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Permit (42) CITY OF TIGARD COMMUNITY DEVELOPMENT PLUMBING PERMIT y Permit#: PLM2016-00132 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/20/2016 TWARD�'* Parcel: 2S 109D B07600 Jurisdiction: Tigard Site address: 13020 SW KOSTEL LN Project: Summit Ridge No.5, Lot 144 Subdivision: SUMMIT RIDGE NO.5 Lot: 144 Project Description: Backflow preventer for irrigation Contractor: TRADEMARK LANDSCAPES INC Owner: DR HORTON INC PO BOX 2410 4380 SW MACADAM AVE SUITE 100 OREGON CITY, OR 97006 PORTLAND, OR 97 PHONE: 503-631-3893 PHONE: 503-222-4151 FAX: 503-631-4737 FEES Quantity Description Date Amount 1 ea Backflow Preventer 05/02/2016 $31.27 Specifics: 1 12%State Surcharge- 05/02/2016 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 05/02/2016 $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: / eermittee Signature: Q • .--�. 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 tCEIVED City of Tigard ���p Re e:137 1 n U�lZ— t7r9r772 9 2016 Date By 4 /l� ,� .�/7 Pertntt\o U q 131_o SW Hall Blvd.,Tigard.O 3 ' a Phone: 503.718.2439 Fax; g Plan Review Other Permit No Inspection Line: 503.639.41 _ O TIGARD Date By 1 I G A R D Date Ready:By Juris• ® See Page 2 for Internet: www:tigard-or.go4' NG MIS' Notified,rlethod: Supplemental Information TYPE OF WORK v FEE" SCHEDULE Nes:construction ❑Demolition For special information use checklist Description I Qtv. I Ea. 1 Total ❑.Addition/alteratiow'replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 e 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437,78 D Accessorybuildins SFR(3)bath 500.32 ❑Multi-family Each additional bath/kitchen 25 02 ❑ Master builder 0 Other: Fire sprinkler(�sq.rt.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: t' (r.-52,,D S-V\.) p tip' Catch basin or area drain 18.76 1�� � 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.: 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 it:i Page 2 Storm sewer(no linear ft. _t Page 2 Water service(no linear ft. _) Page 2 Subdivision: � Lot 144 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 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 .CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ t Page 2 Business name: DR Horton Inc. Contact name: Primer 12 51 Emerald Weeks Roof drain(commercial) 12 51 Address:4380 SW Macadam Ave Suite 100 Sinkbasin lavatory 25.02 City/State/ZIP: Portland, OR 97239 Solar units(potable water) 62.54 Phone:(503 )222-4151 x1107 I Fax: :( 1 Tub/shower/shower pan 12.51 E-mail: esweeks@drhorton.com [;rival 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business nameTrademark Landscapes Inc Water pipm_.D'.1'V 56.29 Address. PO Box 2410 Other: 25.02 city/State/ZlPoregon City, OR 97045 Subtotal Phone:(503) 631-3893 I Fax:(6-03) (.,3/-y73 7 Minimum permit fee. $7250 CCB Lic.: ' i Plan review (25%ofpermit fee) �� Plumbing{ip..to.:mel- e)6ad2 //�� i r i State surcharge(12%of permit fee) Authorized signature: � i��"t�---.J6 , TOTAL PERMIT FEE ,._.?7, Print name: JE irnS i Dale:2016 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry'Service Board. I BuildingPermns.PL5ti-PerrretApp.doc 1001'09 44C-461oTi i0 C2 CO\i RVEB 1 L City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13020 SW KOSTEL LN, TIGARD, OR, 97224 Record Type: Record ID: Residential - Plumbing PLM2016-00132 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: 1 " backflow device Febco model 850 ser#HE21113 approved with test report. Violation Summary: Inspector Contractor