Permit CITY TIGARD PLUMBING PERMIT
,. PERMIT #: PLM2006 00093
-111, DEVELOPMENT Tigard, -639 -4171 DATE ISSUED: 2/15/2006
PARCEL: 1 S 133CD -08800
SITE ADDRESS: 13865 SW CRIST CT ZONING: R -25
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT: 111 JURISDICTION: TIG
Project Description: Install sump pump.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
JOHN & PATR TYSON Description Date Amount
13865 SW CRIST CT
TIGARD, OR 97223 [PLUMB] Permit Fee 2/15/2006 $72.50
[TAX] 8% State Surcharl 2/15/2006 $5.80
Phone : 503 - 521 - 1027 Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # :
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: 6-4114
-yi
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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.
0.2/10/2006 09 : 31 FAX 5035981960 CITY OF TIGARD 2] 0 0 4
Building FittdireAGG .. • •
Plumbing PermirAVOlicat1gn , i.pit ( II .i 1 ONLY
City 0 f Tigard
tR:s 3 Received , ermi
P No.
, _ c 7 /
ermit No.:?: \ Nv....,
6
' .0411i, ij ' 6/ n ' I a - a a 69,1
13125 SW Hall Blvd, Tigard, OR 9722 - VN k- 'CI Plan ReMvi Other Pt :
Phone: 303_639.4171 Fax: 503_558.1960 i (I v A -,,,,..:::„.•,, i Dote(By: .
24-Hour Inspection Line: 503.639.41qt/8 ‘-' (‘"):". „, ..461,... lla Date Ready/Bir: Judi' 0 See Page 2 for ,
Intemcr . www_ci. tigard.or.us L .... ■ '. Notified/Method Supplemestal Information
"7.' .'ll I I ii(iiii"'•17 e??.:C 1 fil iiii • ':.!:,' ..:.,.''; '..J. ,Fit03.7,..,',
For special luformalion use checkasi.
0 New construction p Demolition
D e s c r i p t i o n I Es, I Total
a
isrAdditionfalteratioaireplacement 0 Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
. 11:t'O,0;:, ,, ,t4.?.*:;5: ' ,4; : r 1 ,:. ,... - .".-. . t. ..,. : .. . . , .N:, - , ,i - . .. t, , S F$ _. (1) bath 249.20
rill and 2-fanuly dwelling 0 Commercialrindunrial $IR (2) bath 350.00
SFr: (3) bath
0 Accessory building 0 Multi -- - 399.00
Es&h additional bath/kitchen 45.00
0 Master builder 0 Other .
Fire sprinkler ( sq. ft) • Page 2
I.' ..„:,,A■k T. : :',‘:''' - site utilities
2, address: se,r, c cv,,/ 6 t-7 qt too--r I 4 - Catch basin or area drain 16.60
City/State/ZIP: - 1 - j ' alf-- V7I 0 e_. '1'7 ?-..?-3 ,
.Drvwell leach line, or trench drain 16.60
Footing drain (no, linear ft: ) Page 2.
Suite/bldg./apt. no.: • Project name:
manufactured home utilities 110.00
Cross street/directions to job site;
Manholes 16.60
Wi / 4 Rain drain connector 16.60
Smaitary sewer (no. linear ft: ) Page 2
Skarn sewer (no. linear ft.: _ ) • Page 2
Subdivision: t-r2 VV it I L. 01 eil.44,441 4 Lot no.: Water service (no. linear ft: .
- ..) Page 2
Fixture or item
Tax map/parcel no.; : 16.60
Absorption valve
I:. ''',...'. ' .". , ' • ".',` f;,.'•'" : :' ''4"X.. !..T ; T:. .-:: ':. :‘::. - Page 2
_-
Backwater valve 16.60 ..
C.liithcs washer 16_60
- Dishwasher 16.60
' .
wAittifiel,ififfooiws; ,,;.141tv: laass.4 ,-.. .:, : . Drinking fountain 16.60
Ejectors/sump ' 16.60
Name: To lei fr, 4 Piti Try s 0 frI-- Expansion tank 16.60
---
Address: L3 v,5 ( so,/ k1 , ;1 -- et i- Fixture/sewer cap 16.60
-.
City/State/ZIP; T / i OE / '73 . Floor drain/floor sink/hub.. 16.60
Phone: (S? ) 5 I__ 10 Q7 Fax: ( 50 -i to a6.,, ' I I Garbage disposal 16,60 ._
bib 16.60
Lle maker 16.60
Business name: 16.60
Interceptor/grease trap •
Contact name: Dfiedical gas (value: $ ) Page 2
- ---
Address: Fr Ina 16.60
• P-oof dmin (commercial) 16.60
City/State/Z1P: ...
. .
Phone: ( _ ( )
Fax: ) Sink/basin/lavatory 16,60
I :
''.'etb/shower/shoWer pan 16.60
E-mail; . ,, I hinal 16.60 :
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'.7 '''''' t".t :rtr.V r' : ' :."-•;:.'', W c 16,60
Business name ()Vint( - l ''' --1 Mater heater 16.60
Address: - Othe37
_____ ........--
City/State/ZIP: '
- Subtotal
- Minimum permit fee; $72.50
Phone: Fax: r - • • - . a A Residential backflow minimum permit fee; $36_25
CCB Lie.: ---
' ____.
Plumbing Lie. : _ plan r (25% of permit fee)
no.
State surcharge (8% of permit fee)
. Authorized signature: _......\ (In 11*\ .
TOTAL PERMTT FEE
Print name: • Date: This permit application capires if a permit is not obtained within
• 180 days after it has been accepted as complete.
• Fec methodology set by Tri-County Building Industry Service Board
iN3uildingw.ipArLSAP-PermitApp.doc 06,05 440.4616710/01,COMMP_B)
CITY OF TIGARD -
BUILDING DIVISION PERMIT # :
13125 SW Hall Blvd., Ti ard, OR 97223 DATE ISSUED: 2 (30E.� 't 3
9 2115J:2I; o
Phone: (503) 639 -4171 n Tnq��p�lll i �
Inspection Requests (24 Hrs.): (503) 639 -4175 ''II:.
INSPECTION WORKSHEET FOR DATE 2/23/2006 TIME: 7:0IAlvi PAGE: 80
SITE ADDRESS: 13165 SW CR1s -r C CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOW' 1` 0 $ LOT #: 111 TYPE OF USE:
PROJECT NAME: Tys
DESCRIPTION: Install sump pump.
OWNER: TYSON„ JOHN & PATRICIA PHONE #: 60 :3.91 _ 1027
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: '?J23/2006 Pour Time:
- 7 14-1e
Code # Inspection Description Confirm # Co tact # -ssage "i --
4 3 Plumbing final 027313 -01 W3-443.6156 V
X 1 ( 36
gCorrre�ctiions /C mments /Instructions:
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PASS PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: O Date: ® & Phone #: (503) 718- v ��
_ _ .
CITY OF TIGARD , ail 26 - 6°6193
BUILDING DIVISION
A PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171
/
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: i 3g(4 siA) cv-zs# cA---. CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ....
DESCRIPTION: Q:.A,.......<4
OWNER: PHONE #:
CONTRACTOR: PHONE #:
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Inspection Request Scheduled For: Date: Pour Time:
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Code # Inspection Description Confirm # Contact # Message
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Cor ions/Co ments/Instructions:
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I PASS El PARTIAL APPROVAL 0 CANCEL El NO ACCESS
K FAIL I I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: \/(t (* Date: Viki d te
Phone #: (503) 718-
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tor
1/34i- OF TIGARD . ..... ,-;
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BUILDING DIVISION ------. PERMIT #: P1.1\42006-00093
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 211
Phone: (503) 639-4171 Aiot i #
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2P21/2006 TIME: 7:02AM PAGE: 107
SITE ADDRESS: 13865 SW CRIST CT CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS NO LOT #: 111 TYPE OF USE:
PROJECT NAME: TYSON
DESCRIPTION: Install sump pump.
OWNER: TYSON, JOHN & PATRICIA PHONE #: 6a:ps:-,
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 2/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 027176-01 503-521-1027 N
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Correctiojs/Comments/In , uctions . , l)
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El PASS n PARTIAL APPROVAL D CANCEL pi NO ACCESS
[--X FAIL XCALL FOR INSPECTION H ADDITIONAL FEES ASSESSED
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Inspector: Date: Phone #: (503) 718-
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