Permit CITY OF TIGARD PLUMBING PERMIT
• COMMUNITY DEVELOPMENT Permit #: PLM2013 -00130
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/23/2013
T [ C;.A.R.O 9 Parcel: 2S109DA15300
Jurisdiction: Tigard
Site address: 15337 SW GREENRIDGE PL
Project: Arlington Heights No. 3, Lot 72 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 72
Project Description: (1) backflow device for new SF
Contractor: LANDSCAPE OREGON, INC. Owner: STONE BRIDGE HOMES NW
PO BOX 2386 4230 GALEWOOD ST SUITE 100
TUALATIN, OR 97062 LAKE OSWEGO, OR 97035
PHONE: 503-692-5945 PHONE: 503 - 387 -7577
FAX: 503 - 692 -0768
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 04/23/2013 $31.27
Specifics: 1 12% State Surcharge - 04/23/2013 $8.70
Plumbing
Type of Use SF 41 ea Minimum Fee Adjustment - 04/23/2013 $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: (( , j 6 f Permittee Signature: 111 1 ,Q PP/ i C 4 . U
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.
1 Permit ADplicati n
0F1
ECElVED
Building Fixtures APR 2 3 2013 FOR OFFICE USE ONLY
City of Tigard CITY OF TIGARD Received P�i= P( 3 - m / 3a
• Date,'By: Y-3 r 3
131_5 STti''1311 Blvd.. Tigard, OR 5441i n
g Phone- 503.7 :8.2439 Fax: 93.ING DIVISION P ion 3 eview Other Permit 1do, :u S7 'DD
Date./3y: inspection Line: 503.539.4175
Internet: wtv x.ti aryl- Or.gov Dam Rndv /Py l I S ental Info See Page 2 fur
: :_ g Ie tl p4 Supplemental motion 1
ar . • td ��f ft ( !
' ; -. a - T VA W014 1. N c f a- : �r L+ �tt,•
e
� S m
444 N .� - -:_ :i �.E� .u..� '
® New mnstuction r ❑ Demolition For special information use checklist
Descrintion 1 Qty 1 Ea. I Total
Addition /alteration :replacement l ❑ Other. . - _ w
�f New 1 2 family dwellings (includes JOG ft, for each utility connection)
A ": 2l.l l• � te :c er ne , - ielsi xt O1t'CQ N STRiidraiii 1 , SFR (I; bath I I 312.70
® 1- and 2- family dwelling ❑ Commerial /industri SFR (2) bath 477.78
I] Accessory building ❑ Multi - family SFR (3) bath , 500.32
Bach additional bathlldtchen 25.02
Master builder ❑ r Site utilities:
Other: F -
z -a , ^_ F c ue sprinkler ( sq. ft) Page 2
Es t . ; �a ; t -r s iOE SIT,ta p$rO tT Arti E1)C1.r101 l ti 4 . ; `'rw .0 l „
g02s�Fsip•�uy�ll w , .. 1 iii ,4 . . h.
Job site address: / S 3 3 7 G,2 e r l' ,.ei t . Peeez <'_ Catch basin or area drain ( 18.+6 I --
_ C1tY Ze: '7 1 4�"CL -1.CL e-) /z_ z l 7 ZL� Drywall, Inch line, or trench drain 1 8. ?6
✓ /��� Footing drain (no. linear ft.: _) Page 2
Suite/bklg/ap_. no.: I Project name: / " I Li19 /V1•1 e - Mandacte ed home utilities 50.03
Cross streeb'directions to job site: Manholes 18.76
ate /yutilt° /ti( >ra- L ? Bahl drain connector 18.76
Sanitary sewer (no. Iincar ft.:" Page 2
1
Storm sewer (no. linear ft.: _ Page 2
Water service (no linear P-: _ i I 1 Page 2
Subdivisio r: ) l y? L` f - ry Lot r.c Z
Fixture J � � �� Fixt or Item:
Tax map/par el no (j T Bacidl�w
e t x 1 31.27 31.27
valve T)ESCRIPTIa]Y OF WQRK' , Backwater 1 1151
Clothes washer 25 Landscape Irrigation Back Flow Device
Dishwasher 25.02
Drinking fountain I 25.02
Ejectotsrsump 25.0..''
r4ir „� PRERTY Q�k DER 4 TENAsir ' Expansion tank 12.51
r e
p..: - OP - _: . 444
Name: Stone Bridge Homes ?,V4' LLC Fixttudsewer cap 25.02
Address: 4230 Gnlewood Street Suite 100 f
Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City /State/ZIP: Lake Oswego. OR 97035 lose bib 25.02
Phone: ( ) I Fax ( ) Ice maker 12.51
i � ' t �k 1 A .0.1- C4NT r 1 : n ,2 _ t . !- CONTACrr rFasON Irserceptodgrea�se trap 25.02 f
44 - . _
Business name: Landscape Oregon. Inc. Medical gas (value: S ) Page 2
Contact name: Ellen Sparrow Primer 12.5]
. Roof drain (commercial) 12.51
Address: P.Q. Box 2386 Sinkfbasinflavatoty J 25.02
• City'State2IP: Tualatin, OR 97062 Solar units (potable water) 62.54 ,
Phone: (503) 692 -5945 i Fax:: (503 -) 692.0768 1 Tub/shewen'shower pan 12.51
E-mail: ellen@Jandscapeoregon.com Urinal 25.02
I
t a» m rr w g water closet l 25.02
.: gi .� l i t t £
ra e- y.. » : 5:Si'I A oli r kite l I lnit � r #- „ :0 i
�+ " water heater 37.521
• Business name: Landscape Oregon, Ina Water piping DRn' I 1 56.29
Address: P.O. Box 2386 Otcex: I 25.02 ff
City/State/ZIP: Tualatin, OR 97062 Subtotal 31.27
Phone: (503) 692 -5945 Fax: (503) 692-0768 Minimum permit fee: 172.50 ;2.50
CCB Lie.: LCB 7804 { Plan review (25% of permit fee)
Plumbing Lic. no.:
I
Authorized signat State surcharge (12% of permit fee) 8.70
ure: ......... 'L .. � TOTAL PERMIT FEE , 81•20
t
Pant name: Ellen Sparrow Date. This permit applicadon capita if a person ii not obtained wttani 180 days
1
after it has been accepted as complete.
"Fee methodoiogy set lri Tri- County Building 'Murry Scrricc Board
I. knuildia6 J4r=ks PIJdlrPeaai; I C if.79 44y sin 1 DrtVCON1wF141
£'d 89LO Z69 Uell3 e9£ 80 CI. 8Z Ay
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15337 SW GREENRIDGE PL, TIGARD, OR,
97224
Residential - Plumbing
399 Plumbing final
05/28/2013 00:00
PLM2013-00130
PASS - No C of O
1" Wilkins model 350, serial no. A252825
Violation Summary:
Inspector Contractor