CORY: CS7N . . RUCTION SFR (1) bath . ..:: .... :.:. C.ATE 312.70 ® I- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 ❑ Accessory building 1:1 Multi-family SFR (3) bath 500.32 Each additional bath /kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB S1TR I .. ;NIORl'IATO1 'Ah L , O_CATIO N ;, • - Site utilities: Job site address: 15800 SW Se Ave Catch basin or area drain 18.76 City/State/ZIP: Tigard, OR 97224 Dryw"ell, leach line, or trench drain 18.76 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: 1 Project name: se n h exy,re,r- Manufactured home utilities 50.03 Cross street/directions to job sire: SW Bond St 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: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 :... p -, E :::WORK _ _ _ 5CRI1'TIONOF_.. _ . Sprinkler System Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 ' Ejectors /sump 25.02 IE1 P ROPERTY`" OWR I :- '-, - 0 TENANT Expansion tank 12.51 Fixture /sewer cap 25.02 Name: Amy Schemer _ Floor drain/floor sink/hub 25.02 Address: 15800 SW 80 Ave Garbage disposal 25.02 City /State /ZIP: Tigard, OR 97224 Hose bib 25.02 Fax: ( ) Ice maker 12.51 r. . - :< - . Interce tar/ reaset ... " -, . APPLICANT • - .: '):. - . : _. ..a w� " PERSpN ':':..:.. P g P 25.02 Business name: Oregon Landscape Medical gas (value: S ) Page 2 " Primer 12.51 Contact name: Mike Meyer Roof drain (commercial) 12.51 Address: PO Box 1265 Sink/basinllavatory 25.02 City /State /ZIP: Clackamas, OR 97015 Solar units (potable water) 62.54 Fax: : ( ) Tub/shower /shower pan 12.51 • • E -mail: mikem_olcn"yahoo.com Urinal 25.02 er [':•.: :, -. -_ .eiDNTRACTOR - s ..- . ;•� _ _ .. _. ' ' ' - ;. : _ Water heater 37.52 Business name: Oregon Landscape Water piping/DWV 56.29 Address: PO Box 1265 Other: 25.02 City /State /ZIP: Clackamas, OR 97224 Subtotal 3I.27 Fax: ( ) Minimum permit fee: $72.50 72.50 CCB Lie,: LCB 1#8864 0/ Plumbing Lie. no.: ....,,, State surcharg (12 of per fee) 8.70 Authorized signature: TOTAL PERMIT FEE 81.20 Print name: Mike Meyer Date: 07/25/11 This permit application expires ifa 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:\ auildif ,PerrniatPLMU- PennitApp.doc IO/Ql,' 9 440- 461FT(10 /02/COIVWEB)