Permit £� 11 CITY OF TIGARD
PLUMBING PERMIT
" COMMUNITY
° . Y PERMIT #: PLM2006 -00552
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/13/2006
PARCEL: 2S 115AA -05200
SITE ADDRESS: 10947 SW CHATEAU LN ZONING: R -4.5
SUBDIVISION: REBECCA PARK LOT: 009 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: 40 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ALICE GAUT
10947 SW CHATEAU LN Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 11/13/200€ $72.50
[TAX] 8% State Surcharl 111131200E $5.80
Phone : 503- 639 -8930 Total $78.30
Contractor:
APOLLO DRAIN + ROOTER SERVICE
2208 NW BIRDSDALE #8
GRESHAM, OR 97030 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 239 -8801
FAX 503- 669 -9568
Reg #: LIC 49418
PLM 26 -533PB
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.
Issue By: _ t� Permittee Sig ature: • 1 " . �1!
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.
FROM APOLLO DRAIN 503 - 669 - 9568 (MON)NOV 13 2006 10:23 /ST.10:22 /No. 6812889521 P 1
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City of Tigard Receivett i/ /3 0 . ✓ PcrmitNo.; �/� p 69 -
1 3125 SW 1la11 IIlBIv vd„ Tigard, OR 97223 � Da1NBv ' /
NO 3 20U f Plan Review Other Per tit No.:
Phone: 503.639.4 f 71 Fax: 503.$98,1960 t: ?I► 1�I�.j Dale/11 24- Hour Inspection Line: 503.639.4175 CITY OF TI ' "i � 4 - -'" D ole Rcadyi0y: I 10 See Page 2 for
Internet: www,CLligard.ot',us Ol� Notified /Method: A ' / Supplemental information •
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N ew construction or special in ormation use checklist.
I] New F s P _ I
Description I Qty. I Ea. i Total_
KAddition /a Iteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
;'CA'r EC01R COIV 'CRUC1�Ol,V
;i; 1 ii; x SFR (I) bath .,49 3
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1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350,00
• SFR (3) bath 399.00
Accessory buildin Multi-family
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-' -" Each additional bath/kitchen 45-00
❑ Master builder Q Other:
a
Fire in sq. I) b
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Job site address: q 47 EW C,.& _o_u, Ln Catch basin or area drain 16.60
Crty/Statc/Z1P: - - j q l y J OW- q" i.4, Drywell, leach Tine, or trench drain 16.60
Saito/bldg. /apt - no.:
Footing drain (no. linear R.; ) Page 2
Project name:
Manufactured home utilities 1 10.01)
Cross street/directions to job site: ManholCc 16.60
- Rain drain connector t(>.60
_ _ Sanitary sewer (no. linear It.: ) Page 2
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� Storm sewer (no- linear ft.: ) Page 2
Subdivision: Lot no.: water service (no. linear R.:40_) , Page 2
Fixture or item
Tax map /parcel no.:
n h "> 0.Oh rsd ', .. ,
a::p H ;w.,:.,: ,�:,,•,-:•: - : sl ion valve
1 �..1? i 'Si;�'i�tl,l ;J,l..tr G�M1` _ a i. s .. � i g fi
r Absorption
�l +d Btck11UW prevenit7 Page 2
Replace, lO &k-( aexv i C r} Backwater valve 16,60
Clothes washer 16.60 •
- Dishwasher 16.60
• �.•. n. _ x ,rk p; c �1(, fountain 16.60 .:.. 1. z u�' Drinkin O
airs f
r4a., - '� „ROf' R� ' -� >Et ` } ^ . y °;?i ;: -:. ;in �p•f. • 'c�;rr r�tE �t�
n'.� r*',..,, ?2'1'.:'�rrii � .: .,1!.i,:- ..... �' Fi• -:{ � '.. ' Mh�P, .!'.n•'t3 � :(+
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16.60
Name: G- i j k- 1 & i
G /L w F�4 Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City /State /ZIP: Floor draitt/tloor sink/httb 16-60
., 2 R q - U 2
Phone: ( ) Le tr o tx.J _..,.. . 'r �ar ( -_ Garbage disposal 16.60
u.. :c;law „./,. ilusebib 16.60
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fee maker 16,60
Business name: Interceptor /grease trap 16.60
Contact name: . gas (value: S ) Page 2
Address: _ Primer 16.60
City/Stale/ZIP: Roof drain (commercial) -- 16.60
- Sink/basin /lavatory 16.60
Phone: ( ) Fax;:( ) Tub /shower /shower parr 16.60
E -mail: �. .
Urinal 16,60
_ <' CONTR11:CTOR.:.:: water d o.te? 16.60
Business name: 2,2_0 � O 4. /� � Water heater 16.60 V
Address: IJ
T� \ ;r�.aL p
4 s� fl Q 1 Other: -
nn �y Subtotal
City /Stott /ZIP: &7 (tb hQ..YY'1 (P4[_ "l1,03O - Minimum permit fee: S72.50
Phone: ( ) 2 3r1- iel Fax: ( ) tolL/"t - 61,`�_ 4 Residential backtluw minimum permit fee: 536,25 -.- -_
CCfi Lie.: _ _L `1 l u
A ii f Y Plumbing 5 x 3p Plan review (25% of permit fee)
�- - -� - lumbin g Lic. no.: 2 ,. �+ J �' �_
Q\Ltit-Lli-'. V St to sur eha, l8% f permit fcc)
Authorized signature: TO o TOTAL PEFMIT FEE
Print name )date: t ` 3 This permit applkation expires if' permit is not obtained within
riln - CbY?Gf 1- ! �` } 180 days after it has been accepted as complete -
*Fee methodology set by 1'6 Building Industry Service Board,
RoJdm Ier niis t'LM PermitApp.doc 06.05 110 1010 1(10 02 Cud, 11'I:In
CITY OF TIGARD
r • BUILDING DIVISION PERMIT #: PLM2006- 00652
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/13/2006
Phone: (503) 639 -4171 4 1nigj�fi l
�1
Inspection Requests (24 Hrs.): (503) 639-4175 • -!
•
INSPECTION WORKSHEET FOR DATE: 11/15/2006 TIME: 7 :07AMI PAGE: 41
SITE ADDRESS: 10947 SW CHATEAU LN CLASS OF WORK:
SUBDIVISION: REBECCA PARK LOT #: 009 TYPE OF USE:
PROJECT NAME: GAUT
DESCRIPTION: Replace water service.
OWNER: GAUT, ALICE PHONE #: 503 - 63
CONTRACTOR: APOLLO DRAIN + ROOTER SERVICE PHONE #: 03-239 -8801
Inspection Request Scheduled For: Date: 11/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 039782 -01 503-239-8801 ¥
3 Corrections /Comments /Instructions: r C � , - ti, ,,
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,,, 'ASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 " c° 1 Date: II (I) v Phone #: (503) 718 � �✓