Permit CITY OF TIGARD PLUMBING PERMIT
;':. a COMMUNITY DEVELOPMENT Permit #: PLM2010 -00239
TIGAD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/22/2010
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Parcel: 2S114BA05300
Jurisdiction: Tigard
•
Site address: 9900 SW KENT CT
Subdivision: PICKS LANDING NO. 2 Lot: 87
Project: Masters
Project Description: Replace (1) shower
Owner: FEES
MASTERS, ROBERT M AND MARILYN J Quantity Description Date Amount
9900 SW KENT COURT
TIGARD, OR 97223 1 ea Tub /Shower/Shower Pan 07/22/2010 $12.51
PHONE: 1 12% State Surcharge - 07/22/2010 $8.70
Plumbing
60 ea Minimum Fee Adjustment - 07/22/2010 $59.99
Contractor: Plumbing
RAYBORN'S PLUMBING INC
19990 SW CIPOLE RD
TUALATIN, OR 97062
PHONE: 503 - 692 -4139
FAX: 503 - 691 -2328
Type of Use: SF
Class of Work: ALT 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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: �G��{ J/ Permittee Signature: /
CaII 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 08:32:13 a.m. 07 -21 -2010 1 /2
Plumbing Permit Applicati t ECEIVED
Building F i x t u r e s ; .1 ()R. O 1 , R . 1 (-1i_ .1 1
JUL_ 2 1 210 i
`` C i t of Tigard Received n
:r.w._ Y P Bate, :: 7 / i . , Permit No.: P / ga /0 �o /
9 ® 13125 SW Hall Blvd., Tigard. OR ` U %t OF TIGARD
Plan Review
Phone: 503.639.4171 Fax: 5 I. Date/By: Other Permit Nn.:
Inspection Line: 503.639.4175 NG DIVISION y'
7 I t ti Li ' Date Ready /By: t //�� aSee Page 2 for
_r. Internet: www.tigard- or.gov Notified / Method: I /� Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special informadon use checklist
Description I Qty. I Ea. I Total
g Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
fe I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
building SFR (3) bath 500.32
❑ Accessory g ❑Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler ( sq. R) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: WOO tef l,� Catch basin or area drain 1 8.76
City/State/ZIP: Ti a ®k _ ( ? 7 ,� 4/ Footing drain (line, lior near trench drain 18.76
e
'- h V J� 7 Foatittg dtain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: �� Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
-A-. �_.
Rain drain connector 18.76
/ Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: ,) Page 2
Water service (no. linear ft.: _) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
``'' ,, ,�,/�� __, ) , DESCRIPTION OF WORK Backwater valve 12.51
Y,l S/'�'C(/4K - Clothes her 25.02
II Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROP ER I ❑ TENANT Expansion tank 12.51
Name: / tioj _ ' '-S Fixture sewer cap 25.02
Address: j ? fop I) /�`� � a ,
Floor
Garbage dis Garbage d i s floor sink/hub 25.02
I - c �C posal 25.02
City /State/ZIP: ? !/)'ice-- ex_ 1X'23 Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grnise trap 25.02
Business name: Medical gas (value: S ` ) Page 2
Contact name: Primer 12.51
Roof drain (commercial) 1 2.51
Address:
Sink/basin/lavatory 25.02
City /State /ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 1 12.51 0,..r(
E -mail: Urinal 25.02
CONTRACTOR Water closet 25.02
Business name:
- 1 . Water heater 37.52
• e AO [i Water piping/DWV 56.29
Address:
A i M a • Other: 25.02
City /State/ZIP: % / 4104._ o• //0/ Subtotal I-LSf
` `oi
one: ) 6fo1 -(113 Fax: ( ' 64 �z 2 $ Minimum permit fee: S72.50 of unit fee v a, 5.7) Plan review
I CCB Lic.: j s " 4 A . mbing Li` no.: . 61apie ( ) p7O
/ State surcharge (12% of permit fee) U
Authorized signature: - - .r eV TOTAL PERMIT FEE 8/ 429 l � 1 L. - i �� _ � Date: o� This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
`Fee methodology set by "fn-County Building Industry Service Board.
1 Building Permits PLMU- PermitApp.duc 10 01 09 440...1616T(10.02,COM WEB)