Permit II CITY OF TIGARD PLUMBING PERMIT
1111' ' = COMMUNITY DEVELOPMENT Permit#: PLM2017-00390
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/26/2017
Parcel: 2S112BA04600
Jurisdiction: Tigard
Site address: 14295 SW 80TH PL
Project: Weaver Subdivision: WAVERLY MEADOWS Lot: 9
Project Description: Irrigation backflow.
Contractor: WESTERN ROOTS LANDSCAPE Owner: KROPP, BEVERLY&
3817 SE LIEBE ST WEAVER, RIC
PORTLAND, OR 97202 14295 SW 80TH PL
TIGARD, OR 97224
PHONE: 503-850-8242 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 09/26/2017 $31.27
Specifics:, 1 12%State Surcharge- 09/26/2017 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 09/26/2017 $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 OUNCpby calling 503.232.1987 or 1.800.332.2344.
J
Issued By: ;?E''' ,'
Permittee Signature: 47-77 /
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
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Rt1 Received q
- Date/By: L/Z�p//7 Perrnit N
III
�� 13125 SW Hall Blvd.,Tigard,OR 97223 (ny / �. ie1 h:2c�/7-40390
Phone: 503.718.2439 Fax: 503.598.1960E U�� /j -?c/--
Plan Review
Date/By: Other Permit No.:
TIGARD Inspection Line: 503 639.4175 e Date Read /B
Internet www.tigard-or.gov est 1 y Y' Juris: ta See Page 2 fory c 1 ifred/Method. I Supplemental Information
�� et
S
i LI New construction Demolition I* SGH D ULE
Addition/alteration/replacement CD Other:
For special information use checklist
Description 1Qty. I Ea. 1 Total
` CATEGORY OF' CON TRIJCT1ON �, , -.'i New 1-2-family dwellings(includes 100 ft.for each utility connection)
l-and 2-family dwelling ❑Commercial/industrial SFR(1)bath 312.70
SFR(2)bath 437.78
Accessory building ❑Multi-family
SFR(3)bath 500.32
❑Master builder ❑Other: Each additional bath/kitchen 25.02
JO Ti R T10N E l�]D.LOCATION, Fire sprinkler( sq.ft.) Page 2
Job site address: H) r. e3344..
su 1 Site utilities:
'�'' a �J Catch basin or area drain 18.76
City/State/ZIP: ,, Uri I��Y�
i 9 Drywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.: Project name: L
liAr/if Irr.,7-j iON, Footing drain(no.linear ft.: ) Page 2
Cross street/directions to job site: Manufactured home utilities 50.03
Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Subdivision: Lot no.: Water service(no.linear ft.:_) Page 2
Tax map/parcel no.: Fixture or item:
a D cI OF WOltI(?
Backflow preventer a 31.27 31,37
� �, Backwater valve 12.51
I t.,-‘1,1-03-, Mr - ,fes,
'� Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
f O R ,0 "
v! w � `I'iNAi.1 �,f Ejectors/sump 25.02
Name: Expansion tank 12.51
Fixture/sewer cap 25.02
Address:
Floor drain/floor sink/hub 25.02
City/State/ZIP: Garbage disposal 25.02
Phone:( r)--I Fax:( ) Hose bib 25.02
1 ''IM
t JCONTACT,A r PE1 O D 4" L Ice maker 12.51
Business name: Interceptor/grease trap 25.02
Contact name:
Medical gas(value:$ ) Page 2
Primer 12.51
Address:
Roof drain(commercial) 12.51
City/State/ZIP: Sink/basin/lavatory 25.02
Phone:( ) Fax::( ) Solar units(potable water) 62.54
E-mail: Tub/shower/shower pan 12.51
�r • Urinal 25.02
Water closet 25.02
Business name: ')At,.e ec csliS l cv.d?.le. Water heater
37.52
Address: 3S11 1.35 L-i � Water i in /DWV
56.29
City/State/ZIP: f?�� A 04 ell^� :c Other: 25.02
Phone:(spl )go, zi-,,{ tt3*Fax:( ) Subtotal1:7
CCD L;,,.: �# O jl /g f fir Plumbing Lic.no.: Minimum permit fee: $72.50 i
1 Plan review (25%of permit fee)
Authorized signature: jf State surcharge(12%of permit fee) 7"
Print name: )JJ .- Miter Date: 1„11,t7 TOTAL PERMIT FEE 6 J _°
1:\Building\Permits\PLMU-PermitApp.doe 10/01/09 4404616T(10/02/COM/WEB) 1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14295 SW 80TH PL, TIGARD, OR, 97224 October 5, 2017 at 1 :05:26
PM
Record Type: Record ID:
Residential - Plumbing PLM2017-00390
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
1 " Backflow assembly Febco model 850 ser#HE45244 located next to front door
approved with test report.
Violation Summary:
Inspector Contractor