Permit CITY OF TIGARD PLUMBING PERMIT
11111 Permit#: PLM2014-00187
• COMMUNITY DEVELOPMENT
Date Issued: 06/05/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 6/05/2 C10800
Jurisdiction: TIGARD
Site address: 9382 SW LEHMAN ST
Project: Greco Estates,Lot 3 Subdivision: GRECO ESTATES Lot: 3
Project Description: Residential irrigation backflow.
Contractor: EDWARD MULLEN PLUMBING Owner: LF 8 LLC
1601 SE RIVER RD 5285 MEADOWS RD, STE 171
HILLSBORO, OR 97123 LAKE OSWEGO, OR 97035
PHONE:
PHONE: 503-640-0113
FAX: 503-640-4483
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 06/05/2014 $31.27
Specifics: 1 12%State Surcharge- 06/05/2014 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 06/05/2014 $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: `— 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.
Plumbing Permit Application RECEUE fixture
FOR Fixtures R OFFICE USE ONLY
City of Tigard JUN - 5 2014 Received Permit No.'
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: �S//Y / / 4/y zQ/97
■ Phone: 503.718.2439 Fax: 503.598.196 ' iiu Plan Revte Other Permit Nq ��/yi Q//
DateBy: _
Inspection Line: 503.639.4175 �'yI t�{.r )� pate Ready/By: Iu ® see Pa
I ( n It I> Internet: www.tl and-or. ov `3U ILO+t`+r '�uIIc� Page 2 for
g g Notified/Method: Supplemental lnformation
TYPE OF WORK FEE* SCHEDULE
New construction • s.• olition For special information use checklist
�.. Description I Qty. I Ea. I Total
. 41°1011111'idition/alteration/replacement 7!. • : : New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF C.r. CTION SFR(1)bath 312.70
® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family - - -
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
-
JOB SITE INFORMATION AND LOCATION Site utilities: _
Job site address:9382 Lehman Street Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223 -
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Greco Estates Manufactured home utilities 50.03
Cross street/directions to job site:Greenburg Road 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: I Lot no.:3 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Irrigation-Backflow Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
El PROPERTY OWNER 1 ❑ TENANT Expansion tank 12.51
Name:LF 8,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:5285 Meadows Road Suite 171 Garbage disposal 25.02
City/State/ZIP:Lake Oswego,OR 97035 hose bib 25.02
Phone:(503)657-3402 Fax:( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:JT Smith Companies Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Wayne Pykonen
Roof drain(commercial) 12.51
Address:5285 Meadows Roads Suite 171 Sink/basin/lavatory 25.02
City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54
Phone:(503)358-8955 Fax::( ) Tub/shower/shower pan 12.51
E-mail:waynep®jtsmithco.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: The Mullen Company Water piping/DWV 56.29
Address: 1601 SE River Road Other: 25.02
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Phone:(503)640-0113 Fax:( ) Minimum permit fee: $72.50 -7a,50
Plan review (25%of permit fee)
CCB Lic.:92689 Plumbing Lic.no.:34-260PB State surcharge(12%of permit fee) r, '70
Authorized signature: TOTAL PERMIT FEE ?/,
Print name:Wayne Pykonen Date:6/4/2014 This permit application expires if a 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 1:1Building\Permits1PLMU-PermitApp.doc 10/01/09 440-4616T(IO/02/COM/WEB)
I
L
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9382 SW LEHMAN ST, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
FAIL
PLM2014-00187
George Heimos
1. back flow device, provide test results 603.3.3
Violation Summary:
Inspector Contractor