Permit �, CITY OF TIGARD PLUMBING PERMIT
;`� I:. COMMUNITY DEVELOPMENT Permit#: PLM2016-00120
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/03/2016
T t cit[$.t� g Parcel: 2S109DB08300
Jurisdiction: Tigard
Site address: 13149 SW BLACK WALNUT ST
Project: Summit Ridge No.5, Lot 151 Subdivision: SUMMIT RIDGE NO.5 Lot: 151
Project Description: Backflow for irrigation.
Contractor: TRADEMARK LANDSCAPES INC Owner: DR HORTON INC
PO BOX 2410 4380 SW MACADAM AVE SUITE 100
OREGON CITY, OR 97006 PORTLAND, OR 97239
PHONE: 503-222-4151
PHONE: 503-631-3893
FAX: 503-631-4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 04/29/2016 $31.27
Specifics: 1 12%State Surcharge- 04/29/2016 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 04/29/2016 $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 B i 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.
1
Plumbing Permit Application
Building Fixtures � I OR 111 I I( I I •1 1/vI 1
City �'�►of Tigard G � Received
14 " 13125 SW Hall Blvd.,Tigard,OR 97223,j) 1 r 01� Plan Reviewt
V, V 7 "(v 0,.."--• Permit No.: /,Ij,i,,�a`&- i 1d j)
Phone: 503.718.2439 Fax: 503.598.1911is='R Other Permit No.:
Ins tion Line: 503.639.4175 �(;,;;
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13149 SW BLACK WALNUT ST, TIGARD, OR,
97224
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00120
Don Sylvester
1. 1" febco DC model 850, serial # HE 01056, for irrigation, located at front left corner of
driveway, - ok with test.
Violation Summary:
Inspector Contractor