Permit , CITY OF TIGARD PLUMBING PERMIT
M DEVELOPMENT SERVICES PERMIT #: P 16/200 -00097
' II 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 2/16/2006
PARCEL: 2S 102C B -01802
SITE ADDRESS: 13405 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: (3) sinks. Other fix: trap primer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: I
OCCUPANCY GRP: B FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BARUCH, ISAAC TRUSTEE Description Date Amount
BY PACIFIC PIZZA CO
1905 NW 169TH PL STE 201 [PLUMB] Permit Fee 2/16/2006 $72.50
BEAVERTON, OR 97006 [TAX] 8% State Surcharl 2/16/2006 $5.80
Phone : Total $78.30
Contractor:
WOLCOTT PLUMBING CONTRACTORS
1075 W COLUMBIA RIVER HWY REQUIRED ITEMS AND REPORTS
TROUTDALE, OR 97060
Contact # : PM 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 9 or 1-800- 332 -2344.
Issued By: 503-246
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.
f - FOR OFFICE LSE ONLY MuulibinQ Permit A licatio
D Received. • Permit lo,: P V _24 ., 60
j City of Tigard R Received
13125 SW Hall' Blvd.. Tquird, OR 97223 Plan Review ether permit N `w R (p•p(,�3 •
Phone: 503.639.4171 Fax: 50 3.5 1 3 2006 !. ,._ I i f • lA¢rBY
24- Date Randy/Br �L.� ® S ee P s£o 2 for
Internet: www.eltigard.or.us 503.6.9, Notified/Malted: . 1J Supplemrntel Information
TntmCt: wwwcr.tinus
BUILDING D ON For ale in orotation use checklist: C
0 New construction Demolition Demolition - HIM/ Ea. Total tt
Add iticnn /alterat ❑ Other: New 1- 2- family dwellings (Includes 100 R for each utility connection)
CATEGORY OF C'ONSTRtCTION - SFR(1)bath r 24920
-- bath 350.00 b
2) a
3c 1- and 2- family dwelling ❑ Comm ercial /industrial SFR ( '
SFR (3) bath 399.00
❑ Accessory building ❑ Multi - family 45.00
Bach additional bath/kitchen
❑ Master builder 0 Other: -
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION
. Site utilitiea
Job sitc address: / — M ,, it[ / ' Catch basin or area drain 16.60 MIN t..
Drywall, leach line, or trench drain 16.60 EMIL
Footing drain (no. ling IL: � � Page 2 . -
Suite/bldg./apt no.: Project name: An/ ir . 1-, , , 110.00
Manufactured home utilities III Cross street/directionv to job site: Manholes 16.60
&' Rain drain connector 16.60 L
Sanitary sewer (no. linear ft.: , ) Page 2
Storm sewer (no. linear R: ) Page 2
Subdivision: L?,qt no.:
Water service (no. linear ft.: ) Page 2
' Fixture or item
Tax map /' 1 ccl no.: • Absorption valve 16.60
.„, r9 7 r t!' " BacJcllow pre scatter Page 2
/, 1 .r %`.� 'iv i `' F/7 '� �` Backwater valve 16.60
V yr : / /L• j . Clothes washer 16.60
Dishwasher 16.60
, ,J. % — Drinking Ibuntain 16.60
�r OPLSR' OWNER ❑ TEN.#NT Ejectors/sump 16.60 �.
Name, /UV 144//24 , Expansion tank 16.60 ��,
Address:
p� sk IV Fixture/sewer cap /- 16.60 /
Floor /, / / � 7 • ., loor drain/floor sink/hub 16.60 •
_ -•
s Garbage disposal 16.60
Phone: ( ��ri j i�3r!/ ���+1� )
Hose bib 16.60
_APPLICANT 1C:ANT ❑ CONTACT PERSON ice maker 11/fir 16.60
Businass name: Wolcott Plumbing dbn Jack Howk P , mbIng Interceptor/grease trap I Ia. 16.60
Contact name: 1 / A t '' Medical gas (value; $ A) t la Page 2
Address: 1075 W Historic Co nmbin River Hwy P`',l4111 _ 16.60
Roof drain (commercial) 16.60
City/State/ZIP: Troutdale, OR 97060 —. --- IG.60 A /_ /
Sink/basin/lavatory
Phone: (503) 23. 8784 J Fax: : (503) 491 -2932 Tub/shower/shower Pan 16.60
F: mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Wolcott Plumbing dba Jack Howk Plumbing Water heater 16�60� l
Address: 1075 W Historic Columbia ?River Hwy Olhcr: it • %i K i i
Subtotal 6(0 S/D
City /StatC/ZIP: Troutdale, OR 97060 Minimum permit fee: $72.50 •7�
Phone: (503) 2354784 Fax; (503) 491 -2932 Residential backflow minimum permit fee: $3625 /
Plea review (25% of permit fee) �, 0
CCB Lie.: 23847 • P . bing Lie. no.: 26 -208 PR State surcharge (8% of permit fee) Authorized signature: \ IS L TOTAL PERMIT -.: r
' i' 1' Date: /,.. /3- This permit application expires If a permit Is not nbta • • •
Print name: pi � : • ?g0 daywaitcr It xs been accepted as complete.
*Kr. 'methodology set hvT,.ri-County Building Industry [v ice Bnard.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PI_M 2006- 00037
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 21160006
Phone: (503) 639 -4171 �t F
A
ICI
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/1/2006 TIME: 7:00AM PAGE: 6
SITE ADDRESS: 13406 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: NV HOUSE
DESCRIPTION: (3) sinks. Other fix trap primer. 4/27/06, ADDING Rf' DEVICE.
OWNER: BARUCI ISAAC TRUSTEE, PHONE #:
CONTRACTOR: WOLCOTT PLUMBING CONTRACTORS PHONE #: 503-235 f3'lt'1
Inspection Request Scheduled For: Date: 5/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 029046 01 603 -235 -678.4 N
Corrections /Comments /Instructions:
Ad
I
All . _
,l/ ..
r � ' ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: A4 i r \ Q / Date: Phone #: (503) 718- 1- // 1 2 )
U /
--<-,
CITY OF TIGARD Y
BUILDING DIVISION PERMIT #: PI 2006 000
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/16,000,
Phone: (503) 639 -4171 1 aml, t;1
Inspection Requests (24 Hrs.): (503) 639 -4175 °I �..
INSPECTION WORKSHEET FOR DATE: 2/21/2006 TIME: 7:02AM PAGE: 79
SITE ADDRESS: 13.105 SW PACIFIC H WY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: NV HOUSE
DESCRIPTION: (3) sinks. Other fix: trap primer.
OWNER: BARUCH, ISAAC TRUSTEE, PHONE #:
CONTRACTOR: WOLCOTT PLUMBING CONTRACTORS PHONE #: 503-236-8704
Inspection Request Scheduled For: Date: 2/2.1/?006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing ftrt' 027209-01 503.235.87F34 N
Corrections /Coets /I ru tions
'1--)
•
4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / /li_ Date: ` Phone #: (503) 718-