Permit C ITY OF TIGARD PLUMBING PERMIT
i � DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00193
. .� I� 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 5/2/2006
PARCEL: 2S 102BC - 06300
SITE ADDRESS: 10600 SW PATHFINDER WAY ZONING: R -4.5
SUBDIVISION: YOLO ESTATES LOT: 012 JURISDICTION: TIG •
Project Description: Replace 50' water line.
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: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
FLETCHER, WILLIAM E + MICHELLE L D
10600 SW PATHFINDER WAY Description Date Amount •
TIGARD, OR 97223 • [PLUMB] Permit Fee 5/2/2006 $72.50
[TAX] 8% State Surcha 5/2/2006 $5.80
Phone : 503- 670 -0247 • Total $78.30
Contractor:
CASEY'S PLUMBING INC
PO BOX 30075
PORTLAND, OR 97294 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 253 -0030
FAX 503- 262 -8251
Reg #: LIC 147298
PLM 26 -725PB
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"diezA. �eJ Permittee Signature: 1 /d/rL�
•
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.
Plumbing Permit An ti FOR OFFIC USE ONLY
d
City of Tigard 1- Date/By terra. e . / / fl(o P "CI.P�')o 30
13125 SW Hall Blvd.,'1'igard, OR 97223 o flan Renew
^' they Permit N
Phone: 503.639.4171 Falc 503.598.1960 M� _ • a1► �:c 1.10 1 Date/B
24- Hour Inspection Line: 503.639.4175 V ' -'� Date Ready/By: El See Page 2 for
Internet www.ci.tigard.or.uv C{ Notified/Method: � Supplemental Information
TYPE OF�\ \\ 401.
FEE EDULE
• ❑New construction ' i�j�) Demolition Far special info
axe checklist
Description I Qty. I Ea. I Total
ifil Addition/alteration/replacement ❑ Other New 1- 2 -family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 249.20
14 l - and 2- family dwelling ❑ Comm txcial/industrial SFR (2) bath 350.00 .
❑ Accessory building y ❑ Multifamily
SFR (3) bath • 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORI>tIATION AND LOCATION Site utilities
Job site address: V) ( on() Si) / jrJ 04 Lo / Catch basin or area drain 16.60
City /State/ZIP: 'V i C7 09.- 9„ Drywell, leach line, or trench drain 16.60
Suite/bldg./apt. no.:
1 I Project name: Footing drain (no. linen ft: ) Page 2
Manufactured home utilities 110 -D0
Cross street /directions to job site:
Manholes 16.60
Rain drain connector t 16.60
Sanitary sewer (no. linear ft: ) Page 2
• Storm sewer (no. linear It.: _) Page 2 I
Subdivision l Lot no.: Water service (no. linear fl.: ) Page 2 -
Fixture or item
Tax map/parcel no.: •
Absorption valve 16.60
DESCRIPTION OF WORK Backflow prevemer Page 2
L A ( {ACLU l I pa t1 soxIJ UC.P Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Ig PROPERTY OWNER I ❑TENANT
Drinking fountain 16.60
Ejectors'sump 16.60
Name: r{e ,Q C,, \- � Expansion tank 16.60 •
Address: 1 ( �3C,V �'� i. A X A 1 Fixture /sewer cap 16.60
City/State/ZIP: l l C} o 1 Q3 Floor drain/floor sink/hub 16.60
Phone: (SO3 `- (:)„ Fax: ( ) Garbage disposal 16.60 1
a APPLICANT I ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60 ,
Business name: //`` ��,, �
t� \,u.,1 A 1,a` i rt.. } -./-\ C Interceptor/grease trap 16.60
--►
Contact name: - �L[,1( ,, y\ bed Q Medical gas (value: $ ) Page 2
O
Address: primer r 16.60
City /State//ZIP: ' Po .,e- ( 1 I .(ll �. tt ,�t - 278 Roof drain (commercial) � 16.60
Phone: ( 9 - 3 ) 2 - . S 3 - b I Fax: : (
Z CP Z5I _ Sink/basin/lavatory 16.60
Tub/shower /shower pan 16.60
E -mail: S-ekr pit.LR nio-) @ C ovv \OLLr?+ . v U rinal
I 16.60
C ONTRA OR - Water closet • • 16.60
Business name: Ca S P ? I t�,YyLh�t I ^ 1 G . Water heater 16.60
Address: • r 4_; . E Other:
� 1t.. Q � q -] �o, Subtotal r J ` ° �
City /State/ZIP: P ����2� r Minimum permit fee: 572.50 / �/
Phone: t--�t.l_J� 253 - ) '1 Fax t )9 ZL0 2 - s 7,s- Residential backflow minimum permit fee: $36.25 Z '
CCB Lic.: I i4 7 Z ' [ 1 10 ~ Plumbing Lic. no.:. = Plan review (25% of permit fee)
77 State surcharge (8°,6 of permit fie)
Authorized signature p �.' y� ? ,, f -i ZS� TOTAL PERMIT FEE �Print' name: ��I �/.Z n'l�� -� (� f Date '� 4D(J I This permit application expires If a permit is not obtained within
- 1 80 days after it has been accepted as complete.
'Fee methodology set by Tri -County Building industry Servicepo 0
i:\ EtaldinittPermirstPLM- Permit/ipp.dne 05/05 440 46l6'f(10/02/COM/WEB) ,
vd L9Z9 Z9Z - £05 6uigwnid s ,(ese3 e917:60 90 ZO /(eW
I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006.0 )i!.;3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 512/)006
Phone: (503) 639 -4171 �.��_ �1�`I
Inspection Requests (24 Hrs.): (503) 639 -4175 . _�
INSPECTION WORKSHEET FOR DATE: 5/3/2006 TIME: 7 :08AM PAGE: 62
SITE ADDRESS: 10600 SW PATHFINDER WAY CLASS OF WORK:
SUBDIVISION: YOLt.) E:3 [ATES LOT #: 012 TYPE OF USE:
PROJECT NAME: Ft ETCHER
DESCRIPTION: Replace 60' water line.
OWNER: F t CCHF R, WILLIAM LL. + MICHELLE L, PHONE #: 5036/0 -024 /
CONTRACTOR: CASEY'S PLUMbINCC INC PHONE #: fi0:3- 753.0030
1
Inspection Request Scheduled For: Date: 5/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 02916901 5tfl- 253.0030 N
Corrections/Comments/Instructions:
Cpl} 1
1R-? (ii TD 1 ?— o I If
r" 0 ..i, vi '
P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FO' INSPECTION ❑ ADDITIO L FEES ASSESSED
Inspector: >�V�� ' Date: ' Phone #: (503) 718_