Permit (82) CITY OF TIGARD PLUMBING PERMIT
ICOMMUNITY DEVELOPMENT Permit#: PLM2016-00143
Date Issued: 03/17/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S109DB01800
Jurisdiction: Tigard
Site address: 13090 SW KOSTEL LN
Project: Summit Ridge No.5,Lot 146 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 97045 LAKE OSWEGO, OR 97035
PHONE: 503-631-3893 PHONE.
FAX: 503-631-4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 03/17/2016 $31.27
Specifics: 1 12%State Surcharge- 03/17/2016 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 03/17/2016 $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.
Issued By: ..' ee 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
building Fixtures ���
City of Tigard Re«i.ea _
1.� G DateBy: Q�/ )7 161 - Permit No.:/ N'1�`U�� 091
14 n l I)
13125 SW Hall Blvd.,Tigard,OR 9722 01 Plan Review ((!
Phone: 503.718.2439 Fax: 503.598.1•.'t N.
1 , B Other Permit:�io.. s
1 { 1,l r Inspection Line: 503.639.4175 C Y •�'� } - T�t/16-Q�3�
Internet: www.ugard or.gov `� �y, By 'Allis: 0 See Page 2 for
•\� 4, Supplementallnformadon
TYPE OF WORK ,`�Yk���,1``c;ON 3 FEE* SCHEDULE
j New construction 0 DemolitNt( �1�4 For s tial information use checklist
v�� Description � Qty. Ea. � Total
0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
f 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory buildingSFR(3)bath 500.32
0 Multi-family
Each additional bath/ Itchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION . ND LOCATION �p,�� Q Site utilities:
Job site address: rb ()SRA Ux0 SW Vim- Catch basin or area drain 18.76
V Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97223
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Summit Ridge Manufactured home utilities 50.43
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
It co
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.:1 Fixture or item:
Tax map/parcel no.: Backflawpreventer 1 31.27 31, )...-7
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New SFR Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25 02
• 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:(503) 222-4151 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: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
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name Trademark Landscapes Inc
p Water piping/DWV 56.29
Address: PO Box 2410 Other:
25.02
city/State/ZIPoregon City, OR 97045 Subtotal 31, a7
Phone:(503) 631-3893 Fax:(, ) ( 3/-4/73'7 Minimum permit fee: $72.50 :72 572
Plan review (25%of permit fee)
1 ccs Lig.: / /3 s3 �/` .Plum I.i Aa.:me bold&
��� / State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE j..(
�
Print name: J �l��S Date:2016 This permit application expires if a permit hnot obtained with n ISO day-s
after it has been accepted as compkte.
'Fee methodology set by Tri-County Building Industry Service Board.
1 Butld:ng Permrzs.PLMU-PerrnsApp.doc 100109 440-46161110;1)2rCOM:WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13090 SW KOSTEL LN, TIGARD, OR, 97224 April 17, 2017 at 1 :50:33 PM
Record Type: Record ID:
Residential - Plumbing PLM2016-00143
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
1 " Febco backflow assembly model 850 ser#HE20554 located behind water meter by
sidewalk approved with test report
Violation Summary:
Inspector Contractor