Permit (23) C04,\:•Piri ---V" ''''s '',i'.-)‘.;1,0-4 Yra Nr:ii
City of Tigard 0 COM.MUN1TY DEVELOPMENT DERARTMENT
Request for Permit Action
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TIGARD 13125 SW Fla Blvd. 'Tigard,Oregon 97223 • 503-718-2439
TO: CITY OF TIGARD V 0 I
Building Division ///2/44---
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: R Owner 0 Applicant Ej Contractor 0 City Staff
check i:io one
REFUND OR Name:
INVOICE TO: (Bumn,,,,,or hidi ,h,a1) 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 THEITEM(S) CHECKED (1):
OF CANCEL/\'011) PI:RM1T Al)PI A(:A-PION,
41 IZI,IR:N1) PI:.R:\1 IT H,11 .S (attach copy of original receipt and provide explanation below).
fl INV(ACE 1.:()R PEI S 1),I.'1i (attach case fee schedule and provide explanation below).
—1 RI,..:\1OVE/R1.-IPI.A(T, CON'1R.V-TOR ON PERMIT (do not cancel penult).
Permit 4: C7. "..1.1,,..-, - , , oI5
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Site Address or 'Parcel II: - zi,.....i .) .-.> ' -'''''1 t,
,
Project Name: Hdritage Crossing
Subdivision Name: I..or #... '-i 7
EXPLANATION: We am no loner installing irridntion on this lot and need irrigation removed from
the permit.
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Signature: -,,,V1(....ei 4° 41-..?.., (-, 1.....e.4.141.4-4_, I.)ate: .i,. :i-18-
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Print Name: Mark Grisalor
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FOR OFFICE USE ONLY
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Route to Sys Admin: Date By Route to Records: Dar, ci-e9 / By
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Refund Processed: Date c /?/AP By 6 - Invoice Processed: Date By
Permit Canceled: Date/ /7/4r-- By ." Parcel Tag.Added: : Date By
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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. PLM2016-00615
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 15535 SW Applewood Ln.
Project Name: Heritage Crossing,Lot 47
Job No.: N/A
Refund Method: ® Check#227702 in the amount of$64.96.
❑ Credit card"return"receipt in the amount of$
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ 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
!Pt.-
COMMUNITY DEVELOPMENT
Permit#: PLM2016 00615
T[GA R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/25/2017
Parcel: 2S 111 DA22800
Jurisdiction: Tigard
Site address: 15535 SW APPLEWOOD LN
Project: Heritage Crossing,Lot 47 Subdivision: HERITAGE CROSSING Lot: 47
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 04/25/2017 $31.27
Specifics: 1 12%State Surcharge- 04/25/2017 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 04/25/2017 $41.23
Class of Work: OTR Plumbing
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: AZ:pat,;(4eetcs Permittee 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 Annlicati4RE
Icr,ittvErk
Building Fixtures u
14)1z 01 Ili I. 1 I iiNI 1
Cite of Tigard pd / .b7 /3125SWHallBlvd,Ti ard.OR972'_ , � Anlinlir x>t g `, /�
Phone: 503 718 2439 Fax. 503 598 0 j Other Permit ��
Inspection Line. 503.639.4175 1 it 'a'�y�" gg,g'" 4" 4'
Diate Re a �y
1 1 c,n i t U t.3 ' E� .;� Date Readyily I loris H See P ge 2 for �i—U!'J� ` /
Internet. ww1+tigard-or goy jj� o T q oti6ed%1eihod:
TYPE OF Ri'�� ING DIVISION: Supplemental Information
FEE* SCHEDULE
(il Nest construction 0 Demolition For special infonrwdon,use checklist
Description J Qty. ,j Ea. I Total
❑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
it I-and 2-family dwelling 0 Commercial/industrialSFR(2)bath 437 78
❑Accessory building ❑Multi-Tamil} SFR(3)bath 500.32
❑Master builderEach additional bath+kitchen L3.02
0 Other Fire sprinkler tsq,ft.) Page 2
JOB SITE INFOR.RIATION AND LOCATION Site utilities:
lob site address: ��a�� (31.,7 Catch basin or area drain 18 76
� � &Ant_
Drywell,leach line,or trench drain 18.76
City/State/ZIP. Tigard, OR 97223
• Footing drain(no.linear V ) Page 2
Suite/bldg/apt.no.. Project name' V� le,,C D93 n(� Manufactured home utilities
" 50.03
Cross street directions to job site: J Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no linear ft.:, 1 Page 2
Storm sewer(no.linear ft.: i Page 2
Subdivision: Lot no.: L
Water service(no linear ft.., ) Page 2
y 7 Fixture or item:
Tax maprparcel no.: Backflow preventer 1 31.27
DESCRIPTION OF WORKBackwater valve 12.51
New SFR Clothes washer 25 02
Dishwasher 25.02
Drinking fountain 25.02 1
Ejectors/sump 25 02
• PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: DR Horton Inc. Fixttuu'sewer cap 25 02
Address.4380 SW Macadam Ave Suite 100 Floor drain/floor sink hub 25.02
Garbage disposal 25.02
citvstaterziP: Portland,OR 97239 Hose bib2
Phone:(5031222-4151 Fax ( ) 5.0_
Ice maker 12 51
0 APPLICANT CONTACT PERSON Interceptorrgrease trap 25.02
Business name: DR Horton Inc. Medical gas(value.S ) Page 2
Contact name Emerald Weeks Primer 12.5)
Roof drain(commercial) 12.51 •
Address:4380 SW Macadam Ave Suite 100 sink/basin/lavatot.
2502
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
Vater heater 37.52
Business nameTradema-k Landscapes Inc - -
Water piping'DWV 5629
Address: PO Box 2410 Other: 25 02
Cit}%State/ZlPOregon City, OR 97045 subtotal f
Phone:(503) 631-3893 Fax (49:)31 ('3/-v737 Minimum permit fee: $72.50
CCB Lie /3 s3 - Plumbin Llr no,: i , Plan review t2.5%of permit fee)
1 - .
Authorized signature: �' 1 r , State surcharge(12%of permit fee)
�
'' TOTAL PERMIT FEE
Print name: � � £�,� i This permit application spires if
1 Date'2016 PP p permit is not obtained within 180 days
after it has been accepted as complete.
"fee methodology set b+Tri-Counp Building Industry Service Board.
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