Permit a CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00331
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/7/2008
PARCEL: 1 S125DA -05601
SITE ADDRESS: 06620 SW ALFRED ST ZONING: R - 4.5
SUBDIVISION: KINGS VIEW LOT: 042 JURISDICTION: TIG
PROJECT: SARRINEN
Project Description: Move kitchen sink, add (1) watercloset, (1) lay and move water heater.
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: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
ANNETTE SAARIN EN
9755 SW PEMBROOK ST Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 8/7/2008 $72.50
[TAX] 12% State Surcha 8/7/2008 $8.70
Phone : 503 -619 -1040 Total $81.20
Contractor:
RAYBORN'S PLUMBING INC
19990 SW CI POLE 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.
Issued 4 Permittee Signature: OA /9-70/0L%6.9 -77' 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.
aar,i503 691 2328 Rayborns Plumbing 10.09:39 a.m. 08 -06 -2008 1 /2
. _ •
Plumbing Permit Application a FOR OFFICE USE O \(.\
t�.. Cl of Tigard 20t .1 Received � Permit 07 �J
g p 1 ((!! 6 L / C �' ,Q /� No.� /,[.1tY t� -+•i'
.'+ 13125 SW Hall Blvd., , OR 97223 41 E] DateBy: dl �F� - ` , ��
`l� Tigard
® lane Review _ s ff -
" �� Phone: 503.63 4171 Fax: 503.59b.1960 ' Va /By: Other Permit No.:
' Inspection Line: 503.639.4175 of T 1 IG • ead y
r1 isA it .D t YB Iyp. BI See Page 2 for
IInternet: www.tigard or.gov G I " r � IVISi L onfied/Method: / �G Supplemental Informat
TYPE OF WORK B� `ylS FEE° SCHEDULE
['New construction [l Demolition For special information use checklist
Description I Qty. i Ea. 1 Total
A Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
Al- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building El Multi-family SFR (3) bath 399.00
E] Master builder Each additional bath/kitchen 45.1)0
❑ Other. Fire sprinkler ( sq. R) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 6 ,7 o S ', , ,4).2' s'7 Catch basin or area drain 16.60
City /State /ZIP: 7--,- s r" Ue 9 77 2. v` Drywell, leach line, or trench drain 16.60
Suite/bldgiapt. no.: Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
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
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
t n
f inn ,.4t,G.&. 5.., k r Iv, f / 2_ti f'. Backwater valve _ 16.60 - -
Ad J L I P 71Ler Clothes washer 16.60
Dishwasher E 16.60 _-
1 Drinking fountain 16.60
❑ PROPERTY OWNER ❑ TENANT ;
/ Ejectors /sump 16.60
Name: ///✓/✓ - /"./ . E
1T Expansion tank 16.60
Address:
9 7 5-5- xfrr) �O6- r� ,q��i C s e� Fixture/sewer cap 16.60
City/State /ZIP: 7 7 ��42
6' g 9 / a L� Floor drain/floor sink/hub 16.60
Phone: .(5 ) 6 / l�D 9-/9 Fax: ( ) / Garbage disposal 16.60
❑ APPLICANT ❑ CONtACT 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
Phone: ( ) Fax:: ( ) Sink/basin/lavatory F . _ 16.60
Tub /shower /shower pan 16.60
E -mail: •
Urinal 16.60
CONTRACTOR ' Water closet 16.60 76 '
Business name: 9 X c'`f J / g Water heater / 16.60 /[ Go
-� f / U�., ,L!k
Address: 0 / 6,, x 6 � L Other:
/ P Subtotal //
City/State /ZIP: ? 5 k 1' C 9 ?a ‘ Z C)6 .
Minimum permit fee: $72.50
Phone:$' )/ 2 Z 5--. rl, F IA: 5 �C/ Z.3 Z Et Residential backilow minimum permit fee: $36.25
CCB Lic.: o ?�S Z Plumbing Lic. no.:3 Plan review (25% of permit fee)
Y / ) // State surcharge
Authorized signature:
2/7/A) 1� -
'� // arge (12% of permit fee) TOTAL PERMIT FEE g
Print name: Le r/5 4 r e" �_5. V Date: --, - I This permit application expires if a permit is not obtained within
J 180 days after it bas been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
1. lBuilding \ Permits \PLM- PermitApp.doc 06/26/06 /W
440- 4616T(10/02/COMEB)
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM20013- 00331
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 0m2000
Phone: (503) 639-4171 , t1/ 1 , 41 1 i i ll\ P
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1 7. I 1 2 / 2 0 0 8 TIME: 7:00AM PAGE: 14
SITE ADDRESS: 06620 SW ALFRED ST CLASS OF WORK:
SUBDIVISION: KINGS VIEW LOT #: 042 TYPE OF USE:
PROJECT NAME: SARRINDI
DESCRIPTION: Move kitchen sink, add (1) watercloset, (1) lay and move water heater.
OWNER: SAARINEN, ANNE' 1E PHONE #: 603,619.1m
CONTRACTOR: RAYBORN'S PLUMBING INC PHONE #: 503-69241139
Inspection Request Scheduled For: Date: 12/12/2008 --1(8")./ S 0 0
Pour Time: AL) 1 0
Code # Inspection Description Confirm # Contact 1 Me-
399 Plumbing final 079009-01 503-692-4139
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Corrections/Comments/ structions: L 442
Ala._
7: Z.— / )—vd ci
il
V ik
dis-A-s-s
fl PARTIAL APPROVAL fl CANCEL Li NO ACCESS
FAIL I CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: \ ,- Date: ‘ 7sft a Phone #: (503) 718-
—/---
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A . .
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: PL 2c08.00331
•
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8f7f008
Phone: (503) 639- 4171�l��y l ��l
Inspection Requests (24 Hrs.): (503) 639 -4175 .._' W _ ...
INSPECTION WORKSHEET FOR DATE: 1121200 TIME: 7 : 00AM PAGE: 1e
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION:
06620 SW ALFRED ST LOT #: TYPE OF USE:
PROJECT NAME: KINGS VIEW 042
SA62RINLJd
DESCRIPTION:
Move kitchen sink, add (1) watercloset, (1) lav and move water heater.
OWNER: SAARINEN, ANNETTE PHONE #: 503 - 610 - 1040
CONTRACTOR: RAYBORN'S PLUMBING INC PHONE #: 503-692-4139
Inspection Request Scheduled For: Date: 8112/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 074066 -01 503-692-4139 N
Corrections/Comments/Instructions:
21—) C \ \ 4 \ P t ,.--Ir c✓ 4C \i`k f y 1 ■/■, Lo c „A-4 wi It. k \ \
® ra c-e 0E S ok ✓-.
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(;O v...i\Jst, `a 4 — ‘e ,^- .i - ft :KO‘/Z/ Cc,. 1 0 ro✓ S C i
X PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
I FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: ) V\ ------ Date: Q c)., 0 Phone #: (503) 718-