Permit (46) CITY OF TIGARD PLUMBING PERMIT
1111
COMMUNITY DEVELOPMENT Permit#: PLM2016-00374
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/12/2016
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: 60 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.
FAX:
FEES
Quantity Description Date Amount
60 If Storm Sewer 07/12/2016 $62.54
Specifics: 1 12%State Surcharge- 07/12/2016 $8.70
Plumbing
10 ea Minimum Fee Adjustment- 07/12/2016 $9.96
Type of Use: SF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ermittee Signature: c«c�����"`'""'�
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application ',5 °
BuildingFixtures £$ y,, "
� rOl: O111( r i 1 0N1 1
City of Tigard d.-1%'\\ �iteceived Pamir No.: f�
11:
13125 SW Hall Blvd.,Tigard,OR 97223 \�N r''� - �) l`� / -
Phone 503.718.2439 Fax: 503.598.1960 �` Review /y�
'1'iy" v°"a`1`a.''5"'`Date/By: Other PwntitNo.:/' 3.790/41 .".0i.
Inspection Line: 503.639.4175 °
Internet www.tigard-or.gov 0\�,, ),'s, Note R�y�' tori,: See Penl for
NoNotified/Method: �j See
IInformationTYPE';OF WO1RK `� + t S
Fur special information use checklist❑New construction ❑Demolition
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY•OP CONSTRUCTION SFR(1)bath 312.70 I
and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building
0 Multi-family
❑Master builderEach additional bath/kitchen 25.02
Other: Fire sprinkler( sq.ft.) Page 2
JOB SITM INtoastAnSite utilities:
Job site address: Catch basin or area drain 18.76
City/State/ZIP:
I �� Dtywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 1 Project name: Summit Ridge(?, t'..Jl C i-ty 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.:1.00 Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.:1\./( Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
TPY'l<ON OT ff Backwater valve 12.51
Clothes washer 25.02
f `l --- IA 1 f ___4� Dishwasher 25.02
Drinking fountain 25.02
" ' Ejectors/sump 25.02
r3 PR. 'J RTV I C}.wp a • Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Address:
Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:
Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
:0 Ammon. 0 coo11 '.Atcr:IFirb, f,. Interceptor/grease trap 25.02
Business name: DR Horton Inc Medical gas(value:$ ) Page 2
Contact name:
Emerald Weeks Primer 12.51
Address: 4380 SW Macadam Ave Ste. 100 Roof drain(commercial) 12.51
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/showcrpan 12.51
E-mail: esweeks@drhorton.com Urinal 25.02
Water closet 25.02
1, `,: Water heater 37.52
Business frame i _ 1„) Water piping/DWV 56.29
Address: sL3 0( k\_
ii i Other: 25.02
City/State/ZTP:Q A C) i r-,
VA J Subtotal
Phone:.;Ito b' � � Fax:( v Minimum permit fee: $72.50
CCB Lie.:% 1 -��V � ���LLL - Plan review (25%of permit fee)
Plumbing Lic.no.:
Authorized signature 1 State surcharge(12%of permit fee)
j�- TOTAL PERMIT FEE
Print name: vOl i c' '1 1 ! -4108114111Date: te MILIN This permit application expires if a permit Is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:113uildiug\P,rmits\PLMU-PuatitApp.doc JO/01M 4404616T(10/O2ICOM/WEB)
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 7:57:52 AM
Record Type: Record ID:
Residential - Plumbing PLM2016-00374
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - NoCofO
Comments:
Inspected prior to cover by inspectors, DS an ACG.
Violation Summary:
Inspector Contractor