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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-