Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2014-00408
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/12/2015
Parcel: 2S110BC11600
Jurisdiction: TIGARD
Site address: 12303 SW WINTERVIEW DR
Project: Troy Park,Lot 2 Subdivision: TROY PARK Lot: 2
Project Description: Backflow for irrigation.
Contractor: TRADEMARK LANDSCAPES INC Owner: PRESTIGE INVESTORS LLC
PO BOX 2410 12670 SW 68TH AVE#300
OREGON CITY, OR 97006 TIGARD, OR 97223
PHONE: 503-631-3893 PHONE:
FAX: 503-631-4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 01/12/2015 $31.27
Specifics: 1 12%State Surcharge- 01/12/2015 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 01/12/2015 $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.
`511111.1 � c
Issued By: Permittee Signature:
ilkat 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 I (1IZ (11 1 I1 I I .I (1.I ,
Ci},�,of Tigard Received
City g pate/g Permit No.:
i y !pt Q��y /61124 fit!Y>Dil
13125 SW Hall Blvd.,Tigard, Plan Review /�7 _
= Phone: 503.718.2439 Fax: 50 .5 at 3 0 2014 �y Other Permit No.:�S7-�?n/ir c )209
Inspection Line: 503.639.4175 Date R /B J aP'
I I C,A R[) Ready/By: Juris 65 See Page 2 for
Internet: www.tigard-or.gov
(�( Notified/Method: Supplemental Information
`1 I TPE OF WOGI Fl SCHEDULE
®New construction i,1' -‘1, 1 on For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSi'RUCTIONi SFR(1)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
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:12303 SW Winterview Drive Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_ ) Page 2
Suite/bldg./apt.no.: ( Project name:Troy Park Lot 2 Manufactured home utilities 50.03
Cross street/directions to job site:Bull Mountain Rd. 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:Troy Park I Lot no.:2 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
Single Family Residence
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
z PROPERTY OWNER f ❑ TENANT Expansion tank 12.51
Name:Timberland Homes,Inc. Fixture/sewer cap 25.02
Address:12670 SW 68th Ave.,Suite 300 Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:(503)620-8860 Fax:(503)598-9081 Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:Timberland Homes,INc. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Laura Blake
Roof drain(commercial) 12.51
Address:12670 SW 68th Ave.,Suite 300 Sink/basin/lavatory 25.02
City/State/ZIP:Tigard,OR 97223 Solar units(potable water) 62.54
Phone:(503)620-8860 Fax::(503)598-9081 Tub/shower/shower pan 12.51
E-mail:laura @timberlandhomes.net Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Trademark Landscapes,Inc. Water piping/DWV 56.29
Address:PO Box 2410 Other: 25.02
City/State/ZIP:Oregon City,OR 97045-4545 Subtotal 3/,Minimum 2?
�5 L
Phone:(503)631-3893 Fax:(503)631-4737 permit fee: $72.50
CCB Lic.: 6>10 1 3)1,5' Plumbing Lic.no.: it 353 Plan review (25%of permit fee)
State surcharge(12%of permit fee) B'_70
Authorized signature: d20.A-------- TOTAL PERMIT FEE 6 ))
Print name: / ,� Date: L/1,5//u 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:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)