Permit (94) CITY OF TIGARD PLUMBING PERMIT
t1 . COMMUNITY DEVELOPMENT Permit#: PLM2017 00194
T I(7,A ft D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2017
Parcel: 1 S 125DA03800
Jurisdiction: Tigard
Site address: 6620 SW WALNUT TER
Project: Kovalev Subdivision: KINGS VIEW Lot: 23
Project Description: Installation of residential backflow preventer for irrigation
Contractor: CREEKSCAPE DESIGN LLC Owner: KOVALEV,VITALY&ANITA
4305 SW 185TH AVE 6990 SW CANBY ST
ALOHA, OR 97078 PORTLAND, OR 97223
PHONE: 503-572-5589 PHONE:
FAX: 503-336-0198
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 05/18/2017 $31.27
Specifics: 1 12%State Surcharge- 05/18/2017 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 05/18/2017 $41.23
Plumbing
Class of Work: OTR
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, Stat- of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire f work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility 'cation Ce er. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009 P. You m.y obtain a copy of the rules
or di ct questions to OU - allin. 03.232.1987 or 1.800.332.2344.
Issued By: A 0 i / Permittee Signature: ..' A
Call 503.639.4175 by 7:00 a.m.for the next available inspecti n d. e.
This permit card shall be kept in a conspicuous place on the job site until co pl-tion of the project.
Approved plans are required on the job site at the time of each i ection.
411 q `
Plumbing Permit Application
Site UtilitiesRECEIVEP FOR OFFICE ESE O\l,1-
Received
Ci}�,of Tigard 1
`1 g Date/By: 0 /6 /7 ,l Permit No.: -LM pZ I 7�/9
1114 13125 SW Hall Blvd.,Tigard,OR 9 2017 Plan Review ).-167-09‘)/40,
I�"'
0 Phone: 503.718.2439 Fax: 503.5 0A " ` y Other Permit No.:fT6T�/(Q-66[V//
Inspection Line: 503.639.4175
Date/
By:
I G A R D city
o 'rI `,g t3 b Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov i.i aaAr ftp.... JJ Notified/Method: Supplemental Information
TYPE oB r$ 1NG DIVISION FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist
Description Qty. Ea. Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling 0Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
2 V JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 0 SW Walnut Terrace Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard OR 97223 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: 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.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer ✓ 31.27
DESCRIPTION OF WORK Backwater va 12.51
Clothes washer 25.02
Backflow preventer for irrigation Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTYOWNER 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
o4 .APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Creekscape design LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Juan Gutierrez
Roof drain(commercial) 12.51
Address:4305 SW 185Th Ave Sink/basin/lavatory 25.02
City/State/ZIP:Aloha,OR 97078 Solar units(potable water) 62.54
Phone:(503)572-5589 Fax::(503)336-0198 Tub/shower/shower pan 12.51
E-mail: )N fi Ce1.Cer.s4IKjPLZpg,Ny,4 1.4", Urinal
25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Creekscape Design LLC Water piping/DWV 56.29
Address:4305 SW 185Th Ave Other: 25.02
City/State/ZIP:Aloha,OR 97078 Subtotal
Phone:(503)572-5589 Fax:(503)336-0198 Minimum permit fee: $72.50 7a 50
CCB Lic.:LCB#8718 7(5, l 7 Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee) D.70
Authorized signature: TOTAL PERMIT FEE '/.e)
Print name: .A 01/40 (A Co 1/1 ' it Date:, -/F's/7 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.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
6620 SW WALNUT TER, TIGARD, OR, 97223 May 23, 2017 at 9:03:37 AM
Record Type: Record ID:
Residential - Plumbing PLM2017-00194
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
1 " febco model 850, serial# HE35064 located front of house by entry.
Violation Summary:
Inspector Contractor