Permit C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00328
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/27/2007
PARCEL: 2S112AD
SITE ADDRESS: 06650 SW BONITA RD ZONING: I -
SUBDIVISION: PAUL SCHATZ FURNITURE LOT: 001 JURISDICTION: TIG
PROJECT: THOMASVILLE OF TIGARD
Project Description: TI - replace, decomission and add new fixtures.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS; 2 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 2 URINALS: 0 GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES: 4
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
•
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [PLUMB] Permit Fee 7/27/2007 $215.80
[TAX] 8% State Surcha 7/27/2007 $17.26
Phone : Total $233.06
Contractor:
RAYBORN'S PLUMBING INC
19990 SW CIPOLE RD.
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 692 -4139
FAX 503- 691 -2328
Reg #: LIC 87852
PLM 34 -166PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 -0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: j 1 / 0:1- ,/f Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jul. 24. 2007 12:11PM Rayborns Plumbing No. 5885 P. 1
Pltuftbine Permit Application , IT r
City of Tigard ' , ' d r/
,; .,..T ,1 , a L - °Dates *3" LJ t' 5L Permit No.: Pu92ao--7 -6032$
• 13125 SW Hall Blvd -, Tigard, OR 97223 Plan Review
Phone: 503.639,4171 Fax: 503.598.I960 Da m Other Permit No.: 5w Q 2m - t) J $5
Inspection Line: 503.639.4175 , J J L J !j• 2 Q O y:
7' 7 Ci i111 i) ^' Date Ready/By: kill: fin See Pa 2 far Internet: www.tigard- or.gov _ _Notified/Method: 17 & Supplemental Information
TYPE OF S'$ARI . Qt. . 1 I 1; -i. -. ., ‘0....J ... FEE* ` SC1W
❑ New construction I oliii 3 o� �� special information use eherklist
i i, Y . 6 i� I S j-1 '
Description pti For s 1 Qty. 1 Ea. 1 Total
e Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 R for each utility connecton)
CATEGORY 01? CONSTRUCTION • • • SFR (1) bath 24920
❑ 1- and 2- family dwelling ® Commercial/ industrial SFR (2) bath 350.00
III Accessory building El mufti-family SFR ( bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler (__- sq. R) Page 2 _
JOB SITE INFORMATION' AND LOCATION .. Site utilities
Job site address: 6600 SW BONITA RD. Catch basin or area drain 16.60
City/State/ZIP: TIGARD, OR 97224 Drywell, leach line, or trench drain 16.60
Suite/bldgJapt_ no.: ` Project name: THOMASVI1LF, OF TIGARD Footing drain (n °- linear ft.: ) Page 2
Manufactured home utilities 110.00
Crag Kdi it E8 j813 §i :
- Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear f: _._) page 2
-
Storm sewer (no. linear ft.: _,__) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: _) Page 2
Tax map /parcel no_: Fixture or item
Absorption valve 16,60
DESCRIPTION : OF WORK ' . Backflow preventer Page 2
TENANT IMPROVEMENT OF EXISTING BUILDING Backwater valve 16.60
Clothes washer 16 -60
Dishwasher 16.60
Drinking fountain 1 16.60 16.60
PROPERTY OWNER : ❑ : TENANT F 16,60
Name: Expansion tank 1 16.60 16.60
Address: Fixture/sewer cap 16.60
City /State/ZIP: Floor drain/floor sink/hub 2 16.60 3320
Phone: ( ) Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
® APPLICANT. "' a GbN'CACT:.PERSUN' Ice maker 16.60
Business name: RAYBORN'S PLUMBING
Interceptor /grease trap 16.60
Contact name: RANDY DEADMOND Medical gas (value: $ ) Page 2 Ett
tJ
Address; 19990 SW CIPOLE RD. Primer 2 16.60 3320
City /State/ZIP: TUALATIN, OR 97062 itotr Roof drain (commercial) 16.60
1 a Sink/basin/lavatory 4 16.60 66.40
Phone: (503) 692-4139 Fax: : (503) 691 -2328 s k0-
O� i(� Tub /shower /shower pan 16.60
E -mail: randy @rayborns.com '(t)' , J Urinal _ 16.60
CONTRACTOR On1 : Si' Water closet 2 16.60 33.20
Business name: RAYBORN'S PLUMBING t Water beater 1 16.60 16.60
Address: 19990 SW CIPOLE RD. Other:
City/State/ZIP: TUALATIN, OR 97062 Subtotal 215.80
Minimum permit fee: $72.50
Phone: (503) 692 -4139 Fax: (503) 691 -2328 Residential bacldlow minimum permit fee: $36.25
CCB Lic -: 87852 Plumbing Lie. no.: 34 -166PB Plan review (25% of permit fee)
Authorized signature: / /'
State surcharge (8% of permit fcc)
TOTAL FERN= FEE 233.06 �'
Print name: RANDY DEADMOND I Date: 7/24/07 This permit application expires if a permit is not obtainea within`
180 days after it has been accepted as complete.
*Fee methodology set by Ili-County Building Industry Service Board.
I:\Builairisw rmitorAt- PQmttApp.doc 06/26/06 440.4616T00/02/COM/WEB) 'Valli 4
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CITY OF ,
�*um m n�`n— TIGARD ^—
BUILDING DKNG DUVUSUON PERMIT #: pi JA2007 8032
| 13125 SVVHall Blvd., Tigard, OR 97223 DATE ISSUED: 7070007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 v���' 1 J.t
INSPECTION WORKSHEET FOR DATE: 1/2/3000 TIME: 7:01AM PAGE: 35
SITE ADDRESS: 06660 SWBAN|TAR[} CLASS OF WORK:
SUBDIVISION: PAUL SCHA[ZFURNITURE LOT #: 001 TYPE OF USE:
PROJECT NAME: THOMASVILLE OF TIGARD
DESCRIPTION: ll - »wo}aCm, dexonnimsimn and add new fixtures.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE#:
CONTRACTOR: RAVUORN'S PLUMBING INC PHONE #: 603-692-4139
Inspection Request Scheduled For: Date: 11212008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 062340-01 W3'692-4139 N
Corvectione/Connnnenta/|natructiona:
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0@ PASS |l PARTIAL APPROVAL || CANCEL | | NO ACCESS
1 �� ��
. FAIL / . CALL FOR INSPECTION �� ADDITIONAL FEES ASSESSED
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|nop�c�oc�� �� l44^4.�� k���°�_~ Date: , k � ��� L/� u Phone #: /503\ 718-
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CITY OF TIGARD ���� �
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BUILDING DIVISION ~~~,.~~=°""~~° ~~"°"~,"~~"~ PERK8|T#: PLhA2007-00328
| 13126 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7K27/2007
Phone: (503)630~4171 Ate
Inspection Requea�;24Hm� .
Hrs.): ~��W� ^�--.
INSPECTION WORKSHEET FOR DATE: 12J 7812007 TIME: 7:00Ak4 PAGE: 73
SITE ADDRESS 06660 EW8QN|TA RD CLASS OF WORK
SUBDIVISION: PAUL SCHATZ FURNITURE LOT #: 001 TYPE OF USE:
PROJECT NAME: TMOhMASYLLEQF7lGARD
DESCRIPTION: Tl',eo/eow decomission mdmd�n�my�4u/we
replace,
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: RAXBORW'G PLUMBING INC PHONE #: 503-692-4139
Inspection Request Scheduled For: Date: 121280007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 082232-01 603-692-4139 N
Corrections/Comments/Instructions:
/
.
No .U] t•-/tTr
n PASS 0 PARTIAL APPROVAL 0 CANCEL n NO ACCESS
V LFAIL El CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
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Inspector: �� ~ vv��_�tw\�^~-�~ Oate�1,� Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00328
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/27/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/26/2007 TIME: 7:01AM PAGE: 63
SITE ADDRESS: 0665() SW BONITA RD CLASS OF WORK:
SUBDIVISION: PAUL SCHATZ. FURNITURE LOT #: 001 TYPE OF USE:
PROJECT NAME: THOMASVILLE OF TIGARD
DESCRIPTION: TI - replace, decomission and add new fixtures.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: RAYBORN' S PLUMBING INC PHONE #: 503-692.4139
Inspection Request Scheduled For: Date: 9/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 056356.01 503-692-4139
Corrections/Comments/Instructions:
PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
c
Inspector: <To il-rtAf 1' 1 -' Date: `l j 2b J (h 7 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00328
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/27/2007
Phone: (503) 639 -4171 14"011141t
Inspection Requests (24 Hrs.): (503) 639 -4175 ' I
INSPECTION WORKSHEET FOR DATE: 8/14/2007 TIME: 7:00AM PAGE: 58
SITE ADDRESS: 06650 SW BONITA RD CLASS OF WORK:
SUBDIVISION: PAUL SCHATZ FURNITURE LOT #: 001 TYPE OF USE:
PROJECT NAME: THOMASVILLE OF TIGARD
DESCRIPTION: TI ., replace, decomission and add new fixtures.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: RAYBORN'S PLUMBING INC PHONE #: 603-6914139
•
Inspection Request Scheduled For: Date: 8/14/2007 Pour Time:
Code #` Inspection Description Confirm # Contact # Message
306 Plumbing underslab 063926 -01 503- 692 -4139 N
Corrections /Comments /Instructions:
tgt PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
I FAIL CALL FOR INSPECTION [ I ADDITIONAL FEES ASSESSED
Inspector: v 6 V1• Date: T J J y 107 Phone #: (503) 718-
.