Permit (61) CITY OF TIGARD PLUMBING PERMIT
it ' COMMUNITY DEVELOPMENT
Permit#: PLM2016-00173
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/26/2016
Parcel: 2S109DB01700
Jurisdiction: Tigard
Site address: 13147 SW KOSTEL LN
Project: Summit Ridge No.5,Lot 137 Subdivision: SUMMIT RIDGE NO.5 Lot: Multiple
Project Description: Irrigation backflow for new SF
Contractor: TRADEMARK LANDSCAPES INC Owner: DR HORTON INC
PO BOX 2410 4380 SW MACADAM AVE, STE 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 09/23/2016 $31.27
Specifics: 1 12%State Surcharge- 09/23/2016 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment 09/23/2016 $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 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: ..12)/m77,
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 .,, .,.:,•, ... ,,,„,, ,,..: . ,,t.; 0 „.,
-, it .'- 1 OR t111 It I. 1 1 0\1 1
City of Tigard
RDate/Bye'mived. 2A1/4, ,c(41/4" , PermitN7e2,-/:;0/1---eer7-3
ill . 13125 SW Hall Blvd.,Tigard,OR 97223 5., 4 , _,
Plan Review
Phone. 503.718.2439 Fax: 503.598.1'44:i[3 4 4: 2,,in: Date/By: Other Permit
i , , „ Inspection Line: 503.639.4175
Date Reay(By: hires: fil See Pap 2 for
' ' '''' ' Internet: wuwtigard-or.gov .
'1'1' '4'.ii:1 i d'fo:#4.1(1 N°65"11.4eth°d' Supplemental Irtformatioa
TYPE OF WiT.MICII ,;i- ' ';' - '4k, FEE* SCHEDULE
La New construction '(3 terncifiiio'ii ' ' ' For special information use cisecnist.
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
9 I.-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25 02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION a Site utilities:
Job site address: I t Li 9---- W ,V•DC:...._tel Lark/L,Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97223
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 ft.:_____) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:
te
Fixture or im.
Lot no.: 1714,-. .
Tax map/parcel no.: Backflow preventer 1 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
New SFR
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump , 25.02
• PROPERTY OWNER 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: DR Horton Inc.
Floor drain/floor sink/hub 25.02
Address:4380 SW Macadam Ave Suite 100
Garbage disposal 25.02
City/State/ZIP: Portland,OR 97239
Hose bib 25.02
Phone:(503,1 222-4151 Fax:( ) Ice maker ' 12.51
0 APPLICANT •CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:S ) Page 2
Business name: DR Horton Inc.
Primer 12 51
Contact name:Emerald Weeks
Roof drain(commercial) 12.51
Address:4380 SW Macadam Ave Suite 100
Sink/basin/lavatory 25.02
City/State/ZIP: Portland,OR 97239 Solar units(potable water) 62.54
Phone:(503 )222-41 51 x1107 Fax::( ) Tub/shower/shov.er pan
' 12.51
Urinal 25.02
E-mail: esweeks@drhorton.com
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business nameTrademark Landscapes Inc Water piping/DWV 56.29
Address: PO Box 2410 Other: 25.02
...
CitY/stateoPOregon City, OR 97045 Subtotal
Phone:(503) 631-3893 Fax:(alp 63/-V73 7 Minimum permit fee: S72.50
Plan review (25%of permit fee)
CCB Lic.: ii3--s-s ky 7ke.,---. Plum•' '.. 'i• nci.:1,,,,eive 4,2c13
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: L5 114-3. Date:2016 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,BuildingsPerniiisTIMU-PerrreApp ckx 10,01%09 44d-44516M CUOVCOWWEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13147 SW KOSTEL LN, TIGARD, OR, 97224 April 17, 2017 at 9:25:14 AM
Record Type: Record ID:
Residential - Plumbing PLM2016-00173
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
1 " Febco backflow device model 850 ser#HE06388 located behind meter at sidewalk
approved with test report
Violation Summary:
Inspector Contractor