Permit (47) CITY OF TIGARD PLUMBING PERMIT
ill S < COMMUNITY DEVELOPMENT Permit#: PLM2016-00249
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/11/2016
Parcel: 2S109DB01700
Jurisdiction: Tigard
Site address: 13132 SW KOSTEL LN
Project: Summit Ridge No.5,Lot 148 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 OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: /
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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 Appli t s's LEIVEP
Building Fixtures I ort`01101 I tit tai
City of Tigard MAY 0 5 2016 Received
1
ihr It 13125 SW Hall Blvd., F Tigard 72 Date/By:: �� 'r Pe t•n. �rl�o,,6 y9
li Plan Review
Phone: 503 718.243i
I°TI G A t D Date/By: Other Permit. .i �/4_000S
l t e,ner t>i Inspection Line: 503.639.41 Dare Ready/By. rwu.
Internet: w.v v.tigard.or. ILDING DIVISION see pent 2 for
Notified%Dlabod: _ Supplemental Information
TYPE OF WORK FEE" SCHEDULE
a New construction 0 Demolition For special information use checklist
Description 1 Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
ill 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.ft.) Page2
Site utilities:
JOB SITE INFORMATION AND LOCATION
Job site address: 131 )2. 54,--- Kos*/ in Catch basin or area drain 18.76 i
Dry ll,leach line,or trench drain 18.76
Cityistate/ziP: Tigard,OR 97223
Footing drain(no.linear tl.: ) Page 2
Suite/bldg./apt.no.: , 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.:„.....) Page 2
Storm sewer(no.linear ft.'„_,,,,,,) Page 2
Water service(no.linear ft.:_,) Page 2
I
Subdivision: I Lot no.: (16 Fixture or item:
Tax map/parcel no.: Backflow prcventer 1 31.27
DESCRIPTION OF WORK Backwater valve 12.51
New SFR Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25,02
Ejectors/sump 25.02
IS PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: DR Horton I11C. FixtttreJsewtrcap 25.02
Address:4380 SW Macadam Ave Suite 100 Floor drain/floorspa sink/hub 25.02
City/State/ZIP: Portland,OR 97239 Garbage a; osl - 2502
Hose bib 25.02
Phone:(503) 222-4151 Far:( ) Ice maker 12.51
0 APPLICANT 4 CONTACT PERSON Interceptor/grease trap 25.02
Business name: DR Horton Inc. Medical gas(value 5_) Page2
Contact name:Emerald Weeks Primer 12.51
Address:4380 SW Macadam Ave Suite 100 Roof drain(commercial) 12.51
Sink/basin/lavatoty 25.02
city/state/zip: Portland,OR 97239
Solar units(potable water) 62.54
Phone:(503 1222-4151 x1107 Fax::( ) Tub/shower/shower pan 12.51
E-mail: esweeks@drhorton.com Urinal 25.02
C0N'TRaCTOR Water closet 25.02
Water heater 37.52
Business nameTrademark Landscapes Inc .
Water piping/DWV 56.29
Address: PO Box 2410 Other: 25.02
cicy/state/ziPOregon City,OR 97045 Subtotal
Phone:(503) 631-3893 Fax:(6O3) 63/-y7 _ Minimum permit fee: $72.50
CCB Lic.: / /$S3 'r P1un)bin:Lipp•.. �, -i "1 Plan review (25%of permit fee)
8e_--/#07. ��; State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE e,,�Q
//�`s Date:2016 Tbis permit application expires if a permit is not obtained with n 180 days
Print name:
after it has been accepted as complete.
*Fee methodology sells)Tri-County Building industry Service Board.
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City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13132 SW KOSTEL LN, TIGARD, OR, 97224 May 25, 2017 at 12:02:41 PM
Record Type: Record ID:
Residential - Plumbing PLM2016-00249
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
1 " febco model 850, serial # HE10569
Violation Summary:
Inspector Contractor