Permit CITY TIGARD PLUMBING PERMIT
I li i DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00244
�fll DATE ISSUED: 5/31/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112CA - 04800
SITE ADDRESS: 07934 SW ASHFORD ST ZONING: R -
SUBDIVISION: ASHFORD OAKS LOT: 002 JURISDICTION: TIG
Project Description: URGENT 40 ft. water service replacement.
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:
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LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 40 ft
DISHWASHERS: RAIN DRAIN: ft
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Owner: FEES
JIM PHILIPSON
7934 SW ASHFORD ST Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 5/31/2006 $72.50
[TAX] 8% State Surcha 5/31/2006 $5.80
Phone : 503- 639 -5801 Total $78.30 -
Contractor:
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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: g Permittee Signature: 3y\ 0,0
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.
,
pijimbjle Permit A P tic 1 Fort ofrlce USE ONLY .
Eli/ i
City of Tigard I Received � b
13125 SW llail`Blvd-, Tigard, OR 97223 MAY 3 DatrJBy. J �� it -. .
Phone: 503.639.4 x71. Fax: 503.598.1960 1 r; " "'a*� r, Plan Revi. • her Permit 2 ? hryr 1 Pla Re a t Na„
24- Hour Inspection Line: 503.639.4175 C� . , c1 1 Date Ready/BY: FIE m
RI See Page 2 for
Internet: atww.ct.tigard.or.us - N OF Ti T c - ' ■ Notified/Method: Supplemental lafnradon
TYPE OF WORK i r FEE" SCHEDULE
0 New construction ❑ Demolition For special Information use checklist.
(Description 1 Qty. I. 1 a, r Total
X Addition /alteration /replacement ❑ Other; New 1- 2- family dwellings (includes 100 ft. far each utility connection)
CATEGORY OP CONSTRUCTION SFR (1) bath 249.20
ckl I- and 2- Homily dwelling 0 Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchcn 45.00
❑ Master builder 0 Other:
Fire sprinkler ( an. ft.) Page 2
JOB S11.lt INFORMATION AND LOCATION
7 Site utilities
Job site address: - 71 W ��Jrlil4 )41/6 - Catch basin or area drain 16.60
City /State/ZIP: • /ter q7. F Drywcll, leach line, or trench drain 16.60
Soitc/bldg. /apt. no.: Project name: / � Panting drain (no. linear ft.; ) Page 2 mar .J Manufltctured home utilities 110.00
Cross street /directions to job site:
Manholes / / 16.60 � � _
Rain drain connector 1 6.60
Sanitary sewer (no. linear ft.: ) Pagc 2
Storm sewer (no, linear ft.: ) Page 2
Subdivision: I Lot no.: Watcr service (no. linear ft.: Ala Page 2 I Crej, rei fi
Fixture or item
Tax map/parcel no.:
Absorption valve 16.60
DESCRIPTION OF tit( :)R1 Blida ow preventer Page 2
IN'
�,,/jMPT, r • / ' eA 1. .L' htizi Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16,60
�t L�1 / �' PROPERTY' OWNER El TENANT �... Drinking fountain . 16.60
r _ � j�' / . .. E}, I7( p2 %a' 16,60
Name; i 1 ! �' Expansion tank 16.60
Address: - 7q � - / Fixture /sewer cap ' �� j f�`�ff6.60 Wii
G f���A r/ .ill
City/State /ZIP; /t" / 7,, or Floor drain /floor sink/huh M0
T ` r Crarbagc disposal t \11" li w"
Phone: ( 1," Fax: ( ) I - lose bib 16,60
!``S ; J PLJC'ANT 0 CONTACT PERtiON r, —
lee maker 14.60
Bu-uincss name: Wolcott Plumbing dba Jack Hnwk IumbinR interceptor /grease trap 16,60
Contact name: . ' e A/u� Medical gas (value: $ ) Page 2
Address: 1075 W Historic C 7lumbis River Hwy Primer 16.60
City /State/ZIP: Troutdale, OR 97060 Roof drain (commercial) _ ^ 16.60
Phone: (503) 235 - 8784 Fax: : (503) 491 -2932 Sink/basin/lavatory 16,60
Tub /shower /shower pan 16.60
e -mail:
Urinal 16.60
C'ONTRACTOR Water closet 16.60
Business name: Wolcott Plumbing dba Jack Hawk Plumbing Water beater 16.60 `.
- ^
Address. 1075 W Historic Columbia River Hwy Other:
i
ynhtota
City /State/ZiP: Troutdale, OR 97060 Minimum permit feel $72,50 ota
Phone: (503) 235 -8784 Fax; (503) 491 -2932 Residential backtlow minimum permit fee: $36.25 W to 111
CC.B Lie,: 23847 jeyivd-e- Plumbing Lie, no.: 26 -208 P13 Plan review (25 %ofpermit fee)
Authorized signature: State surcharge (8% of permit fee)
l TOTAL PERMIT FE:
Print name: Datgff5/r 3/ This permit applicatlor expires if a permit its not obtai i. wt 7......
180 days after it has been accepted as complete.
04 t 414 F- ^ q3^ "pee methodnlnev set by Tri- County Building industry Service Board.
CITY OF TIGARD . .
BUILDING DIVISION PERMIT #: PLM200C -00244
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5131/2006
Phone: (503) 639 -4171 � � ,
Inspection Requests (24 Hrs.): (503) 639 -4175 _�� __..
INSPECTION WORKSHEET FOR DATE: 6//212006 TIME: 7:03AM PAGE: 13
SITE ADDRESS: 07934 SW ASHFORD ST CLASS OF WORK:
SUBDIVISION: ASHFORD OAKS LOT #: 002 TYPE OF USE:
PROJECT NAME: PHILIPSON
DESCRIPTION: URGENT 40 ft. Water service replacement.
OWNER: PHILIPSON, JIM PHONE #: 503-639.5801
CONTRACTOR: WOLCOTT PLUMBING CONTRACTORS PHONE #: 503 07
Inspection Request Scheduled For: Date: 6/12/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 031572-01 503 - 235-8784 Y
Corrections /Comments /Instructions:
'' 7 Al .
Air 4 1" ,� / % ,� _
i .
(.......'"‘ '. Cej.'''YC \
ig S PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: /1/1/2V Date: , I . Phone #: (503) 718 - 2/