Permit ,a
•
CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006-00113
DATE ISSUED: 3/31/2006
'--y 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 103BA -00108
SITE ADDRESS: 11650 SW ANN ST ZONING: R -4.5
SUBDIVISION: LERON HEIGHTS LOT: 008 JURISDICTION: TIG
Project Description: Replace 50' of 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: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MIKE SPRAGUE
11650 SW ANN ST Description Date Amount
TIGARD, OR 97223
Total 7' 30
Phone : 503- 313 -3481
Contractor:
WOLCOTT PLUMBING CONTRACTORS
1075 W COLUMBIA RIVER HWY
TROUTDALE, OR 97060 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 235 -8784
FAX 503- 491 -2932
Reg #: LIC 23847
PLM 26 -208PB
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: �� LJ Permittee Signature: -L, N `\t
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.
tion 'lumban]Permlt �' � rgr7 or( rcr.. 1 ;5r ovl.v
City of Tigard
1 - 3125 SW Hall'Blvd., Tigard, OR 97223 ` .__.1_ t / `
Phone: 503.639.4x71 Pax 503.598.1960 2006 i., Q Plan Review
24- Hour inspection Line: 503.639.4175x1 J '" T 1l i " Date/By _ Other Permit No,:
Internet: www.ci.tiRard.or.us TIGARC' ' "'� Om Ready/By: . � la See Page 2 for
r. Y OF Notibed/Method;
Supplemental Information
T ATA t o tiocikkv 1 ivt' FEE" SGIItEDiTLE
❑ New construction ❑ Demolition For special information use checklist.
NI Addition /alteration /replacement ❑ Other Die ' Qty, Ea. l Total
— New I- 2-family dwellings (includes 100 It. (breach utility connection)
_ CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
Pif 1- and 2- family dwelling 0 Commercial /industrial SFR (2) bath _ 350.00
• ❑ Accessory building ❑ .Multi- farnily SFR (3) bath 399
❑ Master budder Each additional bath/kitchen 45.00
❑ Other;
— Fire sprinkler ( s9, ft,) Page 2
JOB SITE INFORMATION AND LO( ION —"
/ / Site utilities • Job site address: iL 4 A% � Catch basin or area drain 16.60
y
City/State /ZIP: 7.07 / 4 lDrywcll, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project nam Footing drain (no. linear !ti: ) 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: 7 Lot no.: — Water service (no, linear ft. Page 2
Tax map /parcel no.:
Fixture or item
Absorption valve 16.60
Ib1SC'Ri.PTION OF WORK
Backflow preventcr Page 2 —
' fr 151, ,1 - Backwater valve 16.60
4 / ..JI 4 r . Clothes washer 16.60
Dishwasher 16.60
Drinking fountain
E 16.60
1 PROPERTY ORN13R I 0 TENANT
r x pa ns ion ta 16.60
Name: �'�� ��� Expansion tank 16.60
Address:
/4
'�" _ Fixture /sewer cap 16.60
City /State /ZiP: � 4 -WO Floor drain /floor sink /hub 16.60 --
Phone: ( ��'�,1T , /ax: ( ) Garbage disposal 16.60
Hose bib III 16.60
04' APPLICANT ❑ C'ONTAC,T PERSON
Ice maker 16.60
Business name: Wolcott Plumbing dim Jack Hnwk Plumbing Intcrcc.tor /grcaserrsp 16,00
Contact name: tom% T �.
Address: 1075 W Historic Co amble River Hwy a 16.60 El:
City /State /Zi,P; Troutdale, OR 97060 " , • , • .. (com . r ' '' tig
Phone: (503) 235 -8784 Fax; : (503) 491 -2932 I 't _ i� a • i �
Tublsltower /sho • ` „ 16.60
E-mail; Urinal r /, • 16.60
('ONTrt- kc 'TOR ^_, Water closet 6 16.60
Business name: Wolcott Plumbing dba Jack clown Plumbing Water heater i6.60
Address: 1075 W Historic Columbia River Hwy w- Other:
City /State /ZIP: Troutdale, OR 97060 Subtotal
Minimum permit fee: $72.50
Phone: (503) 2354784 Fax: (503) 491 -2932 Residential backtlow minimumare tee: $36.25 • . (
CC8 Lie.: 23847 Plumbing Lie. no,: 26 -208 Fe Plan review (25% of permit fee)
State surcharge (8% of permit fee) 1j1
Authorized signature: ' ''. • . '/ — TOTAL PERMIT FEE �� j
Print name: t I r ':/ Date; ea ^1% /�/ � This permit application expires if a permit is not ob""�"'s i'ft`
f� 180 days after It has been accepted 11 complete.
*Fcc methodoloev set by Tri-County Building Industry Service Board.
et
CITY bF TIGARD
BUILDING DIVISION " A PERMIT #: PLM2006-00113
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/31/2005
Phone: (503) 639-4171 ip
Inspection Requests (24 Hrs.): (503) 639-4175 Aljr
INSPECTION WORKSHEET FOR DATE: 4/11/2006 TIME: 7:07AM PAGE: 4
ntbr\ 116
SITE ADDRESS: 11650 SW ANN ST CLASS OF WORK:
SUBDIVISION: LERON HEIGHTS LOT #: 006 TYPE OF USE:
PROJECT NAME: SPRAGUE
DESCRIPTION: Replace 50 of water service.
OWNER: SPRAGUE, MIKE PHONE #: 503-313-34M
CONTRACTOR: WOLCOTT PLUMBING CONTRACTORS PHONE #: 503-235-8784
Inspection Request Scheduled For: Date: 4/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # • -
330 Water servico, 027746-01 503-236-8764
Ft/4 r
Corrections/Comments/Instructions:
il Pc•
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. -
Or
M
oveporww .
ir1 PASS ' R AL APPROVAL E] CANCEL El NO ACCESS
[ F L CA L FOR INSPECTION n ADDITIONAL FEES ASSESSED
7 /
Inspector: 11A11111b■ „ h
Date: (1 Phone #: (503) 718- 4----4°