Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00126
,I DATE ISSUED: 3/28/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S133CD-05000
SITE ADDRESS: 13645 SW FEIRING LN ZONING: R -25
SUBDIVISION: COTSWALD MEADOWS LOT: 048 JURISDICTION: TIG
Project Description: Replace water service.
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:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 30 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
WARNER, HAROLD E + BETTE K
13645 SW FEIRING LN Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 3/28/2005 $72.50
[TAX] 8% State Surcha 3/28/2005 $5.80
Phone : Total $78.30
Contractor:
CROWN PLUMBING
5429 SE FRANCIS
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Phone : 503- 771 -9449
Reg #: LIC 42671
PLM 34 -70PB
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: L LB Permittee Signature: .3_,CZ
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.
03/2812005 07:55 503 - 771 -9454 CROWN PLUMBING PAGE 01
P11111 . 1 .Per1��i>� Applicatiiono 0lt.c ,
Pl
`'i r tJ4[: ONLY
e 1'Cigard ®N , � ttoeciv - _
S ,n,' -fall Blvd., Tigard. OR 9e cg,,,
I' mil No� `tom_ ��a1� )�/
1312
Phone 03.639.4 1 71 Pax: 5t
`�(3 Plan Review
`�`'�� / j)
24- Hou Inipeetion Line, 503.6 9. 175 p �00� , 1'�'�I ) ° t ` y Other Permit Nu.:
Internet w ww,ci.tigard.or,us ��t C7 -! - ' No te Ready/By: Si Sec Page 2 fnr
nil tt r . �� Notified/method; Supplemental Information
!jP; 't`;�Ir I : '%: Lei: � : '
!.k� ' }' ,:� r��.};�a�+. !}1yn:: o riW "'.t t,, ,rc hn+, er 1 . a�nn _
. 1.l : : : .a•.• ,t ✓ '. ' , tr f�'�t l�,P�h ^.t' 'C.rl`il' !i..�'17 �'"., 1' t; S' K4'* - °7!,- "'.'
.1 .1.7^^r "� • d �IL' � A � ra'_4 .4�1� •� , ( �1 : �1t,I(n.� ) ;e. 1, ! (� "v ^IRS .'�:Y •y ,'- !. 2
� �� � '1•'i:. " F'� � 11 ,I� ' Y y�1 ^i�'T' a i ��l'�..�:.. l �t1. �,},�,� "I.:' � � :i: -
❑ �C DLL : � F:tF;n.u: r � `�'�•rb� �'r t t, N'1,1' i �''Ti1C' 3G�'t'�JQi7� , ....., . i'.' � � :,, .
IL ' f. A'J.' h%' 1 1k1 "1 .:7 ",a' m: . : r. ..�5;�'n''',r } ; niil _ �,,; .f,'.
New ■ On }[ruction CA t ,yO, u el nation Fnr Special information use checklist
lddit >n alter \V Description
alteration/replacement co ❑ Otl'er: Q[Y. Ea. I TOUT
1 r try ' J1r_ I t , New 1.2-family dwellings (includes 100 R. for each utility connection)
;;!, ; :..''> .... i 's.•!,,, %ul'; ..: I'.. ,+ r ' � \, t f , 1 •m.ak 4 k t SFR I bath
r..>w9 {,r/Ir�y�u� O 249.20
0 I - and 2. ` amily dwelling ❑ Co: /industrial SFR(2) bath 350.00
❑ daces :orl
building SF12 3 bath 399.00
- � R ❑ Mu ti family ()
: r . Each additional bath/kitchen 45,OU
[] Marie builder 0 021
c t
!li` t ..1 .i , : : � ; ' t , ta., �;r.; ':;sr a a R,5�4 . * Eire sprinkler ( s9- ) Page 2
�'i r nr ?; t.,_ ,a�•,,i "Q'4 „.. 1{p I ° I y 'd 4u ,rs �';�,, i� `1" i� -. • - ,r�..�.;r�r,6?h11..: ' y t ” Site utilities
Job site at dr' ss: /3 L y/$'- S L) Fe. ; hP ,' ~S L. a4, Catch basin or arca drain 16,60
City /State ZI ?: � 0k , s 7273
Drywall, leach line, or trench drain 16.60
cuite/bid2 /al a. no.: Project name: ' Footing drain (no. linear ft.: ) Pa
; —^
—
Cross stre :tic irectiens to job site: Manufactured home utilities 1 10.00
lvlattholes 16.60
-• • - Rain drain connector 16.60
Sanitary sewer (no. lineal' ft.: ) Pagc 2
W Storm sewer (no, linear ft.; ) Page 2
Water ater service (no, linear ft.: ;CO
-- ,- ----•
Lot no.: ) Page 2
Tax ' areal no,: Fixture or item
P' X
Backtlow preventer Page 2
+h i$ii: :J Gri' !::TIECn r � it k :r w„7��t.r.r1M: ,. ) , t , , .� Absorption valve I 16,60
4['44 � _:,iy ' ', ,'' } ; : ; :.; : :' ,,, ‘?4N�, •, , I'i , •lifklGd'S:�iik_ YU4.il �)' } i'N'' P?
-
RG ; =t'4 4.'e �.a )c dc.. . ' ' , se , . . ■ = , I. .. Backwater valve 16,60
• Clothes washer _ 16.60
Dishwasher 16.60
.; ry; �r'iir %ii — _ ... , tt:'} .tr,. ,r � . r< *.w r x�3o s � zan ,,... 1 , ry �.
` .1.460 l2 4 s, ' la , f4 ,, , t I '4 .'At , ,. nr + , l .r. t,.p . Drinking fetal
.I'iq:' ,1;. : O. >' , I '• :>~x, t ,t y � ,1 [ k ' -1 .���/y,"���j� I�S��y� �;. g rain 16,60
..•,4.. 1 �+`n..�I,`.1'II1.`1rv,hP:: "A}t '' i '•i.. e /r111'ik t r- 6 r •/
Name: I _ Ejectors/sump � 1 16.60
--- f'l�e..ra. _ t''�v ... e... Expansion tank I 16.60
.' , ddrcss:
04� a . Fixture/sewcr cap_ 16.60
City /State!. ' i F. Floor drain/floor sink/hub 16.60
• Phone; ti i?) s-Z y _ 5 Fax: ( ) . Garbage disposal 16.60
f';•` Vi i: 'A ?I:FC;4Z-- Wp a'. ) Ir; :x i w r ,.'t r. c , 3 ^ H ose bib
• .. i,: -. : :. :ia.i,1,•U ". !I tA : 7k :, 4: 1 'i ' . ' ' ,I , �^ � 'g 2 . ? I , + 16.60
Business Ill
ma : Ice maker 1 6,60
- ' Interceptor /grease trap 16.60
Contact Dal le:
• - - - Medical gas (value: S ) Page 2
Address: _
• Primer • 16.60
c'_iry• /State /: IP Roof drain (commercial) 16.60
•
i- atone: ( • t — Fax: ; ( Sink/basin/lavatory 16,60
E-mail; - Tub /shower /shower pan 16.60
e3 , # i aF :: ;.' '�.,,, z ,. Urinal (
�S t ,,,." 4 tiv- • 16.tiU .J
^ ',:' ; :•;;. 5 �'; : I t : ,rtQ!;k'1� iT'0f ¢i; .,. bl,? ?" f ''t'�; a —
— _
', ^,.`,..r aK•• 4r .9 leS': w�i } w t 7`n ' .1,.� WaterClOSe[
16,60 —
Business na ne CROWN PLUMBING Water heater --I __ 16.60
- Address! 5429 SE FRANCIS STREET Other; -
City State/Z P: (PORTLAND, OR 97206 Subtotal
_ PhP 're; (503 7"1_344; Fax; (50;•I 771 -9454 Minimum permit fee: 572,50
Residential backflow minimum permit fee: 536,25 7 ASS
•
CCI3 Lic.: 416', I Plumbinj; Li o,: 34 -70PE3 Plan review (25% of portrait fee)
4 uthorized ! i.`r arure: - surcharge (11% o fac)
/ State lurch
,` - TOTAL PERMIT FEE '?p. 3 Q
rint name acuitls Underwood Date: 3/Zq J - 1 This permit application exptrea if a permit is not obtained within
` 180 days after it has been accepted as complete_
r ;uiWing l e ,na • PI. v.'.ry „'itApp.dn� r /03
'Fee methodology set by Tri -County Building lndusny Seri ice Board.
44 0 4 616T(I0/07 /Cor\4/WE1A)
•
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: PLM2005 00125
i k 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/28/2005 .
Phone: (503) 639 -4171 // lrl i '
Inspection Requests (24 Hrs.): (503) 639 -4175 .......Wr —
INSPECTION WORKSHEET FOR DATE: 4/1/2005 TIME: 7 :10AM PAGE: 102
SITE ADDRESS: 13645 SW FEIRING LN CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS LOT #: 048 TYPE OF USE:
PROJECT NAME: WARNER
DESCRIPTION: Replace water service.
OWNER: WARNER, HAROLD E 4+ BEI I E K, PHONE #:
CONTRACTOR: CROWN PLUMBING PHONE #: 503- 771 -9449
Inspection Request Scheduled For: Date: 4/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 003299.01 503. 771 -9449 N
Corrections/Comments/Instructions:
/
C 6(fe P /i/C(1
I/ PASS n PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / /r7)7, Date: G 6 Phone #: (503) 718-