Permit (44) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00375
1 tGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/12/2016
Parcel: 2S109DB01700
Jurisdiction: Tigard
Site address: 13156 SW KOSTEL LN
Project: Summit Ridge No.5,Lot 149 Subdivision: SUMMIT RIDGE NO.5 Lot: Multiple
Project Description: 58 ft.of storm sewer to connect to lateral.
Contractor: G CAM LTD Owner: DR HORTON INC
PO BOX 1144 4380 SW MACADAM AVE SUITE 100
CANBY, OR 97013 PORTLAND, OR 97239
PHONE: 503-263-2005
PHONE: 503-222-4151
FAX:
FEES
Quantity Description Date Amount
58 If Storm Sewer 07/12/2016 $62.54
Specifics: 1 12%State Surcharge- 07/12/2016 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 07/12/2016 $9.96
Plumbing
Class of Work: ALT
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: w 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
Building Fixtures § f'
.� ,yy� � roll Orf I( r I .r c)\I.1
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},,..-T1 -: Received
City of Tigard -�� i
13125 SW Hall Blvd.,Tigard,OR� Ci Datemy: `� L/ 017-- Permit No.: t i41 o?3z
a Phone: 503.718.2439 Fax: 503.598.196 �., Plan Review j
Other Perini[Nu.:M t i.��yah
Inspection Line: 503.639.4175 ���\S Date/By: ` ' S/�f l d V '
Internet. www.tigard-or.gov , ,i:.- [c RcadyBy: fu ls: See Page 2 for
Notificd/Method: Supplemental Information
OF W,,,,���7 s a�tiII
t :, r .HE,
El New construction , '' kkniolition For tial in ormation use checklist ,
Description Qty. J Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATI GORY OP CONSTRUCTION LION SFR(1)bath 312.70
[ and 2-family dwellingSFR(2)bath 437.78
0 Commerc;aUindustrial
❑Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
d°11INt RMAIT AND 'MN Site utilities:
Job site address: i I Catch basin or area drain 18.76
V 7
l' elll i
Dryw each line,or trench drain 18.76
City/State/ZIP:
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: { (`
Summit Ridge 1 1 s`-t�1- i h 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.:,_2. Page 2
-_./ -, Water service(no.linear ft.: ) Page 2
Subdivision: Lot no . Fixture or item:
Tax map/parcel no.: �� Backflow preventer 31.27
olr ;imam Backwater valve 12.51
�\k I/� Clothes washer 25.02
`, �� " ° ` r "�1 �_ Dishwasher 25.02
Drinkingfountain
/� j v ) 25.02
` r [ `� v Ejectors/sump 25.02
CI i'llOPERTY OWNER t C TENANT Expansion tank 12.51
Name: I Fixture/sewer cap 25,02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP:
Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
L'Att'I!€tjptai°t 0 CONTAtw7' Interceptor/grease trap 25.02
Business name: TiDHorton Inc Medical gas(value:$ ) Page 2
Pr
Contact name: Emerald Weeks111C1 12.51
Roof drain(commercial) 12.51
Address: 4380 SW Macadam Ave Ste. 100 Sink/basin/lavatory 25.02
City/State/ZIP: Portland,OR 97239 Solar units(potable water) 62.54
Phone:(503 ) 222-4151 ext 1107 Fax::( ) Tub/shower/shower pan 12.51
E-mail: esweeks@drhorton.com Urinal 25.02
Water closet 25.02
Water heater 37.52
Business name CAA/V1L Water piping/DWV 56.29
Address: )Q V( ' A 4Other: 25.02
City/State/ZTP:� 3 CAO,,. LA 1 bk ) Subtotal
Phone:1. 570 Fax:( Minimum permit fee: $72.50
J��� �� Plan review (25%of permit fee)
CCB Lic.:(,1 -. \ e� 1� I Plumbing Lic.no.: - tat
V ! ( S e surcharge(12%of permit fee)
Authorized signature l ! TOTAL PERMIT FEE
41 0 / 1-
Prim name: ^ \ � � Date: 1efar i , This permit application expires if a permit k not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Pamits\PLMU-PumitApp.doc 10/01/09 440-4616T(1.0/O2ICOM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13156 SW KOSTEL LN, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Plumbing PLM2016-00375
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor