Permit (82) INCITY OF TIGARD PLUMBING PERMIT
0 • COMMUNITY DEVELOPMENT Permit#: PLM2019-00349
T 1 G A R in 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2019
Parcel: 2S106DB03100
Jurisdiction: Tigard
Site address: 13337 SW AUBERGINE TER
Project: Wills Subdivision: RIVER TERRACE NORTHWEST Lot: 31
Project Description: Backflow preventer for landscape irrigation.
Contractor: BLESSING LANDSCAPES Owner: WILLS, DAVID R
7219 NE 47TH AVE WILLS,AMBER M S
PORTLAND, OR 97218 13337 SW AUBERGINE TER
SHERWOOD, OR 97140
PHONE: 503-784-4883
503-284-3557
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 08/28/2019 $31.27
Specifics: 1 12%State Surcharge- 08/28/2019 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 08/28/2019 $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:
A
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
Site Utilities FOR OFFICE t,SE O\1.l'
City of Tigard 4 A Received / i "� ' 7'0/7
/
• 13125 SW Hall Blvd.,Tigard,OR 97223 2 F Plan Revie
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= Phone: 503.718.2439 Fax: 503.598.1964 {- . Date/By:
Date/By: Other Permit No.:
i'I t, ,It I Inspection Line: 503.639.4175 Date Ready/By: loris: ® See Page 2 for
Internet: www.tigard-or.gov fi Notified/Method: Supplemental Information
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®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(1)bath 312.70
Z 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑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:13337 SW Aubergine Terrace Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Sherwood,Oregon 97140
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Wills 10011 Manufactured home utilities 50.03
Cross street/directions to job site:SW Sabrina Ave 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: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
DESCRIPTION Or Backwater valve 12.51
' Clothes washer 25.02
Install Backflow Preventer
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
tr PROPERTY OWNER ` ,' f"TENANT , Expansion tank 12.51
Name:Dave&Amber Wills Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:13337 SW Aubergine Terrace
Garbage disposal 25.02
City/State/ZIP:Sherwood,Oregon 97140 Hose bib 25.02
Phone:(503)784-4883 Fax:( ) Ice maker 12.51
t.4. APPLICANT j" 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Blessing Landscapes Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Emily Stiff
Roof drain(commercial) 12.51
Address:7219 NE 47th Ave. Sink/basin/lavatory 25.02
City/State/ZIP:Portland,OR 97218 Solar units(potable water) 62.54
- .Fmc.. ... ,T_iti: ia.owa a _.,___.1151.
E-mail:admin@blessingland.com Urinal 25.02
Water closet 25.02
CONTRACTOR
---„-. -. ----- Water heater 37.52
Business name:Blessing Landscapes Water piping/DWV 56.29
Address:7219 NE 47th Ave Other: 25.02
City/State/ZIP:7219 NE 47th Ave Subtotal 31.27
Phone:(503)284-3557 Fax:( ) Minimum permit fee: $72.50 72.50
CCB Lic.:7843 Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee) 8.70
Authorized si afore: p rj d , TOTAL PERMIT FEE 81.20
Print name:StacyMayfield� ; Date:8/19/19 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
.J *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)