Permit • ' V CITY OF TIGARD PLUMBING PERMIT
. ' . COMMUNITY DEVELOPMENT
Permit # PLM2012 -00271
Date Issued 09/18/2012
T [ GARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 2S109A614000
Jurisdiction Tigard
Site address 14319 SW ALPINE CREST WAY
Project DR Horton Subdivision ALPINE VIEW Lot 21
Project Description (1) backflow preventer
Contractor TRADEMARK LANDSCAPES INC Owner DR HORTON INC - PORTLAND
P 0 BOX 2410 ATTN MELISSA TRUNNELL
OREGON CITY, OR 97006 4380 SW MACADAM STE 100
PORTLAND, OR 97239
PHONE 503-631-3893 PHONE 503 - 222 -4151
FAX 503 - 631 -4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 09/18/2012 $31 27
Specifics: 1 12% State Surcharge - 09/18/2012 $8 70
Plumbing
Type of Use SF 41 ea Minimum Fee Adjustment - 09/18/2012 $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 „ it „ r Permittee Signature DM J1 P/ e L/ n J1 Mk/
Call 503 639 4175 by 7 00 a m for the next available inspection date PP L/
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 Applicati �' ��
Building Fixtures FOR OFFICE USE ONLY
City of Tigard SEP fl 8 2012 Received / P ermi t No
t3 g Date/By 91 t $ / !)— sir PvA 30/3• 0027
q 13125 SW Hall Blvd , Tigard OR 97223
L , .' , , Plan Remy. i ter Permit Phone 503 718 2439 Fax 503 5��� �6� k �v Y i Date/By Oh Pet N Ci .219/11.`a04 7,4
inspection Line 503 639 4175 , t P
TIGARD Internet wsv,t tieard -or eov ; ,1PQ¢ I .,, F� I "?� . 0.,1 - yr 0, " ,. Notified Ready/B% I / ®Sec Page 2 for
Nonfcd.M Method (�p Supplemental Information
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolition For special information use checlimst.
Description I Qty I Ea I Total
❑ Addition/alteration/replacement ❑ 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 ❑ Commercial/industrial SFR (2) bath 437 78
❑ Accessory building ❑ Multi - family SFR (3) bath 500 32
Each additional bath/kitchen 25 02
❑ Master builder ❑ Other Fire sprinkler ( sq fl) Page 2
JOB SITE INFORMATION AND LOCATION - l Site utilities:
/i Job site address 3/9 /�/ 8 ��f J Catch basin or area drain 18 76 I
City /State/ZIP TIGARD, OR 97224
+ Drywe(I leach line, or trench drain 18 76
Footing drain (no linear ft _ ) Page 2
Suite/bldgJapt no Project name ALPINE VIEW Manufactured home utilities 50 03
Cross street/directions to job site SW ALPINE VIEW AND SW ALPINE CREST Manholes 18 76
WAY 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 ALPINE VIEW 1 Lot no . Z Fixture or item:
Tax map /parcel no Back preventer 31 27
DESCRIPTION OF WORK Backwater valve CI
12 51
• Clothes washer 25 02
NEW SINGLE FAMILl RESIDENTIAL Dishwasher 25 02
Drinking fountain 25 02
Ejectors/sump 25 02
® PROPERTY OWNER ❑ TENANT Expansion tank 12 51
Name D.R. HORTON INC. - PORTLAND Fixture/sewer cap 25 02
Address 7380 SW MACADAM AVE, SUITE 100 Floor drain floor sink/hub 25 02
Garbage disposal 25 02
City/State /ZIP PORTLAND, OR 97239 Hose bib 25 02
Phone (503)222 -4151 Fay (503)222 -1304 ice maker 12 51
❑ APPLICANT ® CONTACT PERSON Interceptor /grease trap 25 02
Business name D.R. HORTON INC. - PORTLAND Medical gas (value S _) Page 2
Contact name GARY CULP Printer 12 51
Roof dram (commercial) 12 51
Address SAME Sink/basin/lavatory 25 02
City/State /ZiP Solar units (potable water) 62 54
Phone ( ) Fax • ( ) Tub /shower /shower pan 12 51
E -mail, gaculp@drborton corn i Urinal 25 02
Water closet 25 02
CONTRACTOR
Water heater 37 52
Business name TRADEMARK LANDSCAPES, INC Water pipmg/DWV 56 29
Address. PO BOC 2410 _ ___ Other I 25 02
City /State/ZIP OREGON CITI, OR 97045 Subtotal
Phone (503) 631 -3893 Fax (503) 631 -4737 Minimum permit fee 572 50 72 50
CCB Lie, 6796 / � riberfg, 2no 11353 Plan review (25% of permit fee)
/� State surcharge (12% of permit fee) 8 70
<1.! Authorized signature ' _ I TOTAL PERMIT FEE 81 20
Pnnt name STEVE ELLIS Date (" [ C� This permit application expires if a permit is not obtained sirthm 180 days
ffff after it has been accepted as complete
"Fee methodology set by Tn -Count) Building Industry Service Board
i 9u,id,ng'Pem is PL\rL P, r mil App dm 10 /09 4 10 0 'CO\i WF B)
09/18/2012 13:50 FAX Ij001 /002
4380 SW Macadam Ave Suite 100
Portland, OR 97239
Phone 503-221-4151 ext 1135 D.R. HORTON INC.
Fax 866 - 364 -6764
www drhorton com
Fax
To: City of Tigard From: GARY CULP
Fax: 503 - 598-1960 Pages: 2/
Phone: 503-718-2700 Date: 9/18/12
Re: PERMIT FEES cc:
❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle
• Comments: PLEASE USE ATTACHED CHARGE CARD FORM TO PROCESS PAYMENT FOR
ALPINE VIEW LOT 21 BACKFLOW AND AIR CONDITIONER PERMIT
THA •
GARY CULP