Permit P
IN `a CITY OF TIGARD
_'+ PLUMBING PERMIT
''' COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00340
1'I GA! W : 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/20/2008
PARCEL: 25111 BC -01700
SITE ADDRESS: 10265 SW VIEW TER ZONING: R -3.5
SUBDIVISION: GREENBRIER LOT: 001 JURISDICTION: TIG
PROJECT: STACK
Project Description: Replacing kitchen fixtures.
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 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: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
RICHARD & STACK
10265 SW VIEW TERR Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 8/20/2008 $72.50
[TAX] 12% State Surch 8/20/2008 $8.70
Phone : Total $81.20
Contractor:
RAYBORN'S PLUMBING INC
19990 SW CIPOLE RD
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 692 -4139
FAX 503 -691 -2328
Reg #: LIC 87852
PLM 34 -166PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
c Issued B Permittee Signature: .c...--c �/ //r/ /✓
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
®•503 691 2328 Rayborns Plumbing 10:51:28 a.m. 08 -19 -2008 1 /2
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Plumbing Permit Applicatio ;. -a�� ulcucll l l �: 1. c) t .4 i R , sl ;,
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y s City of Tigard y AUG 9 2008 R « °,vea . ` r�
> J g Date/Iiy �� j - /_ Permit No.: �J �„plr
t • 13125 SW Hall Blvd., Tigard, OR 97223 ��+
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Ea Phone: 503.639.4171 Fax: 503.59$.1 o` TIQ� n v iCW Other Permit No.:
11 1 y\ti`t Inspection Line: 503.639.4175 � DWWS r ., e /S : rr;.
s, °c .:Earw . Internet: www.ti ardor. ov N Y /M y 0 See Page 2 for
g g ®�1�1 Notified/Method' o w,. , Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special infornuaion use checklist
Description 1 Qty. 1 Ea. 1 Total _
IQ Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 T
Ii1 1- and 2- family dwelling E Commercial/industrial SFR (2) bath 350.00
Accessory building SFR (3) bath 399.00
❑ ry g ❑ Multi - family
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
Fire sprinkler ( sq. 11.) Page 2
JOB SITE (INFORMATION AND LOCATION Site utilities
Job site address: ) 0.16 ' e'5Y, I Vltui 4 ea fP4 �4 Catch basin or area drain 16.60
'T
City /State /ZIP: ' L e)/2 Q � 2 7 Drywell, (each line, or trench drain 16.60
1 I Footing drain no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: 4 g
Manufactured home utilities 110.00
Cross street/directions to job site: / Manholes 16.60
6 S S D 6 Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.: Water service (no. linear fl.: ) Page 2
Tax map /parcel no.: Fixture or item
Absorption valve 16.60
DESCRIPTION OF Bacldlow preventer Page 2
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•
C2. 11,4( -/41 g1,L4.L ,6, Backwater valve 16.60 _
Clothes washer 16.60
_ _____ Dishwasher l 16.60 / / 6 Le
kJ PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name:
91$4‘,4. Expansion tank 16.60
Address: /t)4 A r gskJ U1 7e..4' - Fixture/sewer cap 16.60
City /State /ZIP: le j 52 972z Iii Floor drain/floor sink/hub 16.60
Garbage disposal 16.60 `0
Phone: ( ) Fax: ( ) � P � � b _
❑ APPLICANT ❑ COINtACT PERSON
Hose bib 16.60
Ice maker 16.60
Business name: Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
•
City/State/ZIP: Roof drain (commercial) 16.60
Sink/basin/lavatory 1 16.60 1L
Phone: ( ) 1 Fax:: ( ) -
- Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: i 6i Water heater 16.60
Address: C/ .., • j Other:
City/State /ZIP: 111.04. 14 O2 i 97 Subtotal 17#1'
Minimum permit fee: $72.50 Zilb
Phone: ( 03 ) 61,1_ Yi 39 Fax: (J) 4/ 2-32.g Residential backflow minimum permit fee: $36.25 2
CCB Lic.: i i Plumb' Lic. no.: ^�(i. /api Plan review (25 %ofpermit fee)
Authorized signature: ,,
J State surcharge (12% of permit fee) •
��t `s 1l _. TOTAL PERMIT F EE _
Print name: tiff ,M111114 / f � j � Date: J r This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1 \ Budding \Perr°iis\PLM- PermitAPP.doc 06/26/06 440-0616T(10/02/COM/WIS10
CITY OF TIGARD _-
BUILDING DIVISION PERMIT #: PLM2006- 00340
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: a770'7008
Phone: (503) 639 -4171 1 ���1
Inspection Requests (24 Hrs.): (503) 639 -4175 s_�
INSPECTION WORKSHEET FOR DATE: 10/20/2008 TIME: 7 :00AM PAGE: 36
SITE ADDRESS: 10265 SW VIEW TER CLASS OF WORK:
SUBDIVISION: GREENCBRIER LOT #: 001 TYPE OF USE:
PROJECT NAME: STACK
DESCRIPTION: Replaci kitchen fixtures.
OWNER: STACK, RICHARD & JUDI I-FI PHONE #:
CONTRACTOR: RAYr )l,'N'5 PLUMBING INC PHONE #: E,03.69`?- 4133
Inspection Request Scheduled For: Date: 10/20/2008 Pour Time:
_ Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 07687T01 371 -663 -316 Y
Corrections /Comments/ Instructions:
C k,„,,t_ 9 i
IX PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSE=SSED
Inspector: A...1 .\" \h..t� Date: � °A%1.6‘ otl Phone #: (503) 718-