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Permit IIII CITY OF TIGARD PLUMBING PERMIT = COMMUNITY DEVELOPMENT Permit#: PLM2014-00291 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/27/2014 Parcel: 25111 CC22800 Jurisdiction: Tigard Site address: 10400 SW GREENLEAF TER Project: Crismon Subdivision: SUMMERFIELD NO.5 Lot: 286 Project Description: Installation of(1)shower,(1)toilet&(2)lays. Contractor: RAYBORN'S PLUMBING INC Owner: CRISMON, BONNIE J TRUST PO BOX 69 BY CRISMON, BONNIE J TRUSTEE 19990 SW CIPOLE RD 10400 SW GREENLEAF TER TUALATIN, OR 97062 TIGARD, OR 97224 PHONE 503-692-4139 PHONE: FAX: 503-691-2328 FEES Quantity Description Date Amount 2 ea Lavatories 08/27/2014 $50.04 Specifics: 1 ea Tub/Shower/Shower Pan 08/27/2014 $12.51 1 ea Water Closet 08/27/2014 $25.02 Type of Use: SF 1 12%State Surcharge- 08/27/2014 $10.51 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $98.08 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificat•- --' er. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct qu-: ions to OU by calling 503.232.1987 or 1.800.332.2344. l 4111 Ikk ' , / Issued :y: / a fe Permittee Sig ature: / Lam/ \ - Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 08-27-14; 16: 19 ;Rayborn's Plumbing ; 5036912328 # 2/ 3 ..... �..... �..a • ... . .. V... , r,„ ..Y.P"W , ,".VV Vif VL 09-26-14:115:02 :Rayborn's Plumbi ;5036912325 4 1/ 2 '' 'pku rjPelrmit Application • Building Fixtures }OP t►I Flt r tt'sr )tit- City of Tigard oI M w i EMEM-110a9 13125 SW Nei Blvd,.Tigerd.OR. 97223 Man ltcviow ■ Phone: 503,634,4171 Fir: 50I,S98.1960 n,ty8 Other Pamir No,; TIC.A F ln:pechen lirsC SC3.639.d 175 Does 1tatoy/By 1t+lr W Sce Paec I for !Ar mee: www.tiaard.or,$ov NatlticdMatlitaf: cuppletnent I Innm.a R lea . -• TYPE OF WORK ' •. • .. . - FEE" SCHEDULE,• ' ©Nfw construction ❑Demolition For: cdal lufbrmacon use c/uckllo- 'Da-nation I Qty En'-TToul „K AdditionlalteraJan/repI+cement i ❑Other: _ New 1-2-family dwcllio,(includat 100 a,rorceiahutlltly canna:tion} - ' CA'x')rGORX OP'CONSTRUCTION ' • : , SFR(I)bath _ i 312,70 1-and:-family dvJ Cvrumcrciallindustrial SFR(2)bath 437.78 f SFR.(3)bath J 500.32 C Axesso1 J{ ry building O Multi•famiiy ^ ❑Master builder Eoeh aelditional batt khrn J 25.02 I _ O Other; Fira dinkier JOB SITE INrORMATIO^t'AND LOCATION. , L---s9•�) I I ?ages, Site utlllt;ce, f Cnte basin.omen drain 18.76 fa sire addrss: / j/ ` a - Drywall,leach line ar trench• in I 1 8,76 Ciry/stata ri I Footing drain(no.linear:AIM Pa go 2 , Suite/bldg./slot.no.: Projeet name, tries I 50.03 j Cross s T'-cJdircctions tel job site; ICEZNIFAM 18,76 1 ' . _ .4•_ " CM=2VFAMIIIII.1 1R,75I e'(no.linear f.:_) Par 2 • se4tl•(no.hear P,.: ) Paget service(no,linear P.:__) Page 2 Subdivioion: Lo:no.: PR A1aurc or;I n - Tax reap/pare&no.: �Bnck;lou Dtc�cnt t ! 3127 DESCRIPTION OF\4pILK, _ 9aekwatCvalve 12.5) I /� Clothes wester i __ a �`` .. 25.021 it 1" Dishwasher I 1"- C2-1- 502 Drinking fountain _ 25,42 Ejector:/sump 25.02 I • 1] PftoPERTY OWNER O TEN• . Experiron tank 1241 I Name: Fixture/sower cap 2$.02 Address: Flpor dr'in/1loor alnkrhob 25.02 I — Onrbagc disposal I 25.02 CIry/Sqr JZIP: / Nose bib 25,02 I 1 Phone;( ) Fa><;{ ) Icalco me — l2.S1 )2 APPLICAI.T D CONTACT PERSON Intetacptodg)aut:trap I 25.02 Bus peas pane: a ... Medical pi(values x ) Paget • Prima Contact name: I�.)��� 7 i e' — � 12.51 �/ R00rdnin(commctt:lal) J 12,51 Addresr:; itto S C TL P-u SlnWhasinllavatory ';e 25.02 _J L. City/5itttc1Z1P• d. (• ' Q Solar unit(potable wale) 62.$4 j Phone: ) C . Z - I, 3 Fa:;::(spy ) ‘Q i-'1?3 r Tub/showeiVshowcrpan T I 17.,51 E-mail: AI c� Urinal 25.02 CO, CTOR Water close u / 25.02 Business came: ' t -1 water hesar -52 L. ' . a• 'd Water 'ng/DWV 56 29 Address: P • • C ,(.'e-.. Other. 2.5,02 ‘tt20 t. _ Subtotal Phone . ) - . .L 3 nut:( • ) g• j - _- Minimum',emit roc S72.50 I{ CCD Lic: gs a i P "rag u.„,... 3t.{... di-ip„L3 Plan review (25%ofpermit fee) I I -Slate ettn hatse(129G of pe mil Cc,) Authariscd sig-ta;urc � �t - . TOTAL PERMrf FEE I �5 Print Home: /, I. Date. ThII pertatt appile l on ehPiret if n pennit u net abtalnc4 Within IMp raga / X, aMr It Ivor brcn►etopted ax cvmplctn •Fee methodole J Mt I yTrf.Coatta 1,111iis',envy 5n-ice Steam oftwIelinortoritnnk•_.ProrM taloat 1P91/00 • 4.4•44 6r(to,Q am/won)