10599 SW RIVER DRIVE 10599 SNN' River Dr
7 CITE' OF TIG ® RD
DEVELOPMENT SERVICES PLUMBING PERMIT
CITY IPERMIT#: PLM2002-00142
,
13125 SW Hall Blvd., Tigard, OR 97223 (5031 639-4171 DATE ISSUED: 4/30/02
SITE ADDRESS: 10599 SW RIVER DR
PARCEL: 2S115AD-07100
SUBDIVISI04: COVER LANDING ZONING: R-4.5
BLOC C: LOT: 054 JURISDICTION: TIG
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:
TUB/SHOWERS- 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHcRS: RAIN DRAIN: ft
Remarks: Removo tub and install shower
FEES
Owner: ---
._.�� __- - – Type By Date Amount Receipt
LE-HI-W, MICHAEL W/DONNA M PRMT CTR 4/30!02 $1'1.50 27200200000
10599 SW RIVER DR 5PCT CTR 4/30/02 $5.80 272.00200000
TIGARD, OR 17223
Total $78.30
Phone 1. —�
Contractor:
RAYBORN'S PLUMBING INC
PO BOX 69
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone 1: 503-692-4139 Rough-in Insp
Reg #: LIC 87852 Top-out Insp
PLM 34-166PB Final Inspection
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 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246, 987.
Issued By: �fL,�._ti �(,-- Permittee 5i.2nature: //�
Call (503) 639-4175 by 7:00 P.M. for an inspection needed a next business day
Plumbin_, Permit Aimlication Date received: Permit no.:
—
City Of Tigard Sewer Permit -T Building Permit No.
13125 SW Hall Blvd. Tigard,OR 97223 r Pnt'ecdA I.No. Expire Date
Phone:503 639-4171,Fax 503 598-1960 J Date issued B Recei,t No.
Land Use Approval Caro Pile No. Payment Tyne
:New
Family dwelling or accessory U Com merei ' al U Multi-family U Tenant improvement
construction d Additio a teratio placement U Faxl service U Other:
4
Job address: 10599 SW River Drive 1)escripGon Qty Foe i ::i
New I &2 family dwelling only:l+ 100 R
Bldg. No.: —Lititc no.: __ SFIt(I)Bath $249.20 n
Tax map/lax lot/account no.: SFR(2)Bath $350 0
SFR(3)Bath $399 0
Lot: Block: Subdivision
Fach additional bath;kitchen $ 0
Proicct name: Site Utilities:Catch basin/area drain $16.60 0
Cil /county : Tigard Zlp 97224 Dry%•ells'leach line/trench drain Y 0
Footing drain(no.I,in.0) $ 11
Description and Location of work: Remove Tub install shower Mnnul'actured Monte utilities-each $46.40 7-
Date of Completion/inspection: Manh,dcs 5 0
Itain diain connector $ 0
Sanitary Sewer(nu.of linear feet)100' 555.(X) 0
Business name : RAYBORN'S PH IMBINO i Sturm Sewer (no.oflineat feel) IMM 555.00 Ir
Address : P.O. BOX 69 Witter S�,rviu. (no.of linear I'ect)100' $55(g) (►
Fixture or item:
City :TUALATIN Slate: OR Zip: 97062 Absorption valve _ $16.60 0
Phone : 503 6924139 Fax : 503 691-2328 Back Ito%%prcventer $27.55 (1
Backwater valve _ $16.60 tl
E Mail Address : Waync(d),Rayborns.com Basins/Lavatory $16.60 u
CCB no. : 87852 Plumb. Bus. No. �4-166PB Clolhcs Washer $16.60 0
City/Metro Lie. No.: 0(11806 Dishwasher V(,611 , V
I)rinking Fountain(s) 516 bu 1
Contractor's signature Ejector/sump $16.60
I'rint name: Wayne Siebold Datc .4129102 P.xpansion Tank _ $16.60 0
Fixture!sewer cap $16 6h 11
Floof drains)floor sinks/I luh
Name: C►arhagc 1)islwsal
Address: I lose Bibb $10 60 0
Ice maker 516.611 11
City : Slate : OR Zip: Interceptor Grease trap $1660 0
Phone : Fax Primer i $16.60 _n
Root'drain(commercial) $16.60 0
Sinks(s) Basin(s),Lav(s) $16.60 (1
Sump $1660 7-
7N :This permit application expires if a permit is not obtained
within 180 days aflcr it has beet,accepted as complete. tubs showeaahowcr pan I S1G.Go 160
-- --- Urinal r6.6, u
Include Fixture fee breakdown sheet. Water Closet Commercial permits require Sewer Tally sheet. ";atet heater Other: II
TOTAL 16.6
Tigard Takes Visa for Payment Minimum Fcc$50 -- 1 S('
Plan review i4,30%,
SIGNATURE Amount$ State charge.(►81% :7* c
Total S4(ltf'
CITY OF T'IGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DR N Business Line: (503)639-4171
�.. BLIP —
Received Qte Requested_ AM a, PM BUP
-__
7 � �� Suite
Location MEC _
Contact Person ___—__- --- Ph(_ ) �e'!2.2, 4/1 3�l PLM
Contractor _-- Ph( ) SWR _
BUILDING Tenant/Owner - - ELC _-
Footing - ELC
FoundationAccess:
Ftg Drain ELR _-
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam -.--.--- -- L
Shear Anchors ��,�; f
Ext Sheath/Shear -
Int Sheath/Shear --
Framing
Insulation
Drywall Nailing -- -- -- ----- -- -
Firewall
Fire Sprinkler --- ---- - _ -- - - -- =-- -- - _ -_
Fire Alarm
Susp'd Ceiling --------- --- ----- -
Roof
--
Other. ------ - -._ .
Final
PASS PART FAIL - --_- -�-__- -- -__..--
PLUMBING -
Post&Beam
Under Slab , (A �' -- ---- - -
f
a er-service
Sanitary Sewer
Rain Drams -- -_ _- ----- � -
Catch Basin/Manhole
Stoim Drain --T -- --- ��- ---- __ ---
Shower Pan �-
P PART FAIL_
ANICAL-- -----_ ---- - -_ - -
Post&Beam -------T__-.
Rough-In --- ---- -- -- - - _-
Gas Line
Smoke Dampers - -- -- ---� --- ---
Final
PASS PART FAIL - - -` - --- -� - -
ELECTRICAL ---
Service
Rough-In �- -- -- -
UG/Slab
Low Voltage _---_- -. - --- ----- --
Fire Alarm
Final L_-I Reinspection fee of�_-____. required Wore next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASSPART FAIL
SITE L] Please call for reinspection RE: Unable to inspect-no access
Fire Supply LineADA
Approach/Sidewalk Data_�=� ._ �._ Inspector-��"
Other.
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL