Permit (48) IIN CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00373
TIGTfGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/12/2016
Parcel: 2S 109 DB01700
Jurisdiction: Tigard
Site address: 13110 SW KOSTEL LN
Project: Summit Ridge No.5, Lot 147 Subdivision: SUMMIT RIDGE NO.5 Lot: Multiple
Project Description: 48 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
48 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
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
4011111,
Issued By: r
Permittee Signature:
/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures k i ;'
�'. )9 4 1--,, Received
is City of Tigard �, � x
w Pelntit No.:
]3125 SW Hall$lvd.,Tigard, } � Datce Plan e 30// F ,sit,..._c S;3 7.
1 Phone: 503.718.2439 - Fax: 5 598.1960, r� S Other Permit Nu.: v j
\7 Date/By: tv7'r�G>i([i (.Z �L
Inspection Line: 503.639.4175 �� .y},,t D�ied/Me Rcady/By: tori,: ® Ser Page 2 for f.x
Internet www.tigard-or.gov „ t F(``t Notified/Method: --(, Supplemental Information
❑New construction g olition Fur special ixfanxodixx use cGuktist
Ne
❑Addition/alteration/replacement C]Other:
11-Other: ton Qty. ( Ea. Total
2-[amity dwellings(includes 100 ft.for each utility connection)
CAtIGORYOr CONSCRUCfl•.O1$ SFR(1)bath 312.70
❑1-and 2-family dwelling 0 Commercial/ind ustrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builder Other: Each additional bath/kitchen 25.02
Fire sprinkler( sq.It) Page 2
. Jo$':SIc INEORMATI LOCATION Site',WidestJob site address: \ \10 J Catch basin or area drain 18.76
City/State/ZIP:
J `" Drywell,leach line,or trench drntn 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: ) Project name: Summit Ridge i (,4.; It(7 Manufactured home utilities 50.03
Cross street/directions to job site: . Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: Page 2
Water _
service(no.linear ft.: ) Page 2
Subdivision: f Lot no.: \\A-"1 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
�
�(� NN Bat kwater valve 12.51
A /: t J/ ' l IA 1t/ Clothes washer 25.02
Dishwasher 25.02
3\1)\44 • \ + C��� /f ' k Drinking fountain 25.01
1l Electors/Sump 25.02
,amortzry.owleitI a•TTdtlAN Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP:
Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APP14c ui r. _ 0 COMOKT IIERSO,r4 Intercepter/grease trap 25.02
Business name: DR Horton Inc Medical gas(value:$ ) Page 2
Contact name: Emerald Weeks Primer 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
�4?NTRACi. R
H l Water heater 37.52
Business[tame _ 1J Waterpiping/DWV 56.29
Address: VOV t\ •-•1/ia < Other:
Ak i/�� 25.02
City/State/ZIP:Q � J Subtotal
Phone: Fax:( J Minimum permit fee: $72.50
CCB Lic.:%1 I Plumbing Lic.no.:
Plan review (25%of permit fee)
- State surcharge(12%of permit fee)
Authorized signature It, I I TOTAL PERMIT FEE
Print name: rIl 1", ' 1 -t ,_ Dam; This permit application expires if a permit is not obtained within 180 days
i atter it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Buidug1Parmits\PLMU-PermitApp.luc 10/01/09 440-4616T(10/02/COM/WEB)