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Permit (70) INCITY OF TIGARD PLUMBING PERMIT It.�'- COMMUNITY DEVELOPMENT Permit#: PLM2016 00174 T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/03/2016 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: Installation of residential backflow preventer for irrigation. 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: 503-222-4151 FAX: 503-631-4737 FEES Quantity Description Date Amount 1 ea Backflow Preventer 05/02/2016 $31.27 Specifics: 1 12%State Surcharge- 05/02/2016 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 05/02/2016 $41.23 Class of Work: OTR Plumbing Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Noffieatioh-C-•er. Thos rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or diec uestions to OU . byIlin/50 - 2.1987 or 1.800.332.2344. Issued By: / / Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available ins ctio date This permit card shall be kept in a conspicuous place on the job site unti comp etion of the project. Approved plans are required on the job site at the time of each inspection. 1 Plumbing Permit Application Building Fixtures #f T 1)41.1 . l 1 N Olt° 1, ($l2 t?E't ' : City of Tigard �. "� Received ' 13125 SW Hall Blvd., 1?ataa$y: ' „9.9. /4, Permit No.: pi1i AQllo,G+�17Y Tigard,OR 97223 fl 1 estiew Phone:1111 503.718.2439 Fax: 503.598.1960 .1.-, 12 `3 Pian 329 01tuu Permit No.: f 3( n it to Inspection Line: 503.639.4179 It,teutet: w w,tigar`d-or.go{ RI See Page 2 for ,t, ore Beady/Bytho jy . a it T � ., Ntifiedtm.titod: Supplemental Information TYPE OF Wf)RKCA 1`R4IS O FEE* SCHEDULE a New construction Far s earl in mutation use ehecddist Description Qty. 1 Ea. 1 Total Q 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 1-and 2-family dwelling 0 Commercial/industrial SFR( )bath 437.78 j]Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities; Job site address: 19,t •-•14, C 1 -)4' " A I Catch basin or area drain 18.76 City/StatetZlP: Tigard,OR 97223 "� f� �`� Drywall,leach line,or trencladrain 18.76 Footing drain(no.linear ft.: ) 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 it:_,..J Page 2 Water service(no.linear ft.:_ ) Page 2 Subdivision: } Lot no.: (L vi Fixture or item: Tax map/parcel no.: Backflow preventer 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 $':PROPERTY OWNER 1 0 TENANT Expansion tank 12.51 Name: DR Horton Inc. Fixture/sewercap 25.02 Address:4380 SW Macadam.Ave Suite 100 Floor drain/floor sink/hub 25.02 Garbage City/State/ZIP: Portland,OR 97239 aipasat 25.02 Hose bib 25.02 Phone:1503) 222-4151 Fax:( ) Ice maker 12.51 0 APPLICANT ii#CONTACT PERSON Interceptor/grease trap 25.02 Business name: DR Horton Inc. Medical gas(value: ) page 2 Contact name:Emerald WeeksPrimer 12.51 Address:4380 SW Macadam Ave Suite 100 Roof drain(commercial) 12.51 Sink/basinnavatory 25.02 City/State/ZIP: Portland,OR 97239 Solar units(potable%ter) 62.54 Phone:(503 )222-4151 xl 107 Fax::( ) Tub/shower/shower pan 12.51 E-mail: eSWeeltnS a@t r'lOrton.corn Urinal 25.02 COLT RCTOII Water closet 25.02 Business nameTradem. Water heater 37.52 ark Landscapes Tnc Water pipin7WV 5629 Address: P©Box 2410 Other: 25.02 City/StatetZlPlpregon City,OR 97045 Subtotal Phone:(503) 63 Fax (Sari) 6,3,1-v737 Minimum permit fee: $72.50 CCB Lic.: .5,,'�j (0 g(d , Plum ' i rto.:mer Jtd 4,2 ' Plan review (25%(12%of permit fee) Authorized signature: ' ""`{ <,,,,(A-, State surcharge(12%of permit fee) { �+/J TOTAL PERMIT FEE ''S/,..S Print name: V L G t(,.F Date:2016 2 i 14, / This permit application eapirts if a pertuit hones obtained within 180 days atter it bas been acreptred as pkte. *Fee methodology set by Tri-County Building Industry Service Board. li u idinesPerniirsTL!vti;-PcrnarArp.:ddt 1010103 444=461 T(tp?9 tCOMIW£$) City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13156 SW KOSTEL LN, TIGARD, OR, 97224 July 20, 2017 at 12:26:18 PM Record Type: Record ID: Residential - Plumbing PLM2016-00174 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS - NoCofO Comments: Backflow devise 1 " model 850 febco, serial # HE21007 located left front. Violation Summary: Inspector Contractor