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Permit • C ITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PE DEVELOPMENT PLM2006 -00380 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/11/2006 PARCEL: 1 S134DA -04600 SITE ADDRESS: 11325 SW 108TH AVE ZONING: R -4.5 SUBDIVISION: DOREEN COURT LOT: 003 JURISDICTION: TIG Project Description: Replace tub & valve. 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: 0 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: 1 SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft • Owner: FEES MATTHEW KOEHSTEDT 11325 SW 108TH Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 8/11 /2006 $72.50 [TAX] 8% State Surcha 8/11/2006 $5.80 Phone : 620 -1906 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 -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. Issued By: 27,4 � Permittee Signature: © ,n 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. Aug. 11. 2006 8:47AM Rayborns Plumbing p1«S hl... c. No.5349 ‘P. 2� -2_3Z " Piumbine Permit Application. I OR OFFICE USE ONLY City of Tigard n( Et, \l E D Res _ � /� �//�� Date<B • G' /� Permit No.. y `'[1 !JV 1 • 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review , Phone: 503.639.4171 Fax 503.598.1960A 1 1 200/ i r D atei B y . Other Permit No.. 24- Hour Inspection Line: 503.639.4175 �J 1 I' Date ReadyBy: . 1 ' 64. 12I See Page 2 for Internet: www.ct tigard or us CITY OF TIGA ' - Nott6ed/M So lemeatal orm r � ! t r c t �' �H ld 1 I G t,:::-. n i i t t f / 't c a s e El New construction ❑ Demolition For apedal informo ioe use checklist ddition/alteration/replacement ❑ Other. Description I Qty. I Ea. I Total , t , rI , , / r , : - 4 New 1- 2- family dwellings (includes 100 ft, each utility nnection) tiw io s for ity co l a.. S �.I r., ' ..... .v.t ' ' ' fc . r . �• _. ' �. , l y^i I ),', t l } l 0 , 1 *! ∎ y , . 1 I . , 1?. j'r ; :1 + Z t . .,! ":' SFR I bath - _ .. ,1., .... ( ) I 24920 - and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 ❑ Master builder ❑Other: Each additional bath/kitchen 45.00 r Fire sprinkler ( sq. ft.) Page 2 _ Pi's i �,�� :r}, 1 S i 5 } i� , '`-. ' \t R' 'J1, l I1tcIL i 1 ,�,.!__. .i - , 1 Site utilities Job site address: //325 45w /6 8 Catch basin or area drain 16.60 City /State/ZIP: 9 -qf Q 4 /J 7.2 a ? •..] Drywell, leach line, or trench drain 16.60 Suite/bldgJapt. no.: [ Proj ' e e cct name: 7 Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: Manufactured home utilities - 110.00 • • Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: _) Page 2 Subdivision: 1 Lot no.: Water service (no. linear R.: ) Page 2 Tax neap /parcel no.: Fixture or item a , r�' ,t r ,� , ,. Absorption valve 16.60 f,._. :`''-t' 17 . � tFC.. - ...�•; „ ta'!i ikll fl A ! . , ,� _. 4, 1 ,�, :.., - -... •- - - � . ... :. ..�. .. �... . � Backtlow preventer Page 2 8 _A)G/a Q Le -t(b add leg ye Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 7- iI -. r- t l ..; : i ? ( t T 1 i r - y e Iir+ ,1�. '3 ' C '` i , : _ / Ejectors/sump 16.60 Name; PeirL Pi A1* l�QL4Peis Expansion tank 16.60 Address: (J3a 6- 5+ / 6,,,./_,A Fixture/sewer cap 16.60 City /State /ZIP: 77 • 0 de 9 7.9... 3 Floor drain/floor sink/lrub 16.60 Phone: ( ) I 4 / ! Fax: ( ) Garbage disposal 16.60 , �l r ' r i ,. t. � , I I 'c ,• R1�� 2�, r 1�� I �� li ] - Hose bib 16.60 _ .. i__...•...r _ -r _.,.. , .s, _.,.. .._!r, __. ... .. f - ,h,, ., . - .‘7 . .,... .. .. _ :.J lee maker 16.60 _ i - ' ' ' / L "R"I Interceptor /grease trap 16.60 Contact name: " �J � �Q Page Medical gas (value: $ ) Pa e 2 Address: .gp � g 9 Primer 16.60 ' � /� / Q City / State/ZIP: - 4 7 d ! a- Roof drain (commercial) 16.60 Sink/basin/lavato Phone: (a.3 64.2 - v`3 ,/ Fax: : ( L 9 /- 23 2 k ry ' 16.60 Tub /shower /shower pan _ 16.60 /4, . ` E- tttarl , t 16.60 } 55 nn .I,[{. , i� S• /. i,l�li ^IC Iii r} . , /� L r .r a d .i. M __,� �' ,r,. 5. ,,,_�!„ . _ , Water closet 16.60 Business name: f q t. d - S eb 6 t� ` `J j r Water heater 16.60 Address: ,J �Q x ^Ot her: City/ State/ZIP: ((x r ' t IL 9 26 4 Subtotal •/t .t a st Minimum permit fee: $72.50 Phone: ( . _ - r ..2 7 Fax: -3 , - � - . Residential backflow minimum permit fee: $36.25 .5 O CCB Lic.: R 7 ? Plumbing Lic. no.:3 d A Plan review (25% of permit fee) e rwillti State surcharge (8% of permit fee) ' Authorized signature: �'1: TOTAL PERMIT FEE 7 '' Print name: e f i /\ - Date: 46 + 11.06 This permit application expires if a permit is not obtalneJ within • 180 days after It has been accepted as complete. `Fee methodology set by Tri -County Building Industry Service Board i:\ BuildingTermiLAMM- PeM 06/05 4404616T(10✓02/COM/wED) • i CITY OF TIGARD BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED PLM2006 0038() Phone: (503) 639 -4171 jell 8/11/2006 Inspection Requests (24 Hrs.): (503) 639 -4175 �'��+�- °: _.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 8/14/2006 7.01AM 59 SITE ADDRESS: CLASS OF WORK: SUBDIVISION: 11325 SW 108TH AVE LOT #: TYPE OF USE: PROJECT NAME: DOREEN COURT 003 DESCRIPTION: KOEHSTEDT Replace tub & valve. OWNER: PHONE #: • CONTRACTOR: KOEHSTEDT, MATTHEW PHONE #: 62�) -1906 RAYBORN'S PLUMBING INC G03 -692 -4139 Inspection Request Scheduled For: Date: at Pour Time: Code # Inspection Description Confirm # 14/2005 Contact # Message 320 Plumbing rough -in 034886-0 503-692-4139 N Corrections /Comments /Instructions: c i d c-pie- 7? 73 9- 2z ? vi --Ss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Dat-. p I I • Phone #: (503) 718 - , is•-?/ CITY OF TIGARD . BUILDING DIVISION PERMIT #: PLM200 &003£30 13125 SW Hall Blvd., Tigard, OR 97223 OP DATE ISSUED: 8/11/2006 Phone: (503) 639 -4171 A � Inspection Requests (24 Hrs.): (503) 639 -4175 °I_L. A. INSPECTION WORKSHEET FOR DATE: 10/3/2006 TIME: 7:06AM PAGE: 76 SITE ADDRESS: 11325 SW 108TH AVE CLASS OF WORK: SUBDIVISION: DOREEN COURT LOT #: 003 TYPE OF USE: PROJECT NAME: KOEHSTEDT DESCRIPTION: Replace tub & valve. 10/2/06: Added (1) shower pan .& valve. OWNER: KOEHSTEDT, MATTHEW PHONE #: 620-1906 CONTRACTOR: RAYBORN'S PLUMBING INC PHONE #: 503..692 - 4139 Inspection Request Scheduled For: Date: 1013/2006 Pour Time: ,( Code # Inspection Description Confirm # Contact # M-ssa•e `� 320 Plumbing rough -in 037557 -01 503-692-4139 Y ? 5:14 Corrections /Comments /Instructions: _ ir r icr 0 / o !i 'ASS n PARTIAL APPROVAL I I CANCEL n NO ACCESS FAIL ( I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 4 c' `� Date: 1 ® �� 16 � Phone #: (503) 718 - v , 2-Y