Permit CITY OF TIGARD PLUMBING PERMIT
a
• COMMUNITY DEVELOPMENT Permit#: PLM2016-00251
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/11/2016
T 1 GARD Parcel: 2S109DB01702
Jurisdiction: Tigard
Site address: 13160 SW BLACK WALNUT ST
Project: Summit Ridge No.5,Lot 164 Subdivision: SUMMIT RIDGE NO.5 Lot: Multiple
Project Description: Irrigation backflow
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: 503-631-3893 PHONE:
FAX: 503-631-4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 05/11/2016 $31.27
Specifics: 1 12%State Surcharge- 05/11/2016 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 05/11/2016 $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/OOUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: - J` 977 Permittee Signature: v /MA
L/eV—770'/
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 ADDIicatiR C I%Ei J)
Building Fixtures MAY t 4►14 4)1 Ulf ► I •.I Oy1
City of Tigard 05 2016 Received
Date/By: S��f/ pemat N9
Cyo1D/6-.0012-5/
1111 �• 13125 SW Hall Blvd,Tigard,OR 97223
ft Phone: 503.718.2439 Fax: 5039 F Plan RaieH
Inspection Line503.639 4175x-, OIIGARD. DatnBy; Otho Permit NSOo� z00/9
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Date Ready!By. Jurb- e1 Ste Page 2 for
Internet: wvt,v.Iigard-or.gov Notified'Melbod: Supplemental information
TYPE OFA► DING DIVISIONFEE• SCHEDULE
gi New construction 0 Demolition I For special information use chedkiite
Description f Qty. l Ea. ( 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
1P3 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.tt) _ Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13 i 60 CL./' $/44-k (fes 11/4/1- '31-. Catch basin or area drain 18.76
Drywe11,leach line,or trench drain 18.76
City/State/ZIP: Tigard,OR 97223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 1 Project name: Summit Ridge Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18 76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:�_j Page 2
Storm sewer(no.linear ft..__,J Page 2
Water service(no.linear ft.:____) Page 2
Subdivision: I Lot no.: )
y Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27
DESCRIPTION OF WORK Backwater valve 12.51
New SFR Clothes washer25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
$ PROPERTY. OWNER ( 0 TENANT Expansion tank 12.51
Name: DR Horton Inc. Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:4380 SW Macadam Ave Suite 100
Garbage disposal 25.02
City/State/ZIP. Portland,OR 97239 Hose bib 25.02
Phone:(503) 222-4151 Fax:( ) Ice maker 12.51
0 APPLICANT It CONTACT PERSON Interceptor/grease trap 25.02
Business name: DR Horton Inc. Medical gas(value S_) Page 2
Contact name: 7 Primer 12.51
Emerald WeekRoof drain(commercial) r _ 12,51
Address:4380 SW Macadam Ave Suite 100 Sink/basinrlavatory 25.02
City/State/ZIP: Portland,OR 97239 Solar units(potable water) 62.54
Phone:(503 )222-4151 x1107 Fax::( ) Tub/shower/shower pan 12.51
E-mail: esweeks@drhorton.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business nameTrademark Landscapes Inc Water piping/DWV 56.29
Address: PO Box 2410 Other: _ 25.02
City/State/ZlPtoregon City,OR 97045 Subtotal
Phone:(503) 631-3893 Fax:(503) G3/-____V-2. ------ Minimum permit fee: 572.50
/��-3 / Plan review(25%ofpermit fee) -
CCB Lit.: �l ,;r��-�Pl irnbinkLi .n .: �,'
/�'T"�.--- State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE Jf-O
Print name: � � //�S Date:2016 nupermit application expires Ira permit isnot obtained within 180 days
after it nus been accepted as complete.
^Fee methodology set by Tri-County Building Industry'Service Board.
I Building Perms PLi.1C-Perms App.doc 10 01 09 440-1616T(10L3•CQit\iEa,
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
13160 SW BLACK WALNUT ST, TIGARD, OR,
97224
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00251
Don Sylvester
1. 1" Febco DC,model 850, serial # HE06549, for irrigation, located at left corner of
driveway - ok with test.
Violation Summary:
Inspector Contractor