Permit 'CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00021
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/17/2006
PARCEL: 2S112BB -11900
SITE ADDRESS: 14095 SW FANNO CREEK PL ZONING: R -7
SUBDIVISION: COLONY CREEK ESTATES NO.4 LOT: 099 JURISDICTION: TIG
Project Description: Replace water service.
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: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 30 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
PAUL VORVICK
14095 SW FANNO CREEK PL Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 1/12/2006 $72.50
[TAX] 8% State Surcha 1/12/2006 $5.80
Phone : 503- 620 -9022 Total $78.30
Contractor:
RAYBORN'S PLUMBING INC
PO BOX 69
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 692 -4139
FAX 503- 691 -2328
Reg #: LIC 87852
PLM 34 -166PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: 7, )64 �'' Permittee Signature: aQ,L \ p
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jan. 16. 2006 11:18AM Rayborns Plumbing No. 9179 P. 2
. ?` P$ rinit Application FOR OFFICE USE ONLY
City of Tigard Received _
Date/By: / - I l O 6 . PMrmitNc 6 Ot c /
13125 SW Hatt Blvd., Tigard, OR 97
g C V' ; Plan Review
Phone: 503,639 4171 Fax 503 :,)I� ,, sk Date/By. other Permit No.:
24- Hour Inspection Line: 503.639.4175 __ ,, 1-')1 j II
4 ... Date Rea /B run
Internet: www ct tigatd or us JAN Y ®See page 2 for
L JAIL in: Notified/Method: I I Supplemental Information
TM -y� t . ��r.?,T�� � r �� -• �t !�f 1< , Yrti7 -'i 'd,0�15' -� ! St- r� iz ��x .,r ^ "' tu : :u T, .'r „k�. , Mt „�m^A.:. ;.� .fG'^'.- ro 7 - MS
, , y _ =1c y T . 5 ,3 , , ; i r i rrl P �T i ..m; r , ; _C.. �" ;y 1r xr t ;TR 1 ., C) m� i a r y t t r ,
k .iei4 t,,. t d - f ,' , , 4 f�� i i da .. r ,,u .a "t"f r,f i sN tzz, x k 1` .,, .s ! " i, ; ;; ,_ �F' ,k r ;t :
�...t�'+,r >ntl i1'. 1_ :n :.. ..��=�'�..:c.��' _i r ,1 „� �atv +r� rr � rt1'G.�',"���``�i ff�i '�r�. rc } ��� .� 'Yx ."f.' �� ` r Y f� � 7�.
, rcu :,E� 3'M_ u _ �. w..,:i c.. ] .�.. .�... t,. .. .. :.t.?. ...�,�,._.� `.a.� :..� {� <4 Tii_ /ar�t'�
❑ New construction B U I L D I • i 4-31:' .; For special ittfotrncaion use ckeckllst
Description I Qty, I Ea. I Total
Addition/alteration/replacement ❑ Other:
New 1 - 2 family dwellings (includes 100 ft. for each utility connection)
1 5 i ;: ifi Ta7 F ri, r a1 R;c k a r '�i MS t S
t r` P` .t v�?II. i 1 J ;4W. )t! 5 t ` ? .. � 1�7 s, , e ". - b b? stv - - , -; 1 y i ', f f SFR (1) bath 24920
11 I - and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building CI Multi-family SFR (3) bath 399.00
Each additional bath/kitcltca 45.00
❑ Master builder ❑ Other:
i 41ik�+f�i"a'�''R?Yx ttt �> jl$i1^ �.`r'+" '7" S!3' ? , a Fire sprinkler s . ft.
t . r al i 9 p 'S fl ii f `'I!, di `.3 i u o 't t a m+ i a s ` ! ' =r Trig ' �' + P ( 9 ) Page 2
Li, it'..w.2 �dt G_ 2..i� 1 .. :.,,i .1u;t e,$K, .r ,- � , F°tor �. i , lAi ;%1-. Site utilities
Job site address: I Libels s to Fian110 creek 0L Catch basin or area drain 16.60 I
City /State/ZIP: --' 9 1 Q ( � d � ' 1 72 a iv r Drywell, leach line, or trench drain 16.60
Suite /bldg. /apt. no.: J I Project name: ' T 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: I Lot no - : Water service (no. linear ft. ) I Page 2 Se ,ca'
Tax map /parcel no.:
Fixture or Item
0c• } Absorption valve 16.60
li }, 110 R,T 7 t1 M,j9 �Bt F�w S TPo � �"ra , Y.m i, 'P� {i p
..a,xY, j - �,r .a- ISr,_. ,,,.,sa s r �",.,A (g a r ... .1 � :40. Back#low prevcntcr
41,
/ , Page 2
• + • a �t t� 4 r cS e r v 1 Ge Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
r T` 4 i' c 3FLI4' �� 1, a r T- naa'rn r
1t m P er e FF, t "t �� 'i; Drinking fountain 16.60
I9 t �; �x��'��� .��,�� ' ,t �*��f?1y�? �, � l =fix"° x v. ` -,�M �� ,i l �!! .�t�� >ri. � t t ' Ejectors /sump
Name pa u L 1Q, V a'C. /e 16.60
)Expansi tank 16.60
Address: • - _ _ - / Fixture/sewer cap 16.60
City /State /ZIP: -77 a OA 9 7d y Floor drain /floor sink /hub 16,60
Phone; et 3) 6 . d w - a r
Garbage disposal 16.60
? t w ,� 1;•l t r h� ° R v }x L ! F r °{5 �, i �.. q 4 t 1e' " � 11 ` s , tt r 4
�r r I, i , �£' ' r icyt,` i I t t-i� i,k r r t:i t i fi is G;•llZ Ho bib 16.60
i ? ¢. Jt �. S ,i`7 ' ,.. t�'1_ Eft. '�; fwt 1 . ilii:ahAi 7,g.11`.4 � 1 ,i5R� 1 • . w i:, Iii : s. ; :.
lco maker 16.60
Business name:
q Li bar A 5 t Iu Pin 1l ! -11 Interceptor /grease trap 16.60
Contact name: ' Ma. /
Medical gas (value: $ ) Page 2
,
Address; O 8,0) 69, Primer 16.60
City /State/ZIP: -rte 4 ie 1 '1 ? 9 7 Roof drain (commetcial) 16.60
Phone: ) i Fax: Sink/basin/lavatory 16.60 •
(Sb3 6 9 ? - y13 (5Q8 , , / _z
.3 Tub/shower/shower pan 1 6.60
E
; � ' • • • v Urinal
tail t .� Sig � f �l t� E ``t` - ltiAd u " t iii" Y) q /i 1 i`T � ` I Water closet 16.60
Business name: q !_ • .1 Al. r Water heater 16.60
Address: 6 e K fv 7 Other:
City /State/ZIP: � �Q 9 / Subtotal S'r' • a G
Lt R /t _ / `U �Op Minimum permit fee: 572.50 /.,
Phone: (b p3 6 9a- y/ 3 9 Fax: (6.2:43 (, 7 /_ 2 a a 2r Residential backflow minimum permit fee; $36.25 7errZ 1 50
CCB Lie.: 8' 7 8. 5 e1. Plumbing Lie. no. :, Li -/4•4f ` Plan review (25% of permit fee)
Authorized signature:
< ( State surcharge (8% of permit fee) • SD
TOTAL PERMIT FEE --18.,3t
Print name: r 11 a -F IL Date: f .. t ( _64 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
"Fee methodology set by Tri County Building Industry Service Board.
is \Bull ding \perri,ite\PLM- PermitApp.doc 0a105 440-4616T(t /02/COM/WEE)
CITY OF TIGARD Aei.H1A0(Q- 00021
BUILDING DIVISION PERMIT #:
1111(1P
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 emrliviiiiil
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11‘1,3/6(D TIME: PAGE:
SITE ADDRESS: I LI o G 6 0 I) CX e • CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
X014 lid s e,ro i
Corrections /Co ments /Instructors:
( C IA 61-. 9N(6 A ) \)b )(_ `'-// ? \ fZ , V VC t ' . ,
5 6e Cc. -
r.
i
tl
lib
r A' 1
//
. // l `!� d o
/ ,"'
R .,
. .5
ASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: (iV Date: ( / - 7/3/ a le Phone #: (503) 718-
CITY OF TIGARD . _.
,
BUILDING DIVISION
PERMIT #: PLIVi2006-00021
-41/ .
13125 SW Hall Blvd., Tigard, OR 97223
DATE ISSUED: 1/17/2006
Phone: (503) 639-4171 .47,, '
Inspection Requests (24 Hrs.): (503) 639-4175 „ill- 11L.,
INSPECTION WORKSHEET FOR DATE: 100/2006 TIME: 7:00AM PAGE: 99
1 SITE ADDRESS: 14095 SW FANNO CREEK PL CLASS OF WORK:
li COLONY CREEK ESTATES NO.4 LOT #: 099 TYPE OF USE:
PROJECT NAME: VORVICK
DESCRIPTION: Replace water service.
OWNER: VORVICK, PAUL PHONE #: 503-620-9022
CONTRACTOR: RAYBORN'S PLUMBING INC PHONE #: 503692-4139
Inspection Request Scheduled For: Date: 1/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Wale: service 026326.01 603-E;92-4139 N
Corrections/Comments/Instructions:
C6' - 1 — VZSLAA
VV1_1251/4 l l've .-
3'. 13 v\( .A...),--<-(c.. 4- vt , _ ,,,d a_S-g, 1---
\--e. -- 4-es k ---
P ■(&O
\A.(
c__„LAJL -e---z-c. A-es A ----
(—Q-.
eeLL
\/2e.C
r1_, —) Lk- \/_
PASS \ kARTIAL APPROVAL n CANCEL n NO ACCESS
0 FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: V6, it-______.
Date: 1 7 z_43I 0 ce Phone #: (503) 718-
CITY OF TIGARD
PL12oo -oc�D.A
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: IA CVO tp TI PAGE:
SITE ADDRESS: N 646 V d CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: ; Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
- 33 6 W&X
Corrections /Comments /Instructions:
L (114;167
Si‘.A4 )ra' c.xL/e__ J2Jz__&
. `• , �X rf C '
Gil. Ce 1 �.. cam. -�� � � - Ye-0 r7F-TNi ----
S
& I d
e/ 1( 2-r i_
• L I ,,r_ i c itV / CJZ_•2___ -
e 6 S
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
1 FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / / �� ' Date: IW� 1° Phone #: (503) 718 - �` 1 �7
CITY OF TIGARD
4 -
A
BUILDING 'DIVISION PERMIT #: PI.M2006-00011
13125 SW Hall Blvd., Tigard, OR 97223 y DATE ISSUE : 1/17/2006
Phone: (503) 639-4171 a*Ix
Inspection Requests (24 Hrs.): (503) 639-4175 112.
INSPECTION WORKSHEET FOR DATE: 1/1W2006 TIME: 7:01AM PAGE: 69
SITE ADDRESS: 14096 SW FANNO CREEK PL CLASS OF WORK:
SUBDIVISION: COLONY CREEK ESTATES NO.4 LOT #: 099 TYPE OF USE:
PROJECT NAME: VORVICK
DESCRIPTION: R water service.
OWNER: VORVICK, PAUL PHONE #: 1 303- 620-9022
CONTRACTOR: RAYBORNS PLUMBING INC PHONE #: 503.6924139
Inspection Request Scheduled For: Date: 1/18/2006 . Pour Time: "
Code # Inspection Description Confirm # Contact # Message
330 Water service 026160-01 603-6914139
CRrrections/Comments/Instructions;
2 A 5 . *IAA\ 6/ Le, ( 1 - 7) YVVAL
Vv\ r1A--)/\
k! o 6 •
PelA . A3)k/L& C teLe
•
' VI "rS 7."kJI kit t4,-N"
El PASS El PARTIAL APPROVAL n CANCEL El NO ACCESS
X FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
i Date: I / C(7
Inspector: Phone #: (503) 718-