Permit - CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00422
TIGARD DATE ISSUED: 9/14/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S125DD-03200
SITE ADDRESS: 06630 SW VENTURA DR ZONING: R - 4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT: 040 JURISDICTION: TIG
PROJECT: MORLEY
Project Description: Kitchen remodel. Other fixture: hose bib
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
MORLEY, RICHARD A +JOAN L
6630 SW VENTURA DR Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 9/14/2007 $72.50
. [TAX] 8% State Surcharl 9/14/2007 $5.80
Phone : 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 canna • • • • • or 1 :44.332.2344.
Iss ed By: Permittee Sign• ure:
i
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.
..� ' ,ep.13. 2007 3:20PM Rayborns Plumbing No. 7324 P. 1
. e
Plumbi Permit Application
Rpm T FOIL Ohr l( l: Iitil. OVL1
City of Tigard ,IF.:. r ?; ,r Received 6 13125 SW Hall Blvd. Tigard ? T Dale/By. '1 1) 1.1 Pr f • Permit No • ak t5,0(ni/�'�/,��i • 0 � , • << D � 1� Review
Phone: 503.639.4171 Fax. Y3. ' . . `�" l 2„
Other permit No.:
24 Flour Inspection Line 503.639.4175 , �, I � I ma y`
Internet www ci tigard or us SEP 1 3 2007 Date Ready/By ® Pa , z �r -
.�� . try ,w yr T F a c " Notified/Method / Sappletpea4t latormahe>a
.%) -1 , tb � -..... . , ,, , it Sit )� } 'k) 7. r , {� 4� 7 , r S - i � :7-;.:%'',-7F , 2t� t r{f . .. � ..y , 1 {7 r r :, L U
y �
_ __ _ . � li . � 1 } x �i -a : w.�� �, r.. ' ti � t '; y ! ) b ) i y � �r (5
❑ New construction , h ;II!!lL�i ' -;0 ` ► , DeScn non For special information use checklist
►_ Addition/alteration/repl• � ' A A Other: P w QIY• Ea. Total
tttt��1'3� ei�i �5
i , � r -r- ^.� . a 1 �-•- ` « New 1- 2-famiiy dwellings (includes 100 ft. for each utility connection)
K3 i r y } J a , x � , i -.).70 °1 I 1 WIC f p, r ' is •4.. a
�. l -\,;',---'-=.!,-',0- J!�, - i , ` �, t SFR I bath t
u . ~ T, , >, O 249.20
1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
olgt ❑ Accessory building ❑ Multi - family SFR (3) bath 399 00
❑Master builder ❑ Other. Each additional batlt/kitchen 45 00
a, ' y tr a rc a -, • i �; 27, e nr u,' -, o: irr , tr 5a r!' F , t n , v );, Fire sprinkler ( sq,it) Paget
�... ...,..., � Site atilltles
Job site address: 6 6 3,.. ) / & b/ , Catch basin or area drain 16.60
City / State/ZIP: j , ` J' - /.7.4 ( _ Drywall, leach line, or trench drain 16.60
Suite/bldg./apt. no.; Proj name: 6/o ` t. Footing drain (no. linear R. _ ) Page 2
Cross street/directions to job site: Manufactured home utilities 110 00
Manholes 16.60
Rain drain connector 1 1660
Sanitary sewer (no. linear ft.: _ ) Page 2
Storm sewer (no linear ft. _ ) Page 2
Subdivision: I Lot no.: Water service (no. linear 1t•; __) Page 2 _
Tax map /parcel no.: Fixture or Item
try �'7 1 w � T 'i s v ' -i , { w ' r J / r , l ) ;I S Absorption valve 16 60
a,.; %.i ^ha m ,S t > /o_ I-J7 i 1 ,P 11 /7 ( ) r4( � lr ' :74,5;:f.';:4:4
,',1 � ri. - c,:: _.... Backflow preventer Page 2
.�{ �eii /?e/'eod� g
Backwater valve 16.60
Clothes washer 16.60
Dishwasher / 16.60
t7 �' i t„36 'j:,, ' °i ciJ r i4.. ii ' i' .." t i . )i r
; F��J,' -, ;6:- 'n� Ish u Z Drinking fountain 16.61)
t.., ,- ,r cF t..,7 . Ejectors/sump 16.60
Naive: i t
Expansion lank 16.60
Address:
Fixture/sewer cap 16.60
City / State/ZIP. Floor drain/floor sink/hub 16.60
Phone. ( ) F ax; ( ) Garbage disposal / 16.60
r��� ?Z'_�l ) ,�i t i-i �'� s'�t " t � � t i. rf y �
r � - ' ��,{�'� °l t:;'E "I��'t ir� {`,. '�; _lime bib � / 1660
r �_ . <.c , ., . Ice maker 16.60
Business name: ' 6erns tp /1e1 SZ i. 1C. • Interceptor /grease trap 16.60
Contact name: l.SS� � .e�,cdt. medical gas (value: $ ) Page 2
_
Address: /no o,e 49 Primer 16.60
City /State/ZIP: 7rli4z.) , d/. 9 7e 6 - Roof drain (commercial) 16.60
Phone; 603 ) 6 99_ 1/ 39 I Fax: : t5D3) C 9/ tl2 3 ae Sink/basin/lavatory er/s / ( 6.60
trail: f ; Tub /shower/shower pan 16.60
E ns Co/n•,
M f.'4 ) e L ') t �+-r --r- , %I C� x ya •r - .,C ,7 , i t `. Urinal 16.60
1 � Y'i1'l'L^ i 1�'?7�i'; ' i f ,� f6 r'I t ., .. �'1 ti . rt,� y" F�ct ` w ' � ,04,...11 {
t. .•c . .3..2 . . . .. - ,. 5..t n71 c.. ,_ �E?., .}... , _,.}.r_.>!:r.. . Water closet 16.60
Business name: /, / : /]� S i` , • Water heater
L' iG• _ 16.6
Address: , A9 . 6 9 Other:
6 /
Phone:
City / State/ZIP; _Ne,.4.4,{, Oil 97e‘..).- So6lotal 44. yo minim= ,(3-3,5) d 902_ /437 Fax; ($-O ) 9/ .D8 R esidential backflow minimum permit fee; 56.20
.3 � permit fee; 5336.25 7Z. S�
CCB Lic.: ef 78.,5-_. Plumbing Lic. no.:,� f‘ ‘ 48 Plan review (25 % of permit fee)
Authorized signature: Ae ` State surcharge (8% of pormit fee)
TOTAL PERMIT FEE 7 Airj
Print name; / I Date:' 4 07 This permit application expires if a permit Is not obtained within
f' 130 days after It has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
i% Building \PmmiisipLlt{.Permltppp. 06/05 440.4616T(10 /02/COM/wEB)
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00422
13125 SW Hall Blvd., Tigard, OR 97223 1 DATE ISSUED: 9/14/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9118/2007 TIME: 7:00AM PAGE: 52
SITE ADDRESS: 06630 SW VENTURA DR '• -CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 040 TYPE OF USE:
PROJECT NAME: MORLEY
DESCRIPTION: Kitchen remodel. Other fixture: hose bib.
OWNER: MORLEY, RICHARD A.+ JOAN L, " . n PHONE #:
CONTRACTOR: RAYBORN'S PLUMBING INC - PHONE #: 503 - 692 -4139
Inspection Request Scheduled For: Date: 9/18 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 055836 -01 503 -692 -4139 N
Corrections /Comments /Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
I nspector:0% h l J 1\ \ - Q_ Date: 91 I 0 - 1 Phone #: (503) 718-
CITY OF TIGARD -
BUILDING DIVISION . PERMIT #: PLM2007 -00122
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/14/2007
Phone: (503) 639 -4171 +�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/19/2007 TIME: 7:01AM PAGE: 45
SITE ADDRESS: 06630 SW VENTURA DR CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 040 TYPE OF USE:
PROJECT NAME: MORLEY
DESCRIPTION: Kitchen remodel. Other fixture: hose bib.
OWNER: MORLEY, RICHARD A + JOAN L, PHONE #:
CONTRACTOR: RAYBORN'S PLUMBING INC PHONE #: 503-692 - 4139
Inspection Request Scheduled For: Date: 10/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 067919 -01 503 -692 -4139 N
Corrections /Comments / Instructions:
C - v c.' _.e A
•
S PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • ►M --'I — Date: /0) /1 /D7 Phone #: (503) 718 -