Permit (15) 11111 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00457
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/29/2016
Parcel: 2S 109BA05500
Jurisdiction: Tigard
Site address: 13782 SW MISTLETOE DR
Project: Ryder Subdivision: HILLSHIRE SUMMIT NO.2 Lot: 41
Project Description: Residential backflow preventer for irrigation
Contractor: LANDSCAPE EAST&WEST INC Owner: MCGEE,WILLIAM H
15601 SE 90TH AVE RYDER, GAIL R
CLACKAMAS, OR 97015 390 17TH ST NE
SALEM, OR 97301
PHONE: 503-256-5302 PHONE: 503 364-6021
FAX: 503-297-6993
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 08/29/2016 $31.27
Specifics: 1 12%State Surcharge- 08/29/2016 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 08/29/2016 $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 direc :.es i. o OUNC by calling 503.232.1987 or 1.800.332.2344.
lss ed By: I 19# Permittee Signa re:
Call 503.639.4175 by 7:00 a.m,for the next available ins••ction 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.
elAug, 29. 2016.s 8;31AM5e3598196e CITY OF TIGARD No. 5631 P. 1 91 91
Plumbing pew p�ica on
Building jFixtures
City o1F igrd (;0� Rcocivad
n 1312$9W Tull Bivd.,Tigard,OR 0^r RDiwa
e" ' 22/60 .� Aormil..:2 , ( /6-� 57
Phnnc: 503.718.2439 i• 503.5 by uk - `.n Rcvlow ---.. .
T 1! ,� n Inspection Line 503.639 4171 ��j \:\‘',
Date/6Yc Other Permit No..
B r n ( y Road hod ami.: li3 fe nPage au(i far
lntornot WWwq ar(l"nr 0v P
� -rte -- - ' `Nod cdQvla
e.1.,•--
,,,L__' ftfi �lr�.,_ a� �<<;'y=' ''- --7 r,72-1.. v.. x „ .7.-•71 -17C-7.7.W.:'"--71-'"r'-'777:77--.
�� So, tomonn,rintormndon
0 New construction 'h,,,cr.r.., !, -I,a__.,+` . 1 ,.,. 1 s '�'' -�"'„'C.---'-•.. 'rc-
+' -c� .:``��..�` :`-'� FL;�� 5 �.�Zw ��. t P IIP°,":,r ,'Y ° u 2q '.
[� i';; . den rr^u.,..cher. G�t 1 I �a t1.
For Fol i o "'
rmar/,od,rA,r checklist
Ei Addition/alteration/replacement 0 Other Dcscrl.t on
Now 1-2-fa 0 . ire Total
' 1-2-family dwellings(includes 100 each utility c
4... I r,'c �r -; i nn, e,�� 'v tF, 7,1; 1 P•Y'� ; , 'a'± 5 i C h' 01ULfC1lOn)
�., a�.r:•,, tti rr'>� �i`,T%i,, .4.'1.
. 7•ti.k',' SFR(1)b bath 312.70
h 4 nr��I�:i ...kV, 312.70
El 1•and 2.family dwelling 0 Commeroialiindtlstrial SFR(2)bath
437.78 -
AcceAsciry building ❑Multi-family SFR(3)bath 500.32
[�
14;. '7------,r17-7---..--.-�;. u ' Each additions[bath/kitchen
hen
MI
•• 25.020 Master bulkier 0(Aar Fire sprinkler $q'�) Page Zr { ": �r T yrr�� tPi,ka^� :fi°4 •ra';� t -v" rSf,"LI7igi1; 51x ,t1 ,••',W177,
1ii }i Sianh
.Tob site address;13782 SW Mistletoe D,` Catch basin or Mea drain
18,76
City/State/ZIp:Tigard,OR 97224 Dryweit,leach lune,or incl,drain 18.76
9uito/(ridg/aPx•no,: Proioet name:Ryder irrigation Footing drain(no,linear R,;__� paw 2
Cross street/directions to job site:SW Alpine View Manufactured home utilities 50.03
Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no,linear ft.: ) Page 2 -
Storm sewer(no.linear f„ ) Page 2 MN-
Subdivision: Water service(no,linear ft.;:) Paso 2
TA no.: Fixture or item:
Tax map/parcel nn
r Backflow prcventcr
L.f'iil� rs3 ..r�l ..tr....,' Vii .el 44,dri ,ii-L:7 ��f X1 `,l , �� � ilAyll � l� ,sun, ,,,tY.�. Backwater valve
1 31.27 31.27
ke.. r.1 k. .1�� ly. �.815.i fi1C
Irrigation installation
clothes
0� washer mmi 25.02 M
Dishwasher 111111 25.02
Drinking/buntslty 25.02
al
IIIII
1. '.
Ejectom/sump
25.02+` rr, , ¢-, � . t^',.0. &7pansion lankari.1...',,V1;r,%.1:4,2,11,,:- .4. 4. rub,Cr,4t i5 -4,' ^n
.,z„�i , ,t: ,rl1„,;:1)k4/nliclt ..".k;tFIxlure/sewer cap ME 25.02Name:Gall Ryder
Address:13782 SW Mistletoe Dr
Floor drain/floor sink/Ituh
25.02
City/State/ZIP:Tigard,OR 97224
00880 diltpoanl 25,02
IHog.
bib
toLIII
rlgn]Age trap
25.02
Phone:(503)364-6021 Fax ( ) Ice maker t2.5Iri �� r�-,U,fi.a1-7; riul iN:.:4.-r.} -vS, L1Kr.,.p4: }`1,1."‘
."'h 25.02
MI
Medical gas(value;$ )
Contact name;Bjorn Not-till-faPrimer Page 2
12.51
'Address:756411 SE'10'hAve
Roof drain(commercial) � 12.51 --_--_�
City/State/TIP:Claarrtas,OR 91015
Snik/bOsiur/1Avatory
Ci25.42
Phone:(503)ZS$,$3p2 Solar units(potable water) 62.54
Fax::(503)297.6993 Tub/shower/showcr pan
E-mail:bjorna@iaadhcapeeastcom 1252.51
Urinal
i1::',d -A'f'.,i` ,':.'1#'.LL t.;":41:, ,•NF:}� ^,z`Si�:rL:4.,1 t. I 'l.es.;;n r % � closet �5(yl
te` 4» %cu.cl 02
Business name:Landscape East&Wesr �r '� Water healer
37.52
Address:1 6O1 SE90th Ave _water pipinp/D'W'y _ 56,29 -
City/State/ZIP;Clackamas OR 97015 Other; 25.02
Thom(503 Z.5 .5302 Subtotal 31,27
Fax:(503)297.6993 Minimum permit fee: $72,50 72,50
CCB Lie.: 91577 rYfo9 ) ' la 1 PlumbingLic,no.; p
Authorized Aignatare: /t 5/(3 /111.1111111.11=2151111:52:1211 rib/
State surcharge(12%of permit foo) 8.7
IPrint name:Bjorn 1Yordqu�¢[ TOTAL PPRM iT PEE 81.20
nate x.17,16 Tlds permit nppliaggon expires ill,permit is nal obtained within rand yq
nim It Aria boon accepted as complete,
*roc methodnlnry act by Tri-Cosily Budding Industry Service board,
tOuildlneermicalPLMlyPermItAyp.dor,1aA11/Ilg
140.45 i r,7(1 e/e5/COM/W12n)
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
13782 SW MISTLETOE DR, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00457
Chip Barnett
Violation Summary:
Inspector Contractor