Permit C ITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00356
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/9/2007
PARCEL: 2S 103DB - 08000
SITE ADDRESS: 11230 SW MORGEN CT ZONING: R-4.5
SUBDIVISION: GENESIS NO. 3 LOT: 095 JURISDICTION: TIG
PROJECT: MCKELLAN
Project Description: Replacing existing fixtures for kitchen remodel, other fixtures include ice maker.
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CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 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: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner:
FEES
MIKE & JUN MCKELLEN
11230 SW MORGAN CT Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 8/9/2007 $72.50
[TAX] 8% State Surcha 8/9/2007 $5.80
Phone :. NA Total $78.30
Contractor:
RAYBORN'S PLUMBING INC
19990 SW CIPOLE RD.
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
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Contact # : PRI 503- 692 -4139
FAX 503 -691 -2328
Reg #: LIC 87852
PLM 34 -166PB
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B �� /✓ ' Permittee Signatur Jf ( /t( C)'J
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
g. 8. 2007 10:26AM Rayborns Plumbing No. 6331 P. 1
bin Permit A EG EIVED FOR OFFICl'. 11Sr ONLY
ty of Tigard ' Reeeive , i y � • �� . � ,
13125 SW Hall Blvd., Tigard, OR 97223 AUG U 7 2007 Date/B ! ' d Permit t ',:�`lt�v�/7�D3J`�o
Phone: 503.639.4171 Fax: 503.598.196 Plan Review
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•. Other Permit No.:
ELL p 639 4 ` �g U BUILDING NG D VIA 4 ., ' ` I I Date/Re �( (, 2 for
� -�$
24- Hour Inspection Line: 503. 1 r
Internet. y www.cl.tigard.or.us ' L _ N ate Ready/By: ech �Or z eg i1Inl
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❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
►� • ddition/alteration/replacement ❑ Other:
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New 1- 2-family dwellings (includes 100ft for each utility connection)
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.SFR(I)bath 249.20 I
t I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath I I 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder ❑ Other: Each additional bath /kitchen 45.00
C,r,'.� �i f{f ft, riry G It4 - �sm,
��, , l u r : rte � r , ,. r r a --Tr*fi t { Fire sprinkler ( sq. ft.) I I Page 2 I
fi J,�t <�t tf il 1 t �sin�! 1 . ! ∎ 1 d ,J" ) ',t' '��6 iS..�� : :, y t�tr� i 7 ,.:, S
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lob site address: ��2-3 0 J.i) / ?. e'gen g ?. Catch basin or area drain 16.60
City /State /ZIP: T�a�d, �) _,Z,,„1. _,�3 Drywall, leach line, or trench drain 16,60
Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.; ) Page 2
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Cross street/directions to job site: Manufactured Dome 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: 1 Lot no.: Water service (no. linear ft.: ) _ Page 2
Tax map /parcel no.: Fixture or item
;1 1 ;i; ;s!' E tri - f , . 9, i? I r1 10. ; TI�41 ;; S f 0 tq�� i t', I t 4 7 � i ,x ,.11 t }... Absorption valve 6.60
c 1r- , .,.r.. �i.;L' itie_.I,.. ., ;e1 t,: : :l. -.._>.,r.�_ .1 , :.a.I_13..r ;a Backllowpreventer Page
• • '. / i t /'� ' ,1 / . , A_ - e i /�; Backwater valve 16.60
1 • I Clothes washer 16.60
Dishwasher , / 16.60 ./` GO
}�_1'yT,•:.?,:f. �.;� ,fl3Pryt}R �Q°* ct-f.t 1 nr�770 't l t'^ I . J , tt . ,t. b. Drinking
°,}f"� x l' r h;Y ` ',tt t� *t +'r"fir; r 2. ' " : � l
t , ii : ti .. 1 v L _, d g fountain 16.60
t aa•.u:.� _'�,+ t �..�.. _...,-, _ .�;,� ? ?...`! _r -
,.,t,. __ .u. .�s.:.a Ejectors /sump 16.60
Name: M1dt. Expansion tank 16.60
Address: ` to .11t9-1-" . Fixture/sewer cap 16.60
City /State /ZIP: ]; Q ,. d .4 9 a Floor drain/floorsink/hub 16.60
Phone ( ) �!�- Fax ( ) Garbage disposal 16,60 l co
ref-,, �Y 1'rf ti zn ; a -c'C dam. R i o
Iv F � (t r L••�t�p�l d'1 h t3I L I ,! 't `4 4, f � t {[ t j• rrst , t �, � c ci 1 t f Hose bib 16.60
.t.0L'e . i : ;irev*? ; r ;n.a � � ;•;•• , I r12 t.1:Lti-t• � ,nr :t n. 1 '.1 3 - , i ' ..
y. P� �L I � }se j,_�. lee maker
/� n n 16.60 /4 �
.C�:S / /l�.& j m e-. Interceptor /grease trap /
Business name: 16.60
Contact name: /SS {v J Medical gas (value: S ) Page 2
Address: f ' ax 49 Primer 16.60
City /State/ZIP: 7U /i2) , 8/4 9'7ode Roof drain (commercial) 16.60
Phone: ( Sink/basin/lavatory / 16.60 E°
S o 3 > d 9� - ' i�9 Fax: �3) j/ ; 3 �8 Tub /shower /shower pan 16.60 I �
Email: /Jl at e/', 175. Co/rt.
t° �, i •';: , ;r? m ire t , �'C t ,_•: , . , ,., :; „ Urinal 16.60
t��i� � l T •`•.•� � T { )t tt. L V i � t �):31� Y'.� � _
a (.q: {i . 11 s5 .F',l L� ,�, , NE ' . � r I.� r , 7 , t S , { t
a -.i�t 1?.. r. Z,.. � �!` r j �_-._ L. I,,' �. ��t!' �_.tl.,,'rs1,f?.�.,� Water closet 16.60
Business name: ,erns Ruix.1323 hie- Water heater 16.60
Address: ,C, 864- A9 Other:
City / State/ZIP: �,,, C j 9 _ 6 _. J ' g72. .6 `�
Minimum Permit fee: $72.50
,g) ti 9 / Fax: (sa 3) 49/ 3 ,08 Residential backflow minimum permit fee: $36.25 7dis
Phone: °
CCB Lic.: e r 7g`j Plumbing Lic. no.: ,i y 4 P8 Plan review (25°% of permit fee)
Authorized signature: ' h�� _ State surcharge (8% of permit fee) I
TOTAL PERMIT FEE / ; 0
Print name: pp��,,,, l p, Date: PP 4 permit B not obtai d
180 days after C,,,rbQ r,� I /� /d7 Thls after it has been accepted as complete.
J *Fee methodology set by Tri- County Building Industry Service Board,
i:\ BuildinsPpermitetel m.permit.app.d0e 06/es 44Q- 4siera0/O2/CoM/wEe)
CITY OF TIGARD , -
BUILDING DIVISION PERMIT #: PLM2007 -00356
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9/2007
Phone: (503) 639 -4171 &
Inspection Requests (24 Hrs.): (503) 639 -4175 a!L ' ilm�
INSPECTION WORKSHEET FOR DATE: 8/15/2007 TIME: 7:00AM PAGE: 53
SITE ADDRESS: 11230 SW MORGEN CT CLASS OF WORK:
SUBDIVISION: GENESIS NO. 3 LOT #: 095 TYPE OF USE:
PROJECT NAME: MCKELLAN
DESCRIPTION: Replacing existing fixtures for kitchen remodel, other fixtures include ice maker.
OWNER: MCKELLEN, MIKE & JUNE PHONE #: NA
CONTRACTOR: MMODEMPICIAMINENc PHONE #: 503 692-4139
Inspection Request Scheduled For: Date: 8/15/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 053992 -01 503-692-4139 Y
Correctio /C ents /I structions:
V .._.. .14
f ( ttiol 0 4 .
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6 ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ��/ Phone #: (503) 718 - - 2-1
CITY OF TIGARD - _
BUILDING DIVISION PERMIT #: PLM2007 -00356
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: mum
Phone: (503) 639 -4171 �gI�I
Inspection Requests (24 Hrs.): (503) 639 -4175 "'
INSPECTION WORKSHEET FOR DATE: 9/28/2007 TIME: 7:00AM PAGE: 67
SITE ADDRESS: 11230 SW MORGEN CT CLASS OF WORK:
SUBDIVISION: GENESIS NO 3 LOT #: 095 TYPE OF USE:
PROJECT NAME: MCKELL.AN
DESCRIPTION: Replacing existing fixtures for kitchen remodel, other fixtures include ice maker.
OWNER: MCKELLEN, MIKE & JUNE PHONE #: NA
CONTRACTOR: Rtastatte, muumsulei EN PHONE #: 503. 692.4139
Inspection Request Scheduled For: Date: 9/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 056536-01 503.692 -4139 Y
Corrections /Comments/ Instructions:
C44-v c 1 "- 9
W PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: k-? ..✓% 0-..--- Date: cTt2 "P7 Phone #: (503) 718-