Permit (38) RECEIVED
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT , ti I8
: 11 Request for Permit Action . i ' :. ii6ARD
„
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tiga`'$ yy' D V! 1 )j'
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223 G
AStir
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard�or. ova
FROM: Owner ❑ Applicant ❑ Contractor ❑ City Staff
Check(V)one
REFUND OR Name:
INVOICE TO: (Business or Individual) D.R. Horton, Inc. - Portland
Mailing Address: 4380 SW Macadam Ave, Suite 100
City/State/Zip: Portland, OR 97239
Phone No.: 503-222-4151
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
CANCEL/VOID PERMIT APPLICATION.
211' REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: PLM2016-00604
Site Address or Parcel #: 15491 SW Applewood LN
Project Name: Heritage Crossing
Subdivision Name: Lot#: 45
EXPLANATION: We are no longer installing irrigation on this lot and need irrigation removed from
the hermit. €i <'
/lie) c-72.. C', /"' -
Signature: �,� Date: 1/16/18
Print Name: Mark Grismer
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests. , .. �3 � c •_ /6� °
FOR OFFICE USE ONLY
Route to Sys Admin: Date By Route to Records: Date 'vZ2 /9 By -�►''
Refund Processed: Datev�/o2'3//cF- By Invoice Processed: Date By
Permit Canceled: Date 02//r B -,F r Parcel Tag Added: Date By
I:\Building\Forms\RcgPermitAction_ 3 4.doc
11111 .
TIGARD
City of Tigard
March 1, 2018
D.R. Horton, Inc.
Attn: Mark Grismer
4380 SW Macadam Ave., Suite 100
Portland, OR 97239
Re: Permit No. PLM2016-00604
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 15491 SW Applewood Ln.
Project Name: Heritage Crossing,Lot 45
Job No.: N/A
Refund Method: ® Check#227702 in the amount of$64.96.
0 Credit card"return"receipt in the amount of$
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
n Trust account"deposit"receipt in the amount of$
Comment(s): Per applicant's request as job was cancelled. Refund 80% of permit fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00604
T[cARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/24/2017
Parcel: 2S 111 DA22600
Jurisdiction: Tigard
Site address: 15491 SW APPLEWOOD LN
Project: Heritage Crossing, Lot 45 Subdivision: HERITAGE CROSSING Lot: 45
Project Description: Backflow preventer for irrigation.
Contractor: TRADEMARK LANDSCAPES INC Owner: DR HORTON INC.
PO BOX 2410 4380 SW MACADAM AVE STE 100
OREGON CITY, OR 97006 PORTLAND, OR 97239
PHONE: 503-631-3893
PHONE: 503-222-4151
FAX: 503-631-4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 04/20/2017 $31.27
Specifics: 1 12%State Surcharge- 04/20/2017 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 04/20/2017 $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: SC r
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.
EP
Plumbing Permit AnnlicatiolEW
Building Fixtures 10. vOV if -i,- I Olt 01 IA( 1- I NI (1yI \
City of Tigard
Amen ed
11 • 13125 SW Hall Blvd,Tigard.OR 97: 3�")]'W OF TIGARD Ptah Re irw rZ�/� Perim' o� ` -0 1 .
Phone: 503 718 2439 Fax. 503 598 i Date Bs Other Permit`o
1 t t,n a t>
Internet.Inspection Line. 503.639.4175��»Zi ugard-or gov BUILDING S� "Iite Reads B} ! — RJ See Pale 3 `�`' •
Notifedihtetbod: air Supplemental inforaadon
TYPE OF WORK FEE* SCHEDULE
New construction I• � ❑Demolition For special information we checklist
Description Qty. I Ea. I Total
❑Addition'alteration/replacement 0 Other: New i-2-family dwellings(includes 100 ft.for each utilit)connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
1� I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437 78
❑Accessory building 0 Multi-famil} SFR(3)bath 500.32
❑Master builderEach additional bath-kitchen 25.02
0 Other-
Fire sprinkler tsq.III Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain ] 1 18 76
Job site address:
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 *IAAll J`r'(,l'D 5 i t1t.21 Manufactured home utilities 50.03
Cross greet/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.: t Page 2
Water service(no linear ft.. ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflowpreventer 1 31.21
DESCRIPTION OF WORKBackwater valve 12.51
New SFR Clothes washer 25 02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors'sump 25 02
Si PROPERTY OWNER 0 TENANT Expansion tank 12.51
I Name: DR Horton Inc. Fixture/sewer cap 25 02
Floor dram/floor sinklhub 25 02
Address.4380 SW Macadam Ave Suite 100 Garbage disposal 25.02
Cit)!State/ZIP: Portland,OR 97239 Bose bib 25.02
Phone:(503)222-4151 Fax t ) Ice maker 12 51
0 APPLICANT *CONTACT PERSON Interceptorgrease trap 25.02
Business name: DR Horton Inc. htedicai gas{value $ ) p 2
Primer 12.51
Contact name
Emerald Weeks Roof drain(commercial) 12.51
Address 4380 SW Macadam Ave Suite 100 Sinkibasin+lavaton2
250_
City/StateiZiP: 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 Water piping'DWV 56.29
Address: PO$4x22410 Other: _ 25 02
CityiState/Z1POregon City,OR 97045 ubtotal
Phone:(503) 631-3893 1 Fax (SeSi (,3/—q73 7 Minimum permit fee; $72.50
Plan renew 125%of permit fee)
CCB Lie.: 1 13.573 r. , _Plumbintl io.no: .11 i(,, 1
r"i State surcharge(12%of permit fee)
Authorized signature: y;Z(! TOTAL PERMIT FEE 1
Print name: Le5/'rLtJ,t_ £//4( I Date:2016 This permit application esplree if a permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set bl Tri.Counn Building Industry Service Board.
I Buudin:PemutsPl\rC-Perm sApp.do. 10 01 09 4404516T0 10 02 COM WEB1