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Permit CITY OF TIGARD PLUMBING PERMIT I� III Ill Permit*: PLM2016-00158 I COMMUNITY DEVELOPMENT Date Issued: 04!12/2016 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S109DB08900 Jurisdiction: Tigard Site address: 13025 SW BLACK WALNUT ST Project: Summit Ridge No.5,Lot 157 Subdivision: SUMMIT RIDGE NO.5 Lot: 157 Project Description: Irrigation backflow for new SF Contractor: TRADEMARK LANDSCAPES INC Owner: DR HORTON INC PO BOX 2410 4380 SW MACADAM AVE OREGON CITY, OR 97006 PORTLAND, OR 97239 PHONE: PHONE: 503-631-3893 FAX: 503-631-4737 FEES Quantity Description Date Amount 1 ea Backflow Preventer 04/06/2016 $31.27 Specifics: 1 12%State Surcharge- 04/06/2016 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 04/06/2016 $41.23 yp 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: e;1 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 RECEIVED Re«ived City of Tigard 3 2s /( Pem,it No 11 • 13125 SW HaII Blvd.,Tigard,OR 9722 Plan Review ` ' ' �� ����Q�'�� I Phone: 503.718.2439 Fax: 503.598.1 R 2 3 2016 Plan Inspection Line: 503.639.4175 Date/By: Other Permit�l�jsTaOi �t7%79 1 I t,:\It t) Date Readc.By. luris 65 See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARDNo;�,M TYPE OF DING DIVISION Supplemental information FEE* SCHEDULE (p New construction 0 Demolition For special information use checklist Description I Qty. I Ea. 4 Total 0 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 el 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑AccessorySFR(3)bath 500.32 building 0 Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATIONOR � AND/ LOCATION\ Site utilities: Job site address: 1' i')!Jj L%)i C),!lx l 1"r^1j\v^-St, Catch basin or area drain 18.76 s/ ' ` Dryw+ell,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 50.03 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: Lot no.S 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 Expansion tank 12.51 Name: DR Horton Inc. Fixture/sewer cap 25.02 Floor drain/floor sinklhub 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 •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: esweeks@drhorton.com Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business nameTrademark Landscapes Inc p Water piping/DWv 56.29 Address: PO Box 2410 Other: 25.02 City/State/ZIPOregon City, OR 97045 Subtotal Phone:(503) 631-3893 Fax:( ) G3/-V73 7 Minimum permit fee: $72.50 7), CCB Lic.: ; . �'j l9Z'f Plum Sto.:jY1eth)6a Plan review (25%of permit fee) -- ..- State surcharge(12%of permit fee) -70 Authorized signature: � TOTAL PERMIT FEE V.).f) Print name: L5da_ //As Date:2016 This permit apptkation expires if a permit is not obtained within 180 days after it has been accepted as compkte. •Fee methodology set by Tri-County Building Industry Service Board. I Building::Pemms'PLMU•Perrmt.lpp.doc 10:01A/9 440-461611101)2rCOht/WEB1 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 13025 SW BLACK WALNUT ST, TIGARD, OR, 97224 Residential - Plumbing 399 Plumbing final PASS - No C of O PLM2016-00158 David Young 1" fence model850, serial # HE04580 located left side of driveway. Violation Summary: Inspector Contractor