Permit CITY OF TIGARD PLUMBING PERMIT
' COMMUNITY DEVELOPMENT Permit#: PLM2022-00082
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/17/2022
Parcel: 2S1070001303
Jurisdiction: Tigard
Site address: 16500 SW BULL MOUNTAIN RD
Project: South River Terrace Subdivision: Lot:
Project Description: Site utilities for Tract K in area A.
Contractor: MOORE EXCAVATION INC Owner: TAYLOR MORRISON NORTHWEST LLC
PO BOX 789 703 BROADWAY ST STE 510
FAIRVIEW, OR 97024-0789 VANCOUVER, WA 98660
PHONE: 503-674-0900 PHONE:
FAX: 503-252-1730
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 03/17/2022 $18.76
Specifics: 338 If Sanitary Sewer 03/17/2022 $175.10
342 If Storm Sewer 03/17/2022 $175.10
Type of Use: SF 1052 If Water Service 03/17/2022 $437.74
Class of Work: NEW 1 12%State Surcharge- 03/17/2022 $96.80
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $903.50
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
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 Application milmcismormiiiiii- ' . --:
Site Utilities
City of Tigard Received
A
.
Permit No.:
y 13 125 SW Hall Blvd.,Tigard,OR 97223 Dat}JSy. `f i) f Pe k?
hart Review
Phone: 503.718.2439 Fax; 503.598.1960 � Other Permit No.:
rlate/By: /V
Inspection Line: 503.639.4175 Date Read!A Jeriv: td See Page 2 for
TIGAItD Y y- S
Internet: www.tigard-or,gov Notitied/Method:ie/pit ,.t, Supplemental information
i �
TYPE OF WORK ,1,,.. t,, t a,' FEE* SCHEDULE
®New construction 0 Demolihtiri ' '-' For.special information use checklist
l ill « t DivI Description I Qty. I Ea. I Total
❑Addition/alteration/re lacement 0 Other. �'�� �I
PNew 1-2-family dwellings(includes 100 ft.for each utility connection)
,, CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
0,-1"-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ,14alti.£aitai y
i' Each additional bath/kitchen 25.02
❑Master builder �]Other: Fire sprinkler( sq.II.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16500 SW Butt Mounatin Rd. Catch basin or area drain 1 18.76 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97723 Footing drain(no.linear ft.:�) Page 2
Suite/bldg./apt.no.: I Project name:South River Terrace (Area A) Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
South of SW Bull Mountain Rd. between River Terrace Rain drain connector 13 18.76 243.88
Blvd. and 16th Ave. Sanitary sewer(no.linear ft.:338) Page 2 175.10
Storm sewer(no.linear ft.: 342) Page 2 175.10
Water service(no.linear ft.:1052) Page 2 437.74
Subdivision: South River Terrace Phase 1 I Lot no.:Tract K, Fixture or item:
Tax map/parcel no.:T2S R1W Sec 7 Tax Lots 1200,1300,1302,1303,1305,1900,2000 I3ackflow preventcr 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Site improvements associated with multi-building triplex development.
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
El PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: Taylor Morrison Northwest, LLC (formerly Polygon WLH, LLC) Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 703 Broadway St, Ste. 710
Garbage disposal 25.02
City/State/ZIP: Vancouver,WA 98660 Hose bib 25.02
Phone:(360) 695-7700 Fax:( ) Ice maker 12.51
" APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Pacific Community Design, Inc. Medical gas(value:S ) Page 2
Primer 12.51
Contact name: KC Schwartzkoph, PE Roof drain(commercial) 12.5E
Address: 12564 SW Main St. Sink/basin/lavatory 25.02
City/State/ZIP; Tigard, OR 97223 Solar units(potable water) 62.54
Phone,(503) 941-9484 Fax::( ) Tub/shower/shower pan 12.51
E-mail: KC@pacific-community.com Urinal 25.02
Water closet 25.02
CONTRACTOR
........___...._._, ..... __ _... - Water heater 37.52
Business name: Moore Excavation, Inc. Water piping/DWV 56.29
Address: PO Box 789 Other: 25.02
City/State/ZIP: Fairview, OR 97024 Subtotal
Phone:(503) 674-0900 Fax:(503) 674-0909 Minimum permit fee: s72s0 1050.5e
CCB Lie.: 28397 Plumbing Lie,no.: 26-775PB Plan review (25%of permit fee) 262 66
State surcharge(12%of permit fee) 126.07 _
Authorized signa TOTAL PERMIT FEE 1,439:30
Print name: 4* f ,. Date;„�„ ,,, This permit application expires if a permit is not obtained within Igo days
�/ ,,.7• after it has been accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
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