Permit CITY TIGARD PLUMBING PERMIT
PERMIT #: PLM2006 -00351
DEVELOPMENT SERVICES DATE ISSUED: 7/20/2006
13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 1S136CB
SITE ADDRESS: 08225 SW PFAFFLE ST ZONING: R - 4.5
SUBDIVISION: PACIFIC RIM PROP PARTITION LOT: 001 JURISDICTION: TIG
Project Description: Water replacement 60'
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: 60 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
PFAFFLE, HELEN N TR
8225 SW PFAFFLE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 7/20/2006 $72.50
[TAX] 8% State Surcha 7/20/2006 $5.80
Phone : Total $78.30
Contractor:
WOLCOTT PLUMBING CONTRACTORS
1075 W COLUMBIA RIVER HWY
TROUTDALE, OR 97060 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: Ai a
Y l/ �' l
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.
. tl/
Plumbing Permit Application 66 ' FOR OFFICE USE ONLY
City of Ti and EGO N/ ED Received /�
�+ DateIBy.1 • 0 0 PrnmtNo.� Oblj -4o36
13225 SW Halh8lvd.. Tigard, OR 97223
Foe 503.598.1960 Plea R
Phone: 503.639.4I.71 F
24- Hour Inspection Line: 503. 639.4175 J u L 2006 ^ `" � ° 1 � I/ D uo Re - Permit Nn. �a�Fj -�fOQ p�p
Daze Raady/liy Jam it
Internet www.ci.tigatd.or.us CITY OF TIGA - Notified/Method: I l See Page 2 for
Supplemental !affirmation
TVPd3 - t' IVI..IOPI _.
FEE* YC'.HxAIR 1;
❑ New construction ❑ Demolition For special Information use checklist
Description I Qty. I Ea. I Total
❑ Addition /altaration/replacement ❑ Other. New 1- 2- family dwellings (includes 100 R. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
1- and 2 - family dwdlling ❑Commercial /industrial SFR (2) bath 350.00
Accessory building ❑ Multi family
SFR (3) bath 399.00
[] Master builder El Each additional bath/kitchen 45.00
Fire sprinkler ( sq. ft.) Page 2
tOB SITE INFORMATION AND LOCATION Site atilides
Job site address: f ZZ 5' al, f f - f FF C ,5-r Catch basin or area drain _ 16.60
City/State/Z1P: 73&,91t 0 at f7 Z Z3 Drywcll, leach line, or trench drain 16.60
Suite/bldg. /apt. no.; I Project name: "Q 47¢- 45 r Footing drain (no, linear ft.: ___.) Page 2
Manufactured home utilities f 110.00
Cross street/directions to job site: 71165 45-s--_ F3 Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear II: ) Page 2
Storm sewer (no. linear R.: ) Page 2
Water service linear ce (no, near f.: ) Page 2 cc,
Subdivision: I Lot no.: W _ crd
Fixture or item
Tax map /parcel no.:
-
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
6^/
(�)(J �tt,t- �� ��,U `13ackwatervalve 16.60
Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNPR l 0 TENANT Drinking fountain 16.60
y �
[ . t�(� � J P A i� T E L/ Expansion tank 16.60
Name; Expansion tank 16.60 ..---
Address; 8 j,Z 5- Sid) P PFLE 5f Fixture/sewer cap 16.60
City/StatcJZiP.' */ ‘- -: bq GI -zz_ - Floor drain/floorsink/hub 16.60
Garbage disposal 16,60
AV.'PANT 0 (ONTa.CT P1?R�ION
Hose bib 16.60
lee maker 16.60
13trsinass name: Wolcott Plumbing dba Jack Howk Plumbing
Interceptor/grease p
tra 16.60
Contact name; I li 0 fertm .ZCt1 i ,5 Medical gas (value: $ ) Page 2 +
Address: 1075 W Historic Columbia River Hwy Primer 16.60
City /Statc%7t.P; Troutdale, OR 97060 Roof drain (commercial) 16.60
Phone; (503) 2354784 Fax: : (503) 491 -2932
Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
6 - mail; _ Urinal 16.60
CON TR.Cl'OR Water closet 16.60
Business name: Wolcott Plumbing dba Jack Howk Plumbing Water heater -.�-. 16.60
Address: 1075 W Historic Columbia River Hwy Other:
City/State/ . P; Troutdale, OR 97060 Subtotal 53 OG
Minimum permit 11x: $72.50 [[��
Phone: (503) 235 -8784 Fax: (503) 491 -2932 Residential backflow minimum permit fee: $36.25 2.. Jam►
CCB Lie.: 23847 Plumbing Lic. no.: 26 -208 P13 Plan review (25% of permit fee)
State surcharge (8%ofpermit fec) .80
Authorized signature:
_ .� / _ TOTAL PERMIT FEE
Print name: I / _ / .DL Ls Date: 7. 4 Thia permit application expires if a permit Is not nhtainc within
180 days after it has been accepted as corn plete
*Fee mclhodoloizv set by Tri- County liuildina Industry Service Board.