Permit CITY TIGARD PLUMBING PERMIT
*��� I,
, DEVELOPMENT SERVICES PERMIT #: PLM2006 -00368
'+ 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/1/2006
PARCEL: 2S 1028 B -00412
SITE ADDRESS: 10130 SW KATHERINE ST ZONING: R -4.5
SUBDIVISION: KAROL COURT LOT: 011 JURISDICTION: TIG
Project Description: 45' water service repair
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: 45 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
CALCAGNO, VICKI A
10130 SW KATHERINE STREET Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 8/1/2006 $72.50
[TAX] 8% State Surcha 8/1/2006 $5.80
Phone : Total $78.30
Contractor:
MR ROOTER OF PORTLAND
15033 SE MCLOUGHLIN BLVD #344
MILWAUKIE, OR 97267 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 653 -5301
FAX 503- 653 -5376
Reg #: LIC 138941
PLM 3 -434PB
WARNING: If the electrical grounding system is rendered ineffective due to replacing metallic piping with
nonmetallic piping, it shall be the contractor's responsibility to notify the homeowner of the hazard.
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: 4.4.14-4-4 Permittee Signature: dtg r
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
RUG- 01- 2006(TUE) 12 24 MR ROOTER PLUMBING (FRX)503 653 5376 P.003/003
Plumbing Permit Application FOR OFFICE USE ONLY
City of Tigard ' EE / b l31' "SSW Hail Blvdfrd, 4R 47 f �I - / l'hnf 503,639,4171 Pax: 503.598, trn;,4r ; tt. I ,•l, L Olhar Permit
Hour inspection Line: 503.639.411$ 2Q0, , ,. it --
'ntetrteG www,ci.ti or,uu .�... DateReady/ 1i I rd sea Paee: roe
(��U { Notified/Method: Supptetnemst tufernlstlnn
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❑ New construction BU1t. al s emalition For eclat In orntatlon use checklist.
Pencrinden Qty. Fa- Total
" �Q Addit{ou/alterntloa/replaeement 0 Other: Mew 1 -2 (amlly dwellings (includes 100 it, for each utility connection)
. -
rye , , th Y y -I- �, , '„•J rr , 1 •r 'w;, rn- 7 r ' �,
ijla . �. fit. ' i� /11,I31; t3�i�N:. �.j i ^., , ';i� 3 dA ,?.,0,7 n' , , } i 'i' 1, 'ill+ +;'ti o}.,.i) r SFR(1) bath NM 247.20
' • and 2. family dwelling CI Commerciulrndustrial SFR (2) bath 350.00
•
Q Acecutorybuilding Q Mu1ti•fatnily SCR (3) both 371.00
0 Master builder 1j Other: Each additional bath/idtclten 45.00
r t I Fire sprinkler Sq. ft.) Page 2
u P * rk l �`+'�a LIZ u . � i ap -oil . Er a � F ; ' I e : s , Si teutllttlN
Job site address: /4/ 3Q 3 ( Dr f /Le ST Caleb basin or area drain 16,60 -.'
City /StitdziP: /7CC jf2 Owe C ? 79,9 3 brywell, leach line. or trench drain 16,60 _—
Suitelbldg. /apt. no.: Project i>ame: Footing drain (no, linear It.: ) Palle 2
1 -- Manufacturcd borne utilities 110,00
Cross strcl:t/dircct{ons to job site : -7 410; (t , j, JO ;71,- t . C 6 f (1 l
Manholes 16,60
• Rain drain connector 1 6,60
Sanitary sewer (no. linear ft: 1 Page 2
Storm sewer (no. linear R.:. _•.,.) Page 2
Subdivision: ( Lot no,: Water service (no. linear tt:g T ^ Page 2
Fixture or Item
Tax map /parcel no,: -
�, ,�fII +� fI Absorption valve 16,60
i;t: ' f}i fM t;�l, :(I 6id'- ,. , " :1I�1 RI, , ,, Lti, „1414 i�'; 1 .,' iM G��€ iu, IL I l3ackflow prcvcntcr Page 2
Backwater valve III 16,60
I { /9# /`� Cloth washer 16,60
f
Dishwasher III 16,60
,,t5lf 4 ^`. a , 'm tit` i 'l n ri wrlil'g�1 i , from I ,, q'�iar i I,l ., id Drinking fountain iG.GO
t� l-� IIII N8.iPluf&- n ,, .�:,e �!i ti tiii R.iI IlEr 'r liai'liMMATy IE r .I I f M .Cj,gtraigutnp 16.60
Name: j) 1rr I C 2 3/)0 Expansion tank 1G,G0
Address: �Q / ?jt) ') - --P f I Q 67- Fixture/sewer 16.60
City/State/ZIP: Tip 2I” 1 02 Qa ,.9, . Floor drain /floor sink /hub 16,40
Phone' (-533) 6 3 9=0 tg (S flax: ( ) Ourbuile tIiupaurl 16,60
! , �� ^1... , I yc, i 1�7q i � 7 �;a, % + � e J ta C,I � MSC 16.60
.'dg ' 711;7 y � ... t 1� r�� �I i V L,} 3. I ` � � F y l r �A�� Fii I I PI NbM.E'M FR C� I'�.`�"'�
i� lee ttatker 16,60
Business name: /31 r /2' n 7 PIa =Ye'- >1-9
Interceptor/grease trap 16.60
Contact numc: ' �-�
r 1 OU / c rS .
tstu Medico! awl (value: y ) Page 2
Athl : / ' 9 3 6 /fir /,, fibQA //'
//l P! / i� . /� , Primer 1 6,60
CityIStuterl1P: )?''1 f l. 1 be_2 ()..2_ q 7.96, 7 floor drain (comma-chi]) 16.60
ho ne: f Fax : e6 Cos x' -53 �6
Sink/ha/tin/lavatory ower /shows 16.60
P
(� � � � Tub /shower /shower pan 16,60
E-mail: Urinal 16,60
�d .r.0 � d .:hc ,u I ' t '' do M,liirtn t Na r.ir j.{ 1111 N,: elr' nlercinset 16.60
Busin =s name: / Water heater 16.60
Address: //i ti ^ , )� / Other:
. - -. City/State ZT-
P.: Subtotal
? mmuiit yertrui fee: !672.50_
Phone: ( ) Flu: ( ) Residential backflaw minimum termit fee: $36,25 (L, V
"C131 -ic.: /C", / ) --- Plumbing Llc, no r
. f y C/ j /�•` D mu :review (2S'N, afpertra fee)
Authorized s {grta re: r- ,r State surcharge (11% of permit fee) ' •
J.i7 ' - - TOTAL PERMIT 115E ', !ti' .. s
Print nnn f L - p � f L/ 1J Ante �/. ( this permit application expires If n permit is nut obtained w" tin
/ 1110 days after It has been accepted an complete.
'Fee methodology set by Tri- County Building Industry Service Board.
MulIAingWennllctt 'LM- PrrtidtApo'Inc t:l137 r.ro..,nl(anortmcoNvwhio
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1
CITY OF TIGARD ,, ,, 4
, jL
BUILDING DIVISION PERMIT #te (p-- eiO3 6, g
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 /ri�ulpo�u�V�l�i/t
Inspection Requests (24 Hrs.): &..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /d /3 O > CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CON TRH OR: i _ i Q ( PHONE #:
Inspection Request Scheduled For: Date: 8 - 3 - Pour Time:
Code # Inspection Description Confirm # Contact # Message
6 081 >
3,3 o -:-peR14/43271 ,___.
3 Ug i/11»1-_ - 7 ° 6 - 1 13 7 D-
Corre ti s /Comments /Instructions:
00 -- /Al .A I1 14 !_ /' 00 — 3: 0 .0. All r
/ 5 7 W4L
' ASS n PARTIAL APPRO , • . ❑ CANCEL Iii _ NO ACCESS
❑ FAIL /(CA = 'EC - ON ADDITION FEES ASSESSED
Inspector: ,,(/_r
/� ite Date: Phone #: (503) 718