Permit (23) CITY OF TIGARD PLUMBING PERMIT
Fri a. COMMUNITY DEVELOPMENT Permit#: PLM2016-00621
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/25/2017
Itar4k�•L g Parcel: 2S111DA22900
Jurisdiction: Tigard
Site address: 15547 SW APPLEWOOD LN
Project: Heritage Crossing,Lot 48 Subdivision: HERITAGE CROSSING Lot: 48
Project Description: Backflow preventer for irrigation.
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: 503-222-4151
PHONE: 503-631-3893
FAX: 503-631-4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 04/25/2017 $31.27
Specifics: 1 12%State Surcharge- 04/25/2017 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 04/25/2017 $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: /f Permittee Signature://eci"ce .- "kica
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.
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Plumbine Permit Application
Building Fixtures
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Cit3•of Tigard Itecei�ed / -7 /�
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74 City
SW Hall Blvd,Tigard.OR 97f 3 /6
■ Plan Reties
Phone: 503 718 2439 Fax. 503 59&l96() lata B% Other Permit
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nspection Line. 503.639.4175 See Page 2 for ���
I 1(''�t t l) `tkte Read>�B�- Suns la
knrnet. w va ugard-or gov otibed Mnhod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
I4 New construction 0 Demolition For special information use checklist
1 Description I Qty. j Ea. I Total
0 Addition/alteration/replacement 0 Other: New I.2-family dwellings(includes 100 ft.for each utiiin connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
el l-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437 78
❑Accessory building 0 Multi-rarttilc SFR(3)bath 500,32
❑Master builder Each additional bath+kitchen 25.02
Othec Fire sprinkler( sq.ft.) Page 2
JOB SITE iNFORtt1ATION AND LOCATION Site utilities:
r't���7 al,/ Catch basin or area drain
lob site address: i1 /_ _ _ 18 76
Cit'/State/Z1P: Tigard, OR 97223 rd L `� Drywall,leach line.or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.. Project name -VQY1le �� 1nO1 Manufactured home utilities 50.03
Cross street/directions to job site: _-.J Manholes 1$.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft:,_,-„) Page 2
Storm sewer(no.linear ft.:�i Page 2
c/ Water service(no linear ft..__-_) , Page 2
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Subdivision: Lot no.: G 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 0 TENANT E tansion tank 12.51
Name: DR Horton Inc. Fixtura`seutr cap 25 02
Floor dram/floor sink;hub 25 02
Address:4380 SW Macadam Ave Suite 100 cartage disposal 25.02
Cit)/State/ZIP: Portland,OR 97239 Hose bib2
s.o_
Phone:(503)222-4151 Fax t ) Ice maker 12 51
0 APPLICANT *CONTACT PERSON Interceptor/grease trap 25.02
Business name: DR.Horton Inc. Medical gas(value $ ) Page 2
Contact name Primer 12.51
Emerald Weeks Roof drain(commercial) 12.51
•
Address:4380 SW Macadam Ave Suite 100 Sink/basin/lavator.
250,.2
City/State/ZIP Portland,OR 97239 Solar units(potable water) 62.54
Phone.(503 )222-4151 x1107 Fax :1 ) Tub/shower/shower pan 12.51
E-mail: esweeks@drhorton.com urinal 25 oz
CONTRACTOR Ater closet 25.e2
Water heater 37 52
Business nameTrademark Landscapes Inc Water piping-'Dwv 56.29
Address: PO Box 2410 Other:
s o=
City/State/ZIPOregon City, OR 97045 subtotal i
Phone:1503) 631-3893 Fax (te) 63/—g737 Minimum permit fee: $72.50
CCB Lic.: l3 3 3 r Plan review 125%of permit feel
j C,, Plumbin4, o.no: (2 x
r <---?`'.
.. , / State surcharge(12%of permit fee)
Authorized signature: �'4/l_ TOTAL PERMIT FEE -
Print name: � �� //�s I Date:2016 This permit application expires ira permit is riot obtained within ta0 daffy
atter it Ass been accepted as complete.
"Fee methodoloo set lx Tri-County Building industry Service Board-
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