Permit (14) � „ CITY OF TIGARD
PLUMBING PERMIT
:' 2 ' COMMUNITY DEVELOPMENT Permit#: PLM2016-00114
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/07/2016
Parcel: 2S109DB01800
Jurisdiction: Tigard
Site address: 13076 SW BLACK WALNUT ST
Project: Summit Ridge No.5,Lot 160 Subdivision: SUMMIT RIDGE NO.5 Lot: Multiple
Project Description: New SF
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 03/07/2016 $31.27
Specifics: 1 12%State Surcharge- 03/07/2016 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 03/07/2016 $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.
— 9
As
Issued By: Ale
� ► Permittee Signature: 9 , 'i
e
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 4
Building Fixtures
City of Tigard r EB 1 1 2016 iteee£va1IIIIIIIrIIIIIIIIIIIIIIIII.„ ,g Permito.:• 13125 SW Hall Blvd.,'Ti atit:�50 oatcByis - ��/ �/4L((7 �j)f 1
Plan Review
111111 II Phone: 503 718.2439 3 1 Other Permit No.:
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Inspection Line: 503.w171-„IT,aa,;r �,...,., DateReadyBy. )arts. H See Page 2for
Internet: www.tigard-OrgOVAL/2 Notified(tietbod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
WS New construction i ❑Demolition Far special information use checklist
f Description ( Qty. ( Ea 1 Total
❑Addition/alteration/replacement 1 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
fl 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family Each additional bathkitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ti.) Page 2
I JOB SITE INFORMATION AND LOCATION Site utilities:
l' [ Catch basin or area drain 18.76
Job site address
rbC 4 `' `d"' 04111,./4 Drywelt,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97223 ;
, Footing drain(no linear ft.: �) Page 2
Suitefbidg./apt_no.: Project name: Summit Ridge
Manufactured home utilities 50.03
Cross streetidirections to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no,linear ft.: ) Page 2
Storm sewer(no.linear ft.:iJ Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Ln L Fixture or item:
Tax map/parcel no.: Backflowpreventer 1 { 31.27 �( �
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25,02
New SFR Dishwasher 25.02
Drinking fountain 25.02
Ejeetorstsump 25.02
at PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: DR Horton Inc. Fixture/sewer cap 25.02
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:1503) 222-4151 Fax:( ) Ice maker 12.51
0 APPLICANT CONTACT PERSON Interceptor.-grease trap 25.02
Business name: DR Horton Inc. Medical gas(value:S Page 2
Contact name: Primer 12,51
Emerald 'r eeks 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 I Fax: :( ) Tub/shower/shower pan 12.51
E-mail: esweeks@drhorton.com Urinal 25.02
CONTRACTOR water closet 25.02
Water heater 37.52
Business name Trademark Landscapes Inc
p Water pipingtDWV 56.29
Address: PO Box 2410 Other 25.02
City/State!ZIPOregon City, OR 97045 Subtotal 3/,.,2:?
Phone:(503) 631-3893 Fax:(t3) 63/-y73 7 Minimum permit fee: $72.50 271,Tt.,
CCB Lie.: �(��� „,----;47):::0:),0,,..c.: -
Pian review (25%of permit fee)
State surcharge(12%of permit fee) j,7 u
Authorized signature: __ f TOTAL PERMIT FEE-
l I y e..�
Print name: J� [//,- 1 Date.2016 91 it,
1�x Th£s permit applicrt£on expires if a permit is not obtained wi in ISO days
Z./
`!! 1 after it has been accepted as complete.
*Fee methodology set in Tri-County Building Industn Service Board.
I'aaildin5.permspL\U-P pp doe IO'OI;OS 440 616T(t0IO2/COM'WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13076 SW BLACK WALNUT ST, TIGARD, OR,
97224
Residential - Plumbing
399 Plumbing final
PASS - No C of O
September 20, 2016 at
2:27:35 PM
PLM2016-00114
Chip Barnett
Violation Summary:
Inspector Contractor