Permit CITY OF TIGARD PLUMBING PERMIT
to COMMUNITY DEVELOPMENT Permit#: PLM2013-00296
•
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/26/2013
Parcel: 2S109DA18900
• Jurisdiction: Tigard
Site address: 12687 SW CANYON RIDGE CT
Project: Arlington Heights No.3,Lot 118 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 118
Project Description: Backflow for irrigation.
Contractor: LANDSCAPE OREGON, INC. Owner: STONE BRIDGE HOMES NW LLC
PO BOX 2386 4230 GALEWOOD ST,STE 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 08/26/2013 $31.27
Specifics: 41 ea Minimum Fee Adjustment- 08/26/2013 $41.23
Plumbing
Type of Use: SF 1 12%State Surcharge- 08/26/2013 $8.70
Class of Work: ALT
Plumbing
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 B / Permittee Signature:
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.
i
Plumbin Permit A licati
Building Fixtures ��L
City of Tigard AUG 2 2 2013 >:ee:i�,ed FOR ohhle r' use: ONLY
i�%` 13125 SW Hail Blvd Tigard,OR 59;2 2.3
Phone: 503.718.2438 Fax; 503.598
D.../By: .2//- ,�j PermitNo.;
T r ;n RD Perdon Lice 503.639.4175 OF TIGARD Ptntt Rcview �, `
Internet www.tiga 3.639ov BUILDING DIVIS100 Other PermitNo.: '
Notified/
. � .:_._.= .. � etlrod:
runs: 1a See Page 2 for • •t 0
TYPE OF WORK ..•New construction = S...lemma!Information
❑Demolition FEE*.SCgEOULE
❑Addition/alteration/replacement acement For ,ecfaf in ormatron use checklist
Other:
a•tioa
CA New 1.2-famil Total•
...._ -:_. TZ ORY OF.CD y dwell( ••amity dwelling NUON:: SFR(])bath s(includes 100each ittili corm(ctioa)
® !-and 2•f
❑Commercial/Indust-la;ria7 312.70
❑Accessory building � 2
D Master builder
CD Multi-family
❑Other: � 50032
Job site'add _ 25.02
Tess: �,�� 7 �`��-LOCATION:``_�City/State/ZIP:ty/State/ZIP: LA�:�< < �/ C �y- Catch basin h area drain
SuitefbldgJapt.no.:/` c` �c( C �L �� :3,...a.."
Drywell,leach line,or(tench drain ���
Footing drain(no.Baez:ft.:`� 111111111223
Cross street/directions to job site:
Manufactured home utilities Mill Manholes 50.03
Rain drain connector 11111111111/ 1
-
Stormsaaer(ao.linearR:_`)
Tax map/parcel no.: �-- � � �
::'•= ,_ •:;.''..•.;.•:::.• 'DESCFt mcw-• g WO Ba lnvate prevcater ��
Backwater valve x
Landscape Irrigation Back Flow Device � -
Clathaa washer _
Dishwasher 25.02
Drinking ish s fauatain MI 25.02 Mill
. .� PROPER Ejectors/sump 25.02 MIN
Name:Stone Bride .❑ rzirAN3. ' ,. 25.62 1
S Homes NW LLC .. ���
Address:42.30 Gal.wood Street Sutra Ion
Facttrre/sewer cap
City/State/ZIP: Floordmia/floor sirtk/hub 25.02 MUM
Lake Oswego,OR 97035 25.02 IMMO
Phone:( ) Garbage disposal
Hose bib 25.02
.:`:= ; �. PLICZ 25.02 UM•
Business name:Landscape •co rm.-4- PERSON
pe Oregon,Inc. dt3rease trap _
Contact name:Ellen Sparrow
25.02 EMI
_��
Address:P.O.Box 2386
IIEGIIIMIII
Ci /Stet Roofdnun(colam l)
n' �:Tualatin,OR 97062
Phone:(503)692-5945 Solar units _ 25.02
Fax::(503-)092.0768 (potable water)
E-mail_elien@landscape0regomeem
1. ���MIMI
,.,.__.�... .roAChOR. - 25.02•
iusiness name:Landscape Oregon,Inc. �yaterhurc 25.02
ddrtss:P.O.Box 2386 ���
'ity/State/ZIP:T Waterpiping/Dyyy _��EMI
aalatia,OR 97062 Ocher
none;(503)692-5945 25.02
Fax (903)692.0768 Subtotal ' 31.27
CB Lie.:LCD 7804
Plumbing Minimum permit fee: 572.50 72.50
uthoitzed signature.;-4.: g Lie.no.:
( � __v )!i `�.t State simharge(]29;of
in:name:Ellen Sparrow Permit fee) 8.70 L.
Date® Thls perrett a Ileadem TOTAL PERMIT FEE 81.20
PP explres.if a Permit Ic not
n7dma per�;t tp utter it yes been accepted ebralaed within 180 days
t APP•dot fOrolro9
'Fee methodology set by Tri-(guy Building Industry Service Board.
L aged 89LOZ69£05 'Dul uo6a.ip adeospuel 1,1`d8E:0 1 E 1.OZ ZZ 6ny