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Permit
- ©1. �'� - t - a (,0. H . � '� C ITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00121 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/26/2007 PARCEL: 2S 102DB -03600 SITE ADDRESS: 13411 SW CHELSEA LP ZONING: R -12 SUBDIVISION: CHELSEA HILL LOT: 013 JURISDICTION: TIG PROJECT: SETTELMEYER Project Description: 40 ft. water service replacement 04/02/2007 Add Water heater. NO l -eat a)J ;e—e-e--V— CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS; All 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 KEVIN SETTELMEYER 13411 SW CHELSEA LOOP Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 3/26/2007 $72.50 [TAX] 8% State Surcha 3/26/2007 $5.80 Phone : 503- 997 -9866 Total $78.30 Contractor: WOLCOTT PLUMBING CONTRACTORS PO BOX 20698 PORTLAND, OR 97294 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: Permittee Signature: 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. , t, ► Plumbing Permit Application FOR OFFICE USE ONLY p City of Tigard r "` Received / 1 r T £+� Detc/By; - V �� . � crmit POP I 13125 SW Hall Blvd., Tiger , O 3 Plan Rev! Phone: 503.639. Fax; 503.548,1960 �oo� Datc/8y Other Permit Nn.; Inspection Line: 503.639.4175 1.4p Ready/By; l : El Sec rage 2 for TiGARD Internet: www.tigard or,gov Date _ q - � t`. NoNtledMicdr 'iupplcmantnllnfnrmntloa TYPE OF , . r �. l .. ... FEE* SCHEDULE New construction t «: •- pi yr , For s ecial in ormatinn else chec/cliet g' "" �� Descri.tion MEM En, Total II Addition /alteration /replacement r Other: New I- 2- family dwellings (includes 100 R. for each utility connection) • CATEGORY OF CONSTRUCTION SFR (1) bath 244,20 P I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 Accessory building SFR (3) bath y g ❑ Multi - family 399.00 ❑ Master builder ❑ Other: •Each additional bath /kitchen 45,00 Fire sprinkler ( so, ft) Page 2 10I3 SITE: INFORMATION AND' LOCATION Site utilities Job site address: 1 -: j 1 SW I I • I / a Catch basin or area drain 16,60 City /Statc /ZiP; I I G/, )' O / q Mg Drywell, leach line, or trench drain -- 16.60 Suite/bldg./apt. no.: Project Warne: —.�- Footing drain (no, linear ft.: ` ) Page 2 Cross street /directions to - job site: Manufactured home utilities 110.00 Manholes 16.60 �A. LA - Rain drain connector 16,60 Sanitary sewer (no. linear ft,; ,) Page 2 J. ' / Storm sewer (no, linear ft.: ) Page 2 • Subdivision: _ Lot nn.: Water service (no, linear ft.: _ ) Page 2 , ilr . 1 Fixture or item Tax map /parcel no.: p 'J . 60 D)CSCkYJhI'ON:G?1.Wll'It%i Absor tio• ivc / y ., . Backflo � f . . . � e2 d ia U • it . t 16,60 4 1" 1 . .1K/g1 Clothes washer 16.60 al Dishwasher 16 60 M . PROPERTY OWINEk• :,..-'. TEN a rnntatn 16.60 nn ng t Name: 1 1 Ejectors/sump 16.60 MN Expansion se tank 10,60 60 e Address: ` / A • Fixture /sewer cap = City /State /ZIP: } I rp E.,v3 0 1 3 Floor drain/floor sink/hub 16 MI Phone: ('S i 4 Fax; ( ) • - Garbage disposai Mill 16.60 M Mos I r::'CniVTACT hI11tS�JiV::: . e bib 16.6[1 • foc _ ► 16.60 Business name: WOLCOTT dba ,IACIC i�1 kaicn BENJAMIN FRANKLIN PLU Contact name: 7� L Q (v '� -� r a trap I 16 C r. : ca gas (value: $ ) ■ Pa g e 2 Page Address: P.O. BOX 20698 4 1 ri w ' 16,60 W City /State /ZIP: PORTiAND OREGON 97294 111E ' oaf . to (commercial) 16.60 - Phone: (503) 235 -8784 Fax: : (503) 491 -2932 I asin /lavatory 16,60 i I Tub /shower /shower pan 16.60 E-mail: Urinal 16.60 '0' IrTR.ACTOR : ; .. .... ' ,.i, Walcr closet 16.60 Business name: WOLCOTT dba JACK HOWK aka BEN FRANKLIN PLUMBING Water heater M t M! Address: P.O. BOX 20698 Other. City /State/ZIP: PORTLAND, OREGON 97294 Subtotal Ill rA Minimum permit fee: $72.50 ILI Phone: (503) 235 -8784 4 i Fax: (503) 235 -8784 Residential backflow minimum cmtit fee: $36,25 CCB Lie,: 23847 ,♦ iimp,1e bing Licxn0,; 26 -2081'1 Plan review (25% of permit fee) Authorized signature: . l; State surehargo (8% of permit fee) � � 1 'TOTAL PERMIT FEE a P Print name: I. / ' / sC , / i Date: � ,, 7 . / T i v permit Application expires If a permit Is not obtnt • 180 days after it has been accepted as complete. lee methodology set by Tri County Building lydus,try Service Board. t,oU,tdi FAX BACK TO JACK HOWK n (A\ Atli _' 01, . f"" CITY OF TIGARD PLUMBING PERMIT III a COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00121 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/26/2007 PARCEL: 2S102DB -03600 SITE ADDRESS: 13411 SW CHELSEA LP ZONING: R -12 SUBDIVISION: CHELSEA HILL LOT: 013 JURISDICTION: TIG PROJECT: SETTELMEYER Project Description: 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: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 40 ft DISHWASHERS: RAIN DRAIN: ft • Owner: FEES KEVIN SETTELMEYER 13411 SW CHELSEA LOOP Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 3/26/2007 $72.50 [TAX] 8% State Surcha 3/26/2007 $5.80 Phone : 503- 997 -9866 Total $78.30 • Contractor: WOLCOTT PLUMBING CONTRACTORS PO BOX 20698 PORTLAND, OR 97294 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 235 -8784 FAX 503- 491 -2932 • Reg #: LIC 23847 • PLM 26 -208PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 -0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By• / , Permittee Signature' 25.-1 a - 7 , 2 _ 10 0_4 , 4 ' (' 4_ Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. r -7 , m < • .Plur�ab>ing Permit Applicat � � 11 ' t :- • City of'>tx and 0 t1 45:=T '`/ I, - ' _ FOR OFFICE USE ONLY � ' • - - Receive � d^� 13125 SW Hall 13Ivd., Tigard. OR 97223 Dntc/B oZ(p 4 7 6$ Pena k ..�yyj --CM .)-1 ' °1 Phone: 503.639,4171 Fax: 50]•598, 960 ' 1 2007 Plait Revue • Date/13y; / Other Permit No. Inspection Li 503.639.4175 ^ ty '. TIGARD Dale Rand /B i Internet: www.tigard- or e Nnllfcd /MY o tu'Ix: d See f'ngc for d d :ki .i.. • . _ . . _„ . a ethd Supplemantnl Information u a '�'t� "-4`i YY�L TYPE OF �' FEE* SCHEDULE T H TTte- 1{ •T Pia +ra as roA .e+. y. ^ q ❑ New construction r' " ° . ' <<•... ° '" r "� t 3I '-- ��..�� • ❑ Dcfnolitinn ForspCda1 Lrjormarlon tine c/reckGst -- Knadition /alteration /replacement 0 Other: Description 1 Qt . Fa, Total NOV I.. 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION . SFR (I) bath 249,20 • - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath _ 399,00 ❑ Master builder Each additional bath /kitchen 45.00 ❑ Other: Firc sprinkler ( sq. ft.) Page 2 • . . JOB SITE •JN>t' OR'MATI.ON AND' LOCATION Site utilities Job site address: 1 34 L SO/ C--In I.S Catch basin or arca drain • 16,60 City /Stal:e/ZIP, c.6,....- d d2 2.22 J Drywell, leach line, or trench drain 16.60 Suite /bldg, /apt, no.: Project namckS s..t't-e.hiM.e��,Q,� Footing drain (no. linear It; �) _ Page 2 Cross street/directions to job site: Manufactured home utilities 110.00 �— Manholes 16,60 IL...! — • — e Rain drain connector --- 16.60 `N- _ Sanitary sewer (no, linear ft.; _) Page 2 Storm Sewer (no, linear ft,; i) Page 2 Subdivision; 7 Lot no,: • Water service (no, linear ft.: _) a rr Page 2 l Tax snap /pareel no.: Fixture or item • . DTtSCICTiON (JF , WC1RY{ Ion valve Absorpt' 16 60 1 • �' .. Backflow preventer Page 2 — - .e:_- 1L. - Backwater va lve 16.60 Clothes washer 16,00 Dishwasher 16.60 ' . P.ItdpERt %" Drinking fountain OWiWE'I2� :.. '[]•.�'F:N�C�NT'��,;° S 16.60 Name: _ F,ICet:ors /sump 16,60 J WZ �' `� _ Expansion tank 3 Lk1,� C ,6.60 Address: � mil? �_ C P_q, �� Fixture /sewer cap 16.60 City /Statd7_IP7 a R. 94 22-'3 floor drain /floor sink /hub Phone: (.61j' le j� it( Fax: ( ) Garbage disposal 16.60 " A1'1 ;L I E*w'NT •.. osc bib . � � [�' 't1�1VT�k;G T F'EIYSUIY'�: � .::i: f GO , , Business name: WOLCOTT dun JACK IdOWK aka BENJAMIN FRANKLIN PLU Ice maker 16.60 3 -� Interceptor /grease trap Cnnract; name: I -„syt Medical gas (value; 3 ) Paage ge 2 2 Address; P.O. BOX 20698 Primer 16.60 City /State /ZI.P: PORTLAND OREGON 97294 Roof drain (commercial) 16.60 Phone; (503) 235 -8784 Fax: : (503) 491 -2732 Sink/basin/lavatory 16.60 E-mail: T•uh /shower /shower pan 16.60 CON PRA TO . • Urinal 16.0 .. C, R . .: i .' Water closet 16.60 Business name: WOLCOTT dha .JACK I aka BEN FRANKLIN PLUMBING Water heater _ 10,60 Address; P.O. BOX 20698 Other. City /State/ZIP: PORTLAND, OREGON 97294 _ Subtotal 503 235-8784 Minimum permit fee: • 72,50 ( ) Fax: (503) 235 -8784 Residential backflow minimum permit fee: 336, 5 1� Phone: CCB Lic.: 238 Plumbing Lie. i il • - ' • : Plan review (25% of permit fee) Authorized sib r:rc: L ‘ State surcharge (8% of permit fee) S — TOTAL PERMIT FEE • ■ Print Warne` ft Dare' i kA.... � 4 9 Phi permit application expires if R permit is n ot obtained within 1 180 days after it has been accepted as complete. BACK �� ]� y � � *Fee methodology set by Trii- � Coountty Building Industry Service Board. I:1Buildi FAX BA JACK CK TO s/ Hl .K If ^ 1 VV K 1/71 (Ct i A01 loll I 10/29/2008 Case Activity Listing 2:21:33PM '4►,....! °' Case #: PLM2007 - 00121 ..., gp�tfe ": Do ne r= AU dated" , b - `°, sue;;, e s yy . • /H s to 1. Date 2.< Date.3 - Hold t .;T � • Acts � D s "'�B °B: r � .... ...... .. .....,,,.,,. », .�... �. <. ti. � °,. Notes;,, �_. PLM1010 Application received 3/26/2007 None RECD FAX 3/26/2007 BB PLM1020 Permit created 3/26/2007 None DONE BB 3/26/2007 BB PLM1030 Check for parcel tags 3/26/2007 None DONE BB 3/26/2007 BB PLM1260 PLM signature on 3/26/2007 None DONE BB 3/26/2007 application BB PLM1280 Issue permit 3/26/2007 None DONE BB 3/26/2007 BB PLM2330 Water service 3/30/2007 4/4/2007 4/4/2007 None PASS JW 4/4/2007 045827 - 01 - 503 235 - 8784 VM - STI Y PLM1290 Reprint permit 4/2/2007 None DONE BB 4/2/2007 Reprinted to add water heater. No BB additional fees. PLM 1740 Case finaled 4/4/2007 None DONE JW 4/4/2007 JW Page 1 of 1 CaseActivity..rpt CITY OF TIGARD '11111bs. BUILDING DIVISION PERMIT #: PLM2007 -00121 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/26/2007 Phone: (503) 639 -4171 :Inspection Requests (24 Hrs.): (503) 639 -4175 . INSPECTION WORKSHEET FOR DATE: 4/4/2007 TIME: 7:01AM PAGE: 65 SITE ADDRESS: 13411 SW CHELSEA LP CLASS OF WORK: SUBDIVISION: CHELSEA HILL LOT #: 013 TYPE OF USE: PROJECT NAME: SETTELMEYER DESCRIPTION: 40 ft. water service replacement. 04/02/2007 Add Water heater. OWNER: SETTELMEYER, KEVIN PHONE #: 503-997-91366 CONTRACTOR: WOLCOTT PLUMBING CONTRACTORS PHONE #: 503- 235 -8784 Inspection Request Scheduled For: Date: 4/4/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 046827 -01 503- 235.8784 Y Corrections /Comments /Instructions: CctV-e f PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 0 Date: y J I S� Phone #: (503) 718-