Permit u CITY OF TIGARD PLUMBING PERMIT
111I '' COMMUNITY DEVELOPMENT Permit#: PLM2014-00324
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/29/2014
Parcel: 2S109DB05900
Jurisdiction: TIGARD
Site address: 13293 SW HAZELCREST WAY
Project: Sequoia Heights,Sales Trailer Subdivision: SEQUOIA HEIGHTS Lot: 7
Project Description: Installation of backflow preventer for irrigation system
Contractor: ASHLAND BROTHERS LANDSCAPES Owner: LENNAR NORTHWEST INC
2153 MOLALLA HIGHWAY 15060 SW 133RD AVE
WOODBURN, OR 97071 TIGARD, OR 97224
PHONE: 503-981-6131 PHONE: 360-258-7900
FAX: 503-981-1058
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 09/29/2014 $31.27
Specifics: 1 12%State Surcharge- 09/29/2014 $8.70
Plumbing
Type of Use: COM 41 ea Minimum Fee Adjustment- 09/29/2014 $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 Notif 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 dire uestions to O C by calling 503.232.1987 or 1.800.332.2344.
Issu d By: Permittee Sig =lure:
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
Site Utilities 1 c71. or f r c r s ic,si,; (),:a,.‘ g
s .�. Received //,,
city Of Tigard ' Dan Rev r Permit No � NJ� ��
m 13125 SW Hall Blvd.,Tigard,OR,97223 Plan Review
Phone: 503.7182439 Fax: 503.598.1 0` Date/By: Cuba Permit No.:�f 7 7/q'_ 7 (x)1
} Inspection Line: 503.639.4175 Date Ready/By. Jwis: la See Page 2 for C
Internet. www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK -. FEE* SCHEDULE
/:,New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. ( Total
❑Addition/alteration/replacement ❑Other:
New 1-2-family dwellings(includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
1:1 1-and 2-family dwelling FR(2)bath 437.78
g ❑Commercial/industrial
----.._,__..___ SFR(3) ath
❑Accessory building ❑Multi-family � 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other Fire sprinkler( sq,ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:13293 SW Fdazeterest Way Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224
Drywell,leach line,or trench drain 18.76
r-- -- Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt_no.: Project name:Sequoia Heights Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
_ - _____.__..__._. Storm sewer(no.linear ft.: ) Page2
Water service(no.linear ft.: ) Page 2
Subdivision:Sequoia Heights Lot no.:6 Fixture or item: -
Tax map/parcel no.: Backtlow preventer 1 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Install Sprinkler System Dishwasher
25.02
___ _ Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:Lennar Custom Homes Fixture/sewer cap 25,02
Address:11807 NE 99`h Street Suite 1170 Floor drain/loon sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:Vancouver,WA 98682 Hose bib
25.02
Phone:(360)258-7870 Fax:(360)258-7875 -Ice maker 12.51
_ ® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:Ashland Brothers Landscapes,Inc_ Medical gas(value:$ ) Page 2
Contact name:Ebony Ashland Primer 12.5I Roof drain(commercial) 12.51
Address:PO Box 130
Sink/basin/lavatory 25.02
City/State/ZIP:Woodburn,OR 97071 Solar units(potable water) 62.54
Phone:(503)981-6131 1 Fax::(503)981-1058 Tub/shower/shower pan 12.51
E-mail:Sccretary@ablandscapes.net Urinal 25.02
- ,... Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Ashland Brothers Landscapes,inc. Water piping/DWV 56.29
Address:2153 Molalla Rd Other: 25.02
City/State/ZIP:Woodburn,OR 97071 _ Subtotal
Phone:(503)981-6131 , Fax:(503)981-10,8 _ Minimum permit fee: $72.50 72.50
CCB Lie.:7174 iS P b';g Lio o.y Plan review (25%of permit fee) 0
LIP' State surcharge(12%of permit fee) 8.70
Authorized sii:aturi:
_..._.._._ �'� TOTAL PERMIT FEE 81.20
Print name:Ebony Ashland Date: 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.
1:mUJding\PermnstPLMU-PermitApp doe 10/01/03 440-4616T(10/02/COM/WEa)