Permit CITY OF TIGARD PLUMBING PERMIT
11 1 I: COMMUNITY DEVELOPMENT Permit #: PLM2012 -00330
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/14/2012
Parcel: 2S109AB16000 •
•
Jurisdiction: Tigard
Site address: 13332 SW PIPIT LN
Project: Alpine View, Lot 41 Subdivision: ALPINE VIEW Lot: 41
Project Description: Installation of residential backflow preventor for irrigation.
Contractor: ASHLAND BROTHERS LANDSCAPES Owner: LENNAR NORTHWEST INC
2153 MOLALLA HIGHWAY 12013 NE 99TH ST #1650
WOODBURN, OR 97071 VANCOUVER, WA 98682
PHONE: 503 - 981 -6131 PHONE: 360-258-7900
FAX: 503 - 981 -1058
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 11/14/2012 $31.27
Specifics: 1 12% State Surcharge - 11/14/2012 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment - 11/14/2012 $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: Permittee Signet • - .
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Call CaII 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.
Nov 14 12 07:45p Ashland Brothers 503 - 981 -1058 p.3
1
Plumbing Permit Applicati oR ECElVE 1 FOR OFFICE USE ONLY
3 1 12 25 5 SW H all B Tigard, OR 9823 1 2 012 D tdB I! '`/ /� ' knit No.: i f a�G✓�? -W . ; 30
NOV 4 f��Y
: g ' Phone: 503.6394171 Fax: 503598 Pfau Review Other Permit No.:
in Lute: 503.639.0 17S
OF TI R ) D at erRe:
T 1 GA:: U Dace Ready/By: lark H Sce Page 2 for
Internet: www.ti BUILDING VIVISION Notified/Method: uppl �orma
Supplemental
TYPE OF WORK FEE SCBEIO
ai New construction ❑ Demolition For special iofor oausechecklrst.
Description 1 Q
❑ Addition/alteration/replacement ❑ Other. y 1 1 T
New 1- 2.O �tlly dwellings (includes 100 (t for each utility canude cn)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
2g.1 and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
Q Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bah/kitchen 45.00
❑ Master builder 0 Other Fire sprinkler ( so. R) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities I
Job site address: 1 3 52- S1JV 1 , p T LFf N t= Catch basin orarea drain 16.60 I
City/State/ZIP: 2Z Drywell, leach line. or tree h drain 16.60
,,bi G� ��1 4
Suite/bldg. /apt. no.: f Project namez A' L r'1( rS.1-�.4-e Footing drain (no. linear R :�-,) Page 2
�' /; Manufactured home utilities 110.00 '
Cross street /tbrections to job site: 3GO p 1 N cu., 4 r 4- ti7a 1� ^ Manholes 16.60
l Rain drain connector 16.60
Sanitary sewer (no_ linear ft.: ) Page 2
Storm sewer (no. linear ft.: _J Page 2
Subdivision: 1-ot no.: L..//
Water service (no. linear ft: _) Page 2 It
Tax map /parcel no.: Fitdtrre or item II
• Absor valve J 16.60 1
DESCRIPITON OF WORK Baddlow preventer Page 2
w'+R
!�C� Suave- t , t le t 1tQ•1� Backwater valve 16.60
Clothes washer 16.60
' Dishwasher 16.60: I
gr Drinking fountain 16.60
PROPERTY OWNER I TENANT Ejectors/sump 16.60
Name: L._e rA*Q_ 1 'l--S • Expansion tank 16.60
Address: 1/0 tmQy1- k-c.t. Ao O. So At. 3oto FixtureJsewer cap 16.60
City/State/Z1P: C `' 4 2,815 Floor drain/floor sink/hub 16.60 I
Ph("ne: 1 ...7 3( -En' 0 Fax: awe-s cal- Garbage disposal 16.60 I
gj Hose bib 16.60 If I
APPLICANT ["CONTACT PERSON [a maker 16.60 I'
Business name: A51r‘‘o•tnQ (3 S !s
` Interceptor/grease trap 16.60 .
Contact name: �1ra� j 1,1 `' � c , / Medical gas (value: S ) Page 2
Address: $3 t M 01 a ii ,.. /4 Primer 16.60
City/StatetZIP: (,jjtx b✓rr1 170 Roof drain (commercial) 16.60
Phone: (03) /f, •-•41, i S f I Fax; ; szi3) awn- J OS-8' Sink/basin/lavatory 16.60
Tub/sbower /shower pan 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet .16.60
Businessnarne: 1Q'6t1,„, 6rosrizei L is . Water heater 16.60
Address: o f AA-3 :4 ti. r f1 pa Other I
City /State/ZIP: ,d„ ,„ q/{ t 02_ CJ al r _ Subtotal �>� O
Minimum permit fee: 57230 �/���� q S
Phone: (no) 987 - lie 131 Fax $V 3) I ri --/Orr • Residential backflow mininmm penult fee: $ 36 . 25 ACS` oT
CCB Lic.: "7 ( ei Plumbing Lic. no. ' _ . _ Plan review (25% of permit fx) a '!
AulhaiZed Signa[lltt : State surcharge (8% of permit fee) ' �6
l ►
A." .-,.
."- r TOTAL PERMIT FEE 31�.v- y ()
0 1 Print name: T ~ � ‘ Ark t, 0 Date: )1- I), 7, This permit application expires if a permit is not obtained within 0 i •
180 days after it has been accepted as complete.
• ' methodology set by Tri-County Building Industry Service Board.
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