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Permit (8) ,14q CITY OF TIGARD PLUMBING PERMIT 1. ' COMMUNITY DEVELOPMENT Permit#: PLM2016-00359 iFGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/07/2016 Parcel: 2S 106DB24000 Jurisdiction: Tigard Site address: SW NO ADDRESS Project: River Terrace NW Subdivision: None Lot: None Project Description: Backflow preventer for irrigation of common area(Tract AA)near Forest Hollow St. Contractor: CASCADIAN LANDSCAPERS, INC. Owner: RIVER TERRACE NORTHWEST HOA 21510 NW FARM PARK DR 109 E 13TH ST, STE 200 HILLSBORO, OR 97124 VANCOUVER,WA 98660 PHONE: 503-647-9933 PHONE: FAX: 503-647-9922 FEES Quantity Description Date Amount 1 ea Backflow Preventer 07/06/2016 $31.27 Specifics: 1 12%State Surcharge- 07/06/2016 $8.70 Plumbing Type of Use: COM 41 ea Minimum Fee Adjustment- 07/06/2016 $41.23 Class of Work: OTR 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 By: f�\ )71 0, 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. 07-05-16; 17:00 ; . # 3/ 6 Plumbing Permit Application Site Utilities toy OFF1('1. 1 Sl. ()11,1 City of Tigard ' 1`�d ),^ 1 gra,t No.: / F,- 13125 SW Hail Bivd.,Tigard OR 97223 pt,n i e ep 1 w Perm,No.: 3 9 s Phone: 503.718.2439 Fait 503 598.1960 piss ltev{ew pater Permit No.: Date/By I t �) t) inspection Line: 503.639.4175 Data Ready/By: hits: 1 See Page 2 for- Internet: www.tigard-orgov Notified/Method: _ Supplements!information TYPE OF WORK PEE* SCHEDULE 0 New construction ©Demolition For special Information use checklist. Description I Qty, I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 1.] I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78 _ 1:1Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 El Muster builder 0 Other•. - Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: t..,(_) J6K67) rjs Catch basin or arca drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigrad,OR - Footing drain(no.linear It:_) Page 2 Suite/bldg./apt.no.: Project name:River Terrace Manufactured home utilities 50,03 Cross street/directions to job site:SW Roy Rogers Road Manholes 18,76 Tract AA --SW Forest Hollow Street--Common Area Rain drain connector I8.76 Sanitary sewer(no.linear ts.: ) Page 2 - Storm sewer(no.linear ft-; ) Page 2 — Water service(no,linear ft.:_) Page 2 Subdivision:River Terrace Lot no.: Fixture or item: Tax map/parcel no.:Tract AA ,A6/4)&D6 a 104)C:) Backflow preventer 1 3127 31,27 DESCRIPTION OF WORK Backwater valve , 12.51 - Clothes washer 25.02 Backflow 25,02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name:Polygon Northwest Company Fixtturlsowcrcap 25,02 Floor drain/floor sink/hub 25.02 Address:109 East 13th Ave - Garbage disposal 25.02_ City/State/ZIP:Vancouver,WA 98660 Hose bib 25,02 Phone:( ) Fax:( ) leo maker 12,51 ® APPLICANT Cl CONTACT PERSON Interceptor/grease rap • 25.02 Business name:Caseadian Landscapers,Inc. Medical gas(value:S ) Page 2 Primer 12.51 Contact name:Arthur Meisner Roof drain(commercial) 12.51 Address:21510 NW Farm Park Drive Sink/basin/lavatory 25,02 City/State/ZIP:Hillsboro,OR 97124 Solar units(potable water) 62.54 Phone:(503)647-9933 Fax::(503)647-9922 Tub/shower/shower pun 12.51 E-mail:patty@eascadianlandseapers,eom u l 25.02 CONTRACTOR -- - Water closet 25.02 - - Water heater 37,52 Business name:Cascadinn Landscapers,Inc. Water piping/DWV 56.29 Address:21510 NW Farm Park Drive ` Other: 25.02 City/State/ZIP:Hillsboro,0 ' Subtotal 31.27 Phone:(503)647-9933 Fax:(503)647-9922 Minimum permit fee; 572.50 72.50 Plan review (25%of permit fee) CCB Lie.:51443 Plumbing Lic.no.:LCB#5185 - Authorized si --- State ewcharge(12%of permit fee) 8.70 --'4''' TOTAL PERMIT FEE 81,20 Print name:Arthur Meisner Date:7-05-2016 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 Hoard. l\Btikiinoccsinp't.Mu.PcmitAcsxduc IIY0lia9 410.46167(l502/COM/WEB)