Permit (42) CITY OF TIGARD PLUMBING PERMIT
" "11 I COMMUNITY DEVELOPMENT
Permit#: PLM2016-00125
13125 SW Hail Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/05/2016
TIGARD Parcel: 2S109DB01800
Jurisdiction: Tigard
Site address: 13014 SW BLACK WALNUT ST
Project: Summit Ridge No.5,Lot 158 Subdivision: SUMMIT RIDGE NO.5 Lot: Multiple
Project Description: Backflow preventer for irrigation.
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 04/04/2016 $31.27
Specifics: 1 12%State Surcharge- 04/04/2016 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 04/04/2016 $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: `_! / Permittee Signature: / }"pVG/ w _ /
,„(19
l yyy 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.
Plumbine Permit Application
' Building Fixtures RIK'YANED ,
City of Tigard Rei°«t Permit No.: „ �
13125 SW Hall Blvd.,Tigard,OR 97223 Daa1By: L l -�� d
Phone: 503.718.2439 Fax: 503598.196 p 'Z 4 201 Plan Review
r D t elBY: Olhn Permit No.:,/Y)5r4it r ed
Inspection Line: 503.639.4175 C �� any J See
for
i t c3 t:t Internet: www.tigard-or.gov t Notified/Method:t1k �'►I:t�.��' _ Supplemental information
TYPE OF WORK.k., NSLe. 1-1 VISION FEE* SCHEDULE
a New construction ❑
For special Gtforntaton use checklist
Description I Qty. ( Ea. f Total
0 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
el 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 bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: l`)21.)1 L cw ‘1,.04..,. 0�j 1 I Catch basin or area drain 18.76
V' �^� Dry-well,leach lir,or trench drain 18.76
City/State/ZIP: Tigard,OR 97223 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: Summit Ridge , Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no,linear ft.:_J Page 2
Storm sewer(no.linear ft.:_J Page 2
Water service(no.linear ft.: Page 2
Subdivision: I Lot no.: 1, (,:-6, Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27
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 I 0 TENANT Expansion tank 12.51
Name: DR Horton Inc. Fixcure'se`'ercap 25.02
Floor
Address:4380 SW Macadam Ave Suite 100 ge dispispoossink/hub 25.02
a
Garbage dal 25.02
City/State/ZIP: Portland,OR 97239 Hose bib 25.02
Phone:(503) 222-4151 Fax:( ) Ice maker 12.51
0 APPLICANT At CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
DR Horton Inc.
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: esweeks@drhorton.com (Irina( 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name Trademark Landscapes Inc Watert in W V 56.29
P�P S�
Address: PO Box 2410 Other: 25.02
City/State/ZIPoregon City,OR 97045 Subtotal
Phone:(503) 631-3893 Fax:( a .) 6j3/..-4/737 Minimum permit fee: $72.50
Plan review. (25%of permit fee)
CCB Lic.: 674(0 7.p
Plum ' o.: _
State surcharge(12%of permit fee)
Authorized signature: /
440)
TOTAL PERMIT FEE
Print name: � �� f fps Date:2016 pelt application expires if permit is not obtained within ISO days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:lituildinaiPermasTLMt1-PemdtApp.doc iO:Olt09 4404616T(1O/02J`COM/WEB)
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13014 SW BLACK WALNUT ST, TIGARD, OR,
97224
Record Type:
Residential - Plumbing
Inspection Type:
399 Plumbing final
Result:
PASS- NoCofO
Comments:
Tel: 503.718.2439
Inspection Date:
February 2, 2017 at 9:04:45
AM
Record ID:
PLM2016-00125
Inspector:
David Young
1" Febco model 850, serial # HE09270 installed front left yard.
Violation Summary:
Inspector Contractor