Permit (36) 1,11
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016 00631
T f G A f;O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/12/2017
Parcel: 2S 111 DA23000
Jurisdiction: Tigard
Site address: 15550 SW APPLEWOOD LN
Project: Heritage Crossing,Lot 49 Subdivision: HERITAGE CROSSING
Project Description: Backflow preventer for irrigation. Lot: 49
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 04/11/2017 $31.27
Specifics: 1 12%State Surcharge- 04/11/2017
$8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 04/11/2017 $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: „ 4.er-i Permittee Signature:
Sr.".
a/ph�-.hOGI
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
m
Building Fixtures i �
IVFE I Olt 01 l t( 1. 1 l OXI 1
City of Tigard FF
1111 13125 SW Hall Blvd T; ard,OR 9722 (/�-� 7 �y Pemnc\oPhone: 503 718 2439 Fax, 503 398 1� U� 2Q16 xa !�I�"" �'^"� ���o'�v��1
r r c n Ic t I' Inspection Line: 503.639.41 T5 orry lata Re other Permit N g 2 for
nLin :tgard-or503. 3 .41 ,'. `( ° Date Ready,Br �C
d,a i:l asaris S See Supplemental
l information
16 Nt— F'"4f,,- t ,F Arnlfied�Slelhad:
TYPE OF ��'(3R�., x -'( "�( � 5upplemenotl tnforrnatton
FEE* SCHEDULE
gil New construction Demolition
❑ For special information use checklist
0 Addition/alteration/replacement - spoon I Qty. j Ea. j Total
0 Other. New i-2-family dwellings(includes 100 ft.for each utility connection)
CATEGOR1 OF CONSTRUCTION SFR(I)bath
31'_.70
ei 1-and 2-family dwelling ❑Commercial/industnal SFR 12)bath 437 78
❑Accessory building 0 Multi-family SFR(3)bath 500 32 j
❑Master builder 0 Other Each additional bath kitchen 25.02
J
JOB SITE INFORMATION AND LOCATION Fire utspilities:
( sq.ft.) Page 2
Site utilities:
Job site address: /5,5-5.0 u/ 40/71„, ,, Catch basin or area drain 18 76 1
City/State/ZIP. Tigard, OR 97223 Dn'we11,1eaeh Irne.or(ren t drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg/apt.no.. 1 Project name le,��` — I
��""'' j 1'1� Manufactured home utilises 50.03
Cross street/directions to job site:
Manholes 18.76
—04
Rain drain connector 18.76 {
Sanitary sewer(no.linear ft:, 1 Page 2
Storm sewer(no.linear ft.: i Page 2
Subdivision: Water service(no linear ft..,-__•) Pae 2
' Lot no.: tie/ Fixture or item: g
Tax map/parcel no.: Backflow preventer
1 31._7
DESCRIPTION OF WORK Backwater tialve 12.51
New SFR Clothes washer 25 02
Dishwasher 25.02
Drinking fountain 25.02 I
Ejectors/sump 25 02
* PROPERTY OWNER I 0 TENANT Expansion tank
12.51
Name: DR Horton Inc. Fixtttra`sewer cap 25 02
Address:4380 SW Macadam Ave Suite 100 Floor dram'tloor sutk hub 25 02
City/State/ZIP: Portland,OR 97239 Garbage disposal 25.02
Phone:(503)222-4151 Fax t Hose bib 25 02
Ice maker
0 APPLICANT 15 51
C'O\TACT PERSON lnterceptorgrease trap 25.02
Business name: DR Horton Inc. Medical gas(value $ ) Page
Contact name Emerald Weeks Primer 32.51
Address'4380 SW Macadam Ave Suite 100 Roof drain(commercial) 12,51 '
City/State/ZIPSink/basin/lavatory 25 02
Portland,OR 97239 solar units(potable water)
Phone.(503 )222-4151 x1107 Fax ( 6_5
? Tubishower'showerpas 12.5i
E-mail, esweeks@drhorton.com Limas 25 02
CONTRACTOR Water closet 25.02
Business nameTrademark Landscapes Inc water heater 37 52
Address: Water ptping17R V 56.29
P9 Box 24I0
Other:
CityiState/ZIPOregon City, OR 97045 ''°-
Subtotal 1
Phone:(503) 631-3893 1 Fax t 1
•� (�,�1"y'J3''J Minimum permit fee: 572.50 i
CCB Lic.: ir /3,5-3 ., Plumbing.I.ie.no: ,,-(. .1.--./.1Plan renew 125%of permit fee)
Authorized signature: / • %,� State surcharge(12%of permit fee)
[ Print name: � � £�,t'
�-yi TOTAL PERMIT FEE
IDate'2016 1 This permit application eaptrcs Ira permet Is not obtained within 180 days
1 after it hrts bttn accepted as complete.
"Fee methodology set bt Tri-Counts Building Industry Service Board-
I Budduy PermitapL\ML'-PerniApp.'sc IC VI 09 43w61eTrit a COMWEBI
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15550 SW APPLEWOOD LN, TIGARD, OR, August 31 , 2017 at 10:19:07
97224 AM
Record Type: Record ID:
Residential - Plumbing PLM2016-00631
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
1 " Febco backflow assembly model 850 ser# HE20079 approved with test report
Violation Summary:
Inspector Contractor