Permit (206) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT
Permit#: PLM2019-00209
T13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/16/2019
T Parcel: 2S106DA08300
Jurisdiction: Tigard
Site address: 16943 SW SNOWDALE ST
Project: Huertas Subdivision: RIVER TERRACE EAST Lot: 83
Project Description: Installing(1)backflow preventer for landscape irrigation.
Contractor: SCHOLLS LAWNCARE&LANDSCAPE LLC Owner: HUERTAS, GEORGE LUIS JR&AMY
12840 SW RIVER RD#A 16943 SW SNOWDALE ST
HILLSBORO, OR 97123 BEAVERTON, OR 97007
PHONE: 503-702-5904 PHONE: 503-347-4559
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 05/16/2019 $31.27
Specifics: 1 12%State Surcharge- 05/16/2019 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 05/16/2019 $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 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: � 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.
Plumbing Permit ApplicatioII E C E I V E D
Site Utilities FOR OFFICE 1''SE ONLY
City of Tigard MAY 16 2019 Received Date/By:
a 13125 SW Hall Blvd.,Tigard,OR 9722 5�� ��q� T Permit
Phone: 503.718.2439 Fax: 503.598 TY OF TIGARD Plan Review
6
EDING DIVISION Date/By: Other Permit No.:
Inspection Line: 503.639.4175 Date Ready/By:1 1�'A K D Internet: www.ti and-or. ov y y
g g Notified/Method: Sup.lemental Information
� For s,ecial in ormation use checklist.
pNew construction 0Demolition
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 Ol? CONSTRUCTION SFR(1)bath 312.70
> -and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: I(pq43 Sit) )d u Lo Si Catch basin or area drain 18.76
C l O n �,� Drywell,leach line,or trench drain 18.76
City/State/ZIP: f`
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: S Manufactured home utilities 50.03
Cross street/directions to job site: .4. (• /• /_,./. ' Manholes 18.76
' Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_I Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: izl y.j -re mot cei Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer I
DESCRIPTION; � Backwater valve
12.51
Clothes washer 25.02
I ns l zt,U aii-io,r) o-f 19Qucf-to ) C4 VI t€, PD Y Dishwasher 25.02
iirVit3 n .OCG l S'}r \ Drinking fountain 1
JJ '""� Ejectors/sump 25.02
PROPERTY OWNER " Il TENANT Expansion tank 12.51
Name: C�,e p,l„e_ .f- /1.rv1',t t / S Fixture/sewer cap l
rr J Floor drain/floor sink/hub 25.02
Address: I(pg43 so Snow(la,I.0 Sfi
Garbage disposal 25.02
City/State/ZIP: ibecwe,Ytvnl Off. 617007 Hose bib 25.02
Phone:(Sob) 3tf-7`y SS / Fax:( ) Ice maker 12.51
APPLICANT ❑"CONTAG'l PERSON Interceptor/grease trap25.02
Business name: S co I I S Lawn ca y-e i- 1. mots C Medical gas(value:$ ) _'
a�an ' �Vi. �7 `� Primer 12.51
Contact name: N
,�/ ^ Roof drain(commercial) 12.51
Address: I2ki0 S� iy�i✓ve- ( 6 #'4 Sink/basin/lavatory 25.02
City/State/ZIP: re'1 i , I i. 0' •-1I2.. Solar units(potable water) 62.54
Phone:(SV 6) 702.-5904 Fax::( ) Tub/shower/shower pan 12.51
Urinal
heater
t
E-mail: S410IIS land sca4nn°°.@ 4Ma././. Wnrfn Water closet i®
Business name: SVY^IQ' h LII WnCGU' - t- LwnoI Gaize,
�
Water piping/DW V '
Address: 1'2-8C f 0 .c& tZ1Ve.,il 41 1://3 Other: ■ 25.02
-
City/State/ZIP: Ifi►1 S bo iv l Or, `']1 2 b Subtotal
I Minimum permit fee: $72.50
Phone:(54) 702.5-10q Fax:( )
CCB Lic.: Plan review (25%of permit fee)
�L�/� 94e, tokA\Ac, Plumbing Lic.no.:
I S State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name: N A 11-1.14n. V 1'4 I Date: S-/G..ti
after it has been acceptedas complete.
*Fee methodology set by Tri-County Buildinglndustry Service Board.
1:1BuildingTemrits\PLMU-PermitApp.doc 10/01/09 440-4616T(IOJO2JCOM/WEB)