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Permit (47) 1111 CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2017-00006 RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/10/2017 t't''` g Parcel: 2S109DB01800 Jurisdiction: TIGARD Site address: 13058 SW BLACK WALNUT ST Project: Summit Ridge No.5,Lot 159 Subdivision: WOODSIDE Lot: 10 Project Description: Backflow preventer for model home with sales office. Contractor: TRADEMARK LANDSCAPES INC Owner: VENTURE PROPERTIES INC PO BOX 2410 4230 GALEWOOD ST STE 100 OREGON CITY, OR 97006 LAKE OSWEGO, OR 97035 PHONE: 503-631-3893 PHONE: FAX: 503-631-4737 FEES Quantity Description Date Amount 1 ea Backflow Preventer 01/10/2017 $31.27 Specifics: 1 12%State Surcharge- 01/10/2017 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 01/10/2017 $41.23 Plumbing Class of Work: OTR Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: _ C9)Ats:r_A-1#4-,' Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application '� , Building Fixtures r � , FOR OFFICE ISE ONL,v r . --^ City of Tigard Received ee /7 ponnit No.: 7'- 1114 13125 SW Hall Blvd.,Tigard,OR 97223 1 u1` y P-1 Res'cavi Other Permit No: T q 1 \ II Phone 503 7183 2439 Fax: 503.598.1960 l te'I3y,. �o2t�tC� -tltk t Inspection Line: 503.639.4175v it,x lb"ate ' ady/By Juris lift see Page 2 for I'IGARE) Internet: wwwtigard orgov J r a ,< /Method,Ilii 69" Supplemental Information '' b� ' �To K'"� X y.ut' . jAr � ii,i . �'^`R '# rip rv: � �.. For special information use checklist. IalNew construction ©Dee on Description { Qty. I Ea. Iota{ 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 10011.for each utility connection) r `c ifitti ` `co J u e- ole " ro SFR(I)bath 312.70 if] I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 n r� i �a -"w a� . _ h ,Ti s e R$Vl1 '['lio f "' �i 1 " Site utilities: ii °'� C. �t' ��� i i Catch basin or area drain 18.76 Job site address: I.3C (3 C i,,,,L,IC,,, ;,Lilk.7,:' G `;' 11, I OR 97223 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard,g Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I 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.: ) Page 2 Water service(no.linear ft.:_) Page 2 , Subdivision: i Lot no.: 15 ei Fixture or item: Tax map/parcel no.: Backflow preventer I 31.27 ��- i� t�. Backwater valve I 12.51 w , # VVI :P- , i' 25.02 Clothes washer New SFR Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 vl 14t a - Expansion tank 12.51 lvatnc. ixture/sewer cap 25.02 DR Horton Inc.IOCFloor 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) 222-4151 Fax:( ) lee maker 12.51 :70,-::rr 'Aic4* !, aVi tr - * Q�l � pi4 Interceptor/grease trap 25.02 Page2 Business name: Medical gas(value:$ ) 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 )222-4151 x1107 Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 esweeks@drhorton.com Water closet 25.02 . ''',,,r1,111-7-1-',-,T,. "•YWater heater 37.52 Business nameTrademark Landscapes Inc Water piping/DWV 56.29 Address: _ ) 410 Other: 25.02 City/State/7,iPOregon City, OR 97045 Subtotal Minimum permit fee: $72.50 Phone:(503) 631-3893 Fax:( ) Plan review (25%of permit fee) CCB Lie.: y Plumbing Lie.no.: - e I 7 G State surcharge(12%of permit fee) Authorized signatur TOTAL PERMIT FEE - ,//// 1 1 1 'ry This permit application expires if a permit is not obtained within 180 days _l Print name:,_ et,, Date: 1 I g 1 1 1 after it has been accepted as complete. lig ( t *Fee methodology set by'I ri-County Building Industry Service Board. I..Building\Permits'J'LA MU-PerrnitApp doe 10%01`09 440-4616T1 I0r63JCOMIWEB1 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13058 SW BLACK WALNUT ST, TIGARD, OR, July 6, 2017 at 8:25:19 AM 97224 Record Type: Record ID: Residential - Plumbing PLM2017-00006 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: 1 " backflow device Febco model 650 ser#RE02741 approved with test report. Violation Summary: Inspector Contractor