Permit va -- CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00491
�GARD: 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
DATE ISSUED: 11/2/2007
PARCEL: 1 S136CB -00227
SITE ADDRESS: 08110 SW THORN ST ZONING: R-4.5
SUBDIVISION: SHANNONDOW LOT: 026 JURISDICTION: TIG
PROJECT: RING
Project Description: Replace tub and valve.
CLASS OF WORK: ALT 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: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
RING, GREGORY PALMER AND
VICTORIA JOY Description Date Amount
627 SE CASCADE PL [PLUMB] Permit Fee 11/2/2007 $72.50
SHERWOOD, OR 97140 [TAX] 8% State Surcha 11/2/2007 $5.80
Phone : 503- 625 -3240 Total $78.30
Contractor:
RAYBORN'S PLUMBING INC
PO BOX 69
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 692 -4139
FAX 503 -691 -2328
Reg #: LIC 87852
PLM 34- I66PB
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: s' / _�� �►/
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.
=_' .Nov. 2. 2007 7:51AM Rayborns Plumbing No. 8626 P. 1
Plumbing Permit A t t 1_&, ,. li , 1 � A. ,t
i. r .i r .�i *�.„.. . I ()t f IC I tfSf f u +
City of Tigard , . ` i_-. `, i !
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13125 S W Hall Blvd., Tigard, OR 97223 2 Date/By: I 1 7- 01 3 PP Permit N.. n 0 0, 1 94 /
NOV - �+ 1 . Plan Review
Phone: 503.639 4171 Fax: 503.598 1960 ,, I o .
{]> , A ( baleB Sher Permit No.:
24- Hour inspection Line: 50J 639.4175 a a 7
Internet www c t tlgard or us
CITY of. fl i �/ + Date Ready/By: See page I for
L >. Notified/Method:,
Et - zzv I r k r; ur z • a y t r e Supplemental Information ld+„7.� Ii 11 .t�rh ' F]` ..Li'rttl< 1 x " A kin F r a l . 5a � T t t ...1 I c . T w n 'TPH'• i •^-r•- i,? ry cr"v 1 4 t 4. : ;1
, ;i... +,M + + . ' r + C ��' ) ;{ 3s, 4i -r �� + i n� � �' r = v �q� i t ti + } / r�+ 'AI
c r' . t {� � i ,:.......� '_` u t� .x. T...i; ...J: i t + 1 � � n { I j r
....ri1�: 1 #-::� - ._.. <fr;� ' t�... � .... � � i ^ � t : a - ' �:'.: �� I 1 r l � +��
❑ New construction ❑ Demolition For special tnfonna►lon use checklist
-
. -, Addltlon/a1teration/replacement ❑ Other: Description Qty. I t a, 1 Total
1 �� , � ru alt � _ ��{{ y ��p+^� r u � � New 1. 2-family dwellings (includes 100 ft for each utility connection)
,1 t a ",t.. ! t3U.t�,".F � �91L'+,.'a': �� : r M
a o , P 17;( C
� 7 I „` r . w � . 3 . r Np3£ SFR 1 bath
ath
�� .., -�w.L r_ lClt f €j Fi , .;, a_;r! () 249.20
,ZI 1- and 2- family dwelling ❑ Commercial /industrial - SFR (2) bath 350:00
II
11 Accessory building El Multi-family
SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑Other:
k` tom,, t." �"'I' ,.+, rnat a •rr, {?+ ^rcr�t -m,. Fires sprinkler
1}7 P (sq:ft.) Paget
LS."r�} �dl. ije� '3�`I 1p R (�rh C;0 4t {1Mt)u•9irfi+,rlx� fril 1 , i si site Ul
3�2'?"
.i. I
.�w 3.114A.,.- 3^�^..°,'w�' ... „� t t.... +<�.3�;,}S.. . 71 � + fllh @a
Job site address: 5.- Q S c Catch basin or area drain 16:60
Drywell, leach line, or trench drain 16.60
Suite/bldg,apt. no.: Project name: Footing drain (no. linear ft .' � ) Page 2
Cross street/directions to job site: A Manufactured home utilities 110:00
5 3t4r4 / 6 SS - FL Manholes 16.60
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 ft.; ) Page 2
Tax map /parcel�no..; r
Fixture or Item
O fr�h } l t + ? +1 i' t `�., n} ll3 � k a5 7y+Fi9.c -^� i ,� `r7 ;1 . :i Absorption valve - 16.60
>.: ' Ea..:. ci,.:tta sa.H>_+ tfi.: ,z-,. :. ;^a / :�:, , n .,,1 ,,:.t. �.. -3,. t.,� ,... .,..A, r? s ., Backflow preventer Page 2
( -e Ip l4 CA 4 i/zi //tz. Backwater valve 16.60
Clothes washer 16.60
Dishwasher ■ 16.60
P 147‘775-4.. a 'y.a.=t r 3 r, a "r99 .rl 'rr'i r- .�r�c� H; � "..:in s7. --i Drinking fountain
t..= . ... th, ,,,4_` " v :-;,,,Aa'Ct+..t � �' _,,.:.oa 1 . ' z. p 2... r. r . a ... ' i .l . «., . -. 16.60
Name: /� } Ejectors /sump 16.60
(/` j- V) _/ t� ‘ ,..,.., _ 1 Expansion tank_ 16.60
Address: '� 2J i a a 5 c.S` S le I Fixture /sewer cap 16.60
City /State /ZIP: . r.>.reiak„1 C ' r7/ Floor drain/floor sink /hub 16.60
Phone: ( " ) 62.s 2 o Fax ( ) Garbage disposal 16.60
I' . H t ` M ;.. 3"J a t'+rC 37,977 - ;,- , + " r"') t t 3 : t �.c ' ?1, lose bi 16.60
. * '',,..ot ■ u-, . .e of 3%,.. '. ' !.t :,:tx: n !i ? � t f; i �:� f 11 4 ra ..a r } }i J
® ) / hl, lee maker 16.60
Business name: (�, sx,a' t ' _ � � interceptor /grease trap 16.60
Contact name: Medical gas (value: $ �) Page 2
Address; / 5 7 f d 5„, [- "fi 4 _Al - Primer
+/ [6.60
City/State/ZIP: 7 s. - Gg. / ?d‘2- Roof drain (commercial) 16.60
Phone; ( ( ) ,9 . 2 32 Sink/basin/lavatory 16.60
v Fax:: U
E-mail: r� Tub /shower /shower pan r' 16.60 ,1=
r wzr �° Urinal
f a t ''�}' { �t�t� lu , : ; tr y. +?:g "'e 1"' �r"r r, K r r L - 'm to 16.60
A, ,Fy R } }3a v a y }1 � � * t) i tr Y . {! ' W l ^ r I: " a t;j" a y • ,ark ra tt�f r4 ,r' � ux "L. 5 � r ? r � i` ) � water closet 16.60
Bus iness name: 1 / l r->_ S y # L, Ip l Water heater 16.60
Address: O C r --ed Other: -_
City /State/ZIP: t f tit-` 0 .6 7e) 4- Subtotal
/ Minimum permit fee; 572.50
Phone: (5 ) 6 f 2 L f3 5 Fax: ( ') 6 T . Z,? Residential backflow minimum permit fee: 53625
CCB Lic.: S'52 a• 4 v Plumbing Lic.no - ' i og - Plan review (25% of permit fee)
Authorized signature: _ State surcharge (8% of permit fee) s
/ _
> TOTAL PERMIT FEE 7 8 ?
Print name: �,� 4 4/12 -tc✓5 / �c� 9 Date: //_ 2-,.7 . This permit application expires if a permit is not obtained within
/'` 180 days after it bas been accepted as complete.
i��Building�Permils�P�M- PcrmitA .doe 0 /
*Fee methodology set by Tri•County Building Industry Service Board.
RP 60 3 440- 4616T(10 /02 /CQMJ'wEa)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: piN2007.00.491
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 111212007
Phone: (503) 639-4171 1.1VAP
Inspection Requests (24 Hrs.): (503) 639-4175 . —
INSPECTION WORKSHEET FOR DATE: 11/13/2007 TIME: 7:01AM PAGE: 103
SITE ADDRESS: 08110 SW THORN ST CLASS OF WORK:
• SUBDIVISION: SHANNONDOW LOT #: 026 TYPE OF USE:
PROJECT NAME: RING
DESCRIPTION: Replace tub and valve
OWNER: RING, GREGORY PALMER AND, PHONE #: 503-62&3240
CONTRACTOR: RAYBORP PLUMBING INC PHONE #: 603
Inspection Request Scheduled For: Date: 11/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 059457-01 5036294139
q77 — 7/2/—
Corrections/Comments/Instructions:
Se C, ,S
•
PASS 1 PARTIAL APPROVAL 0 CANCEL [1] NO ACCESS
El FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: CRivi..A...1 Date: // )0 - 2 Phone #: (503) 718-
Case Activity Listing 10/8/2008 `
4CCEL» 8:53_06AM
Case #:�PLM2007- 0049I` �'�
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
PLMI0I0 Application received 11/2/2007 None RECD FAX 11/2/2007
BB
PLM1020 Permit created 11/2/2007 None DONE BB 11/2/2007
BB
PLM1030 Check for parcel tags 11/2/2007 None DONE BB 11/2/2007
BB
PLM1280 Issue permit 11/2/2007 None DONE BB 11/2/2007
BB
PLM2320 Plumbing rough -in 11/9/2007 11/13/2007 11/13/2007 None PASS JW 11/13/2007 059457 -01 — 503- 629 -4139 — VM -
STI N
,ye Pi
`' No rQ -�-
Page 1 of 1 CaseActivity ..rpt