Permit , i
CITY TIGARD PLUMBING PERMIT
, DEVELOPMENT SERVICES PERMIT #: PLM2005 -00471
'I AIl DATE ISSUED: 9/20/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S 126DC -04400
SITE ADDRESS: 09430 SW CORAL ST 200 ZONING: C -P
SUBDIVISION: LEHMANN ACRE TRACT LOT: 007 JURISDICTION: TIG
Project Description: Move sink, extend existing nitrous & oxygen line to new wall.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: • GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MARTIN, ROBERT CLARE Description Date Amount
THELMA M
BY JO RENE M MOODHE [PLUMB] Permit Fee 9/20/2005 $89.10
SHERWOOD, OR 97140 [TAX] 8% State Surcharl 9/20/2005 $7.13
Phone : Total $96.23
Contractor:
WOLCOTT PLUMBING CONTRACTORS
1075 W HISTORIC COLUMBIA RIVER REQUIRED ITEMS AND REPORTS
TROUTDALE, OR 97060
Phone : 503- 667 -1781
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 • estions to OUNC by
calling 503 - 246 -6699 r 1- 800 - 332 -2344. /�
Issued By: }� Permittee Signature: I ; j
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.
0
A
Plumbing Permit App 04 .,:c 'r ` EIV ` . � FOR OFFICE USE ONLY
�,`
City of Tigard t Date/By: q ;.....24,1 z „ Permi No 31 R -� ( •J (N q 7 l
13125 SW Hall Blvd., Tigard, OR 97223 n
Phone: 503.639.4171 Fax: 503.598.1960 SEP 20 1O ' ' /�. r I ;t Plan Rev Review
y Other Permit No.:
DateB
24 Hour Inspection Line: 503.639.4175 ,1 A � I Date Ready/By: H See 2 for
Page g
t - Information
r.us lem entalInform i
Internet: www.ci.ti ar d.o � � Su
Notified/
g OF TIG � 1 � Supplemental
:.::......:
I=1 New construction 0 Demolition For special information use se checklist.
Description Qty. I Ea. 1 Total
® Addition /alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
.!£2L,
• �- 1 bath -
ru;::?
SFR
❑ 1- and 2- family dwelling Z Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ ire P age 2
Master builder Other:
Fire sprinkler ( sq. ft.)
;
1 ,:.,:.:
:::: ' w � ,..: ., ; " .., ::.::::.:>:::: �;.>»>:>::
t, > >,�:.:,..:::.o..,:.. �.,.�.: ir:.. S:y f
........ Sit Iltllitl
Job site address: SW CORAL ST Catch basin or area drain 16.60
City/State /ZIP: TIGARD Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: ZOO l Project name: DR. CLARKE Footing drain (no. linear ft.: _) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: GREENBURG
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
�'�}, Absorption valve 16.60
.:.. \..a.::. „ .. :::....:..... >�SV/E'.F:c iuFiG'::::: Yfi:. �>.`*,: is:`3:::: ::::::
.
ow preventer
Page 2
B ckfl
MOVE SINK ROUGH - IN TO NEW WALL AND EXTEND EXISTING NITROUS Backwater valve 16.60
AND OXYGEN LINE TO NEW WALL Clothes washer 16.60
Dishwasher 16.60
» :. ::::.::.:..::.:: «::.:::::::::::::::::::.::::::..:....:>:::,::.:>.:.,:.:.:_::...::.::;;:::.:::.:...:::.:::: ::::.:..:.::::. >::.::;.::;;::;. 16.60
:., :_:.,,.:::::. : ::.......::::.... <........:.:..::.:»:..::.,:::::::.: s;:.:::.:::.:.:::.:.:..,.:,,:,.:::.,..:.:::.,.::::.:::.::::.,...:.::::::...:.: :... >:;:.:;: :::;::::::.:::...,. Dunkin fountain
::.:::::::::::. 16.60
Name:
Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City/State /ZIP: Floor drain/floor sink/hub / 16.60 /640
Phone: ( ) Fax: ( ) Garbage disposal 16.60
16.60
....,..:..,::::::::::::::::::.:.::.::::::::.:::.:;. :..:.:.,. .:::._:.:::::.:::..::. Hose bib
.... ..:..............._...._.......::< �:::,,:::.>::...>•,.,:::,:.>,,::,:::;:: ,;..:::. >::,:: >.:- ::.,:.:.,,::: Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ 250) Page 2 i L,rjrn
Address: Primer 16.60
City/State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
.......:.:::.:::.:.:...:::.
11 1<; �`':` �` :: 4' Water cl oset 16.60
Business name: Wolcott Plumbing Contractors, Inc. Water heater 16.60
Address: 1075 W. HISTORIC COULUMBIA RIVER HWY Other:
City /State /ZIP: TROUTDALE, OR 97060 Subtotal
Minimum permit fee: $72.50 cQ
Phone: (503) 6671781 Fax: (503) 6679891 Residential backflow minimum permit fee: $36.25 Xi.
CCB Lic.: 23847 Plumbing Lic. no.: 26 - 208PB Plan review (25% of permit fee)
State surcharge (8% of permit fee) - 7x /3
Authorized signature: /
L «% TOTAL PERMIT FEE 94c ,
Print name: DENNIS L DU / ' G Date: 9/19/2005 This permit application expires if a permit is not obtained within
- 180 days after it has been accepted as complete.
`Fee methodology set by Tri-County Building Industry Service Board.
i:\ Building\Pemiits\PLM- PemdtApp.doc 06/05 440- 4616T(10 /02/COMJWEB)
, .
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
PLM2005-00471
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
9/20/2006
Phone: (503) 639-4171 A ,
....
Inspection Requests (24 Hrs.): (503) 639-4175 d
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
9/2712005 7:06AM 82
SITE ADDRESS: CLASS OF WORK:
09430 SW CORAL ST 200
SUBDIVISION: LOT #: TYPE OF USE:
LEI-IIVIANN ACRE TRACT 007
PROJECT NAME:
DR. DENNIS CLARKE
• DESCRIPTION:
Move sink, extend existing nitrous & oxygen line to new wall.
OWNER: PHONE #:
MARTIN, ROBERT CLARE,
CONTRACTOR: PHONE #:
WOLCOTT PLUMBING CONTRACTORS 503667-1781
Inspection Request Scheduled For: Date: 9/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 016667-01 503-667-1781 V
Corrections/Comments/Instructions:
N 6 L i-e___ •
71 ,
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_ ..... e ..../.40e-elr _Am.. -•"" ,,, .A - - le° aft" ' AMR • 0
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_
PARTIAL APPROVAL 7 CANCEL fl NO ACCESS
I FAIL n CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: Date: / ‘ - II Phone #: (503) 718-
— _ .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 00471
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2005
Phone: (503) 639 -4171 : N4m�ii�ll�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 87
SITE ADDRESS: 09430 SW CORAL ST 200 CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: 007 TYPE OF USE:
PROJECT NAME: DR. DENNIS CLARKE
DESCRIPTION: Move sink, extend existing nitrous & oxygen line to new wall.
OWNER: MARTIN, ROBERT CLARE, PHONE #:
CONTRACTOR: WOLCOTT PLUMBING CONTRACTORS PHONE #: 503- 667 -1781
Inspection Request Scheduled For: Date: 10/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 018364 -01 503. 667 -1781 N
. Corrections /Comments /Instructions:
f44;
ASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: )74/..... Date: (.6 1 I Phone #: (503) 718-