Permit CITY OF TIGARD PLUMBING PERMIT
- COMMUNITY DEVELOPMENT Permit#: PLM2015-00269
• 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/13/2015
TIGARD Parcel: 1 S135AD01900
Jurisdiction: Tigard
Site address: 8810 SW SPRUCE ST
Project: Spruce Village-Lot 5 Subdivision: GRAHAM ACRES Lot: 2
Project Description: Irrigation backflow device.
Contractor: RC LANDSCAPE MAINTENANCE INC Owner: ANDERSON HOMES&CONSULTING LLC
425 NE EDISON ST 5357 LAKEVIEW BLVD
HILLSBORO, OR 97124 LAKE OSWEGO, OR 97035
PHONE: 503-681-7644 PHONE.
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 08/13/2015 $31.27
Specifics: 1 12%State Surcharge- 08/13/2015 $8.70
Plumbing
Type of Use SF 41 ea Minimum Fee Adjustment- 08/13/2015 $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 y. to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-00 t 90. 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: (` / �G Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next availa•le inspection d- e.
This permit card shall be kept in a conspicuous place on the job site until comple'on of the project.
Approved plans are required on the job site at the time of each inspec'on.
Plumbing Permit Application
Building Fixtures RECEIVED
Received /� No/t04/-4:20/5"-��6 9
City of Tigard AUG 13 Z 015
D�eBy: �`/3A Permit
II • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
• Phone: 503.718.2439 Fax: 503.59t Date/By. Other Permit N%Y �/y 40/6
Inspection Line: 503.639.4175 ' OF TIGARD Date Read/B luris H See Page 2 for
I t ^' l' BUILDING DIVISION : Notified/Method: 77 Supplemental Information
Internet: www.tigard-or.gov
TYPE OF WORK FEE £. ,
New construction ❑Demolition - 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 ON CONSTRUCTION SFR(1)bath 312.70
1-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: 46N a ,A1,6 * Catch basin or area drain 18.76
City/State/ZIP: /11 C. _ 470,
D leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name g. 4r. V(4 f6& Manufactured home utilities 50.03
Cross street/directions to job site: ,f4 7 a , Manholes 18.76
l 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: G1 I Lot no.: S Fixture or item:
Tax map/parcel no.: Backflow preventer / 31.27 ESCRIPTION OF Backwater valve 12.51
� Clothes washer 25.02
12A44". Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
[jam OWNER I 0 izNANIf Expansion tank 12.51
Name: /s
l Fixture/sewer cap 25.02
`� (I'�. .1 � Floor drain/floor sink/hub 25.02
Address: 1/� D ti( , (9 �r'0'1) Garbage disposal 25.02
City/State/ZIP l i d e 4?ZZ72 Hose bib 25.02
Phone:( clA .7 86.06, 2.4,„„ Fax:( ) Ice maker 12.51
0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: G 6.A1�0 �� Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: L4) ft 006:.� Sink/basin/lavatory 25.02
City/State/ZIP: (Al a&&'`+SaeO�`-•G� tow/ Solar units(potable water) 62.54
Phone:( 93tI_��.iit .,44,) Fax::( ) Tub/shower/shower pan 12.51
E-mail: VV 7 T �/' Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: t L. t Q.t}pfx, E- Water piping/DWV 56.29
Address: V� sAfg■ge-�+��• pj , Other: 25.02
City/State/ZIP:*� /`a be. co)-1 Subtotal
H� ` Minimum permit fee: $72.50 -7a6-0
Phone:9, ( • .. )4 Fax:( )
CCB Lic.: ;10,11#Co Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee) e,7C
Authorized signature: 4111111 TOTAL PERMIT FEE g1 .AO
This permit application expires if a permit is not obtained within 180 days
Print name: �.� Dater��.\,
a n 1 . FRtG� after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
1:1 Building\Permits\PLMU-PermitAppdoe 10/l 1• 440-4616T(10/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
8810 SW SPRUCE ST, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
FAIL
August 24, 2015 at 9:31:35
AM
PLM2015-00269
David Young
Provide back flow test report for final inspection.
Violation Summary:
Inspector Contractor