Permit (23) CITY OF TIGARD PLUMBING PERMIT
. COMMUNITY DEVELOPMENTIII
Permit#: PLM2017-00164
13125 SW Hall Blvd.,Ti Date Issued: 05/03/2017
TIGARD OR 97223 503.718.2439 9
Parcel: 2S 111 DA00400
Jurisdiction: Tigard
Site address: 15432 SW APPLEWOOD LN
Project: Heritage Crossing,Lot 55 Subdivision: HERITAGE CROSSING Lot:
Project Description: Irrigation backflow
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 05/03/2017 $31.27
Specifics: 1 12%State Surcharge- 05/03/2017 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 05/03/2017 $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.
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Issued By: `- • 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
Site Utilities RECEIVEir
POR OFFICE GCSE ONE}
City of Tigard MAY 3 2017 Received
Date/By: --�/�, ►#'-, PermitN94 �2"`,/1//f
14
13125 SW Hall Blvd.,Tigard,OR 9722311 r (/ ld
Phone: 503.718.2439 Fax: 503.598.19CITY OF fiIH D DatPlane/ReBy:view Other Permit No..
1�, tz la Inspection Line: 503.639.4175 BUILDING DIVISIGhate Ready/By: Juris H See Page 2 for
Internet: www.tigard-or.gov otified/tvlethod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
XNew construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑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
34 I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( ,sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 15 45a S� ii ti • 1a. �-�#- Catch basin or area drain 18.76
City/State/ZIP; �`���� ♦ G1 2 Drywell,leach line,or trench drain 18.76
�t z . , 24- Footing drain(no.linear ft.:) Page 2
Suite/bldg./apt.no.: I Project name: ilex; CS,ctyyc 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: I Lot no.: 55 Fixture or item:
Tax map/parcel no.: Backflow preventer L 31.27 31.A.4..
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Backflow preventer for irrigation system Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT 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 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:DR Horton Inc. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address:4380 SW Macadam Ave. suite 100 Sink/basin/lavatory 25.02
City/State/ZIP:Portland,Oregon 97239 Solar units(potable water) 62.54
Phone:(503)222-4151 Fax::(503)222-3717 Tub/shower/shower pan 12.51
E-mail Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:Trademark Landscapes Inc. Water piping/DWV 56.29
Address:P.O. Box 2410 Other: 25.02
City/State/ZIP:Oregon City, Oregon 97045 Subtotal
Phone:(503)632-0319 e.-4' Fax:(503)632-0321 Minimum permit fee: $72.50'
� ( Plan review (25%of permit fee)
CCB Lic.:11353 .41 ,_ . b-t9(D Plumbing Lic.no.: -
State surcharge(12%of permit fee)
Authorized signature: S 4110j TOTAL PERMIT FEE
Print name:Steve Ellis Date:53J(9J.[_ 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.
I:1Building\Pennits\PLMU-PermitApp.doc 10/01/09 4404616T(10/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15432 SW APPLEWOOD LN, TIGARD, OR, May 4, 2017 at 12:02:47 PM
97224
Record Type: Record ID:
Residential - Plumbing PLM2017-00164
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
1 " backflow assembly Febco model 850 ser#HE66535 located behind meter right of front
walkway approved with test report.
Violation Summary:
Inspector Contractor