Permit fr y
C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00409
..� -- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 915/2006
PARCEL: 25111 CA -13700
SITE ADDRESS: 09685 SW SATTLER ST ZONING: R - 3.5 •
SUBDIVISION: DARMEL LOT: 012 JURISDICTION: TIG
Project Description: New SF sewer connection & reverse drains.
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: 60 ft •
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft •
•
•
Owner: FEES
ROD FURLOTT
9685 SW SATTLER ST Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 9/5/2006 $117.50
[TAX] 8% State Surcha 9/5/2006 $9.40
Phone : 503- 624 -9439 Total $126.90
Contractor:
APOLLO DRAIN + ROOTER SERVICE
2208 NW BIRDSDALE #8
GRESHAM, OR 97030 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 239 -8801
FAX 503- 669 -9568
Reg #: LIC 49418 •
PLM 26 -533PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
•
Issued By: iup Permittee Signature: Sejl,
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FR4M APOLLO DRAIN 503 - 669 -9568 (TUE)AUG 22 2006 10:29 /ST. 10:26/No. 6812889863 P 1
. •'1 ,iii !
Plulmbin! ' e i : I P(.II( (it 'iii 1. (,SE ()NIA
City Tigard Date/13 . , 0 . o g, -oo Z `r Received Pcn nit No.: '� •
13125 SW Hall 81vd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.59$ 1960 C a ►. , i .'o DatelDy: Other Permit No.:
24 Hour Inspection Line: S� .4 / �, 200 ��
Internet: www.ci.tigard.or.us � � � - -� Date RwJY /OY� r % • &1 See Page 2 for
g Notifted/Method: Supplemental Information
at :I:1 •. :P
~ If` '-'4V :A r' n ,',]..':.'.T::.
: For specialinforamrlon use checklist. .
❑ Ncwconstruction /If �TNT, Demol
Description I Qly. 1 Es. I Total
. Addition/allerationlrcplaccmcnt ❑ Other: Ncw I.2- family dwellings (includes 100 ft. for each utility connection)
.t:.:•:,,... - ... :•. : •.;:•... AtP$GORIC� -O� � . . ,,,, GX'IO -, :.i< :��- .,., �•' " : '✓•• ? ' :i•' :_�, : :,�. SFR (1)bath
. • �oNSxrtv ' ..
:
)41- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.110
❑ Accessory building ❑ Multi- family SFR (3) bath 394.00
ID Master builder ❑Other; Each additional bath/kitchen 45.1)0
Fire sprinkler ( sq. it.) Page 2
J lg iINFORMA ION Ar4 D+ ^ tl OC A'1'lf0 ` N.• i y'"'' ° Site utilities
Job site address: - i ( 5 z for S'+ Catch basin or arca drain - -^ 16.60
City /State/ZIP: QQ FR (1.,A eL On '•722A- Drywell, leach line, or trench drain 16,60
Suite/bldg. /apt. no.: I Project taunt: Footing drain (no, linear It: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: US 0) Page 2 5fj
Storm sewer (no. linear It: ) Page 2 �`
Subdivision; I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
_ _ , Absorption valve 16.60
. mil' t S >b. : ;rt "Qi!1 '_OIR h1N , 1,tA � `P t Backllow preventer Page 2
D,` con l m t SS;on Se p4- i c , h c)o\c_. -fie) eliy Backwater valve 16.60
16 (2e0CY'St✓ (triton 1 r�olq c.e, Clothes washer 16.60
h1 Q l h l i n G Dishwasher 16.60
+ r ,n r s m I , w 1 Drinking ountain 16.60
'; Erb ^ etit lliti
:W t •' >R : FOMl 4 :.�Y..: M '� 1) $
nn ip: : e kp Gjextotslsu 16.60
Name: Ra(Jt- Fter1.0`1 4
Expansion tank 16.60
Address: ., Fixture/sewer cap I --- 16.60
City /State/LIP: Floor drain/floor sink/hub 16.60
Phone: ( ) to 2,,A - 4 4 391 Fax: ( ) (srhsgc disposal 16.60
lInse bib 16.60
❑"' :k AlV F •,. , /::. ,,.. •: . O*0ff.A(FTt;.El[tSON;
I maker _ 16.60
Business name: Interceptor /grease trap 16.60
Contact name: Medical gas (value: S ) Page 2
Address: Primer 16.60
[:its /$talc /7,IP; Roof drain (cnmmcrcial) 16.60
Sink/lwsin/lavatory 16.6()
Phone: ( ) I Fax::( )
Tub /shower/shower pan 16.60
E -mail: ,-
Urinal 16.60
' ;..'• ..
. water closet 16.60
Business name:. too 0 rd-1 l/ h eater /� � �- 16.60
Address: Z O ' NV3 181f tSalattC �/ (1 `� ,Oth Water er: l :!'TyG �J G
r �� Subtotal
City /Statc/ IP: &itsha•r, 0(1 ctlo30 - -..... _• - •. -. - -. _... Minimum .. - - -'
Minimum permit lee: S72.50 �/
Phone: ( ) Z3' ?$o I Fax: ( ) Le (. _ v0 y Residential backflow minimum pentlit fee: S36.25 if /
CCB Lie.: 44.1 i g Plumbing [.ic. no b J33 p$ Plan review (25% of permit fee)
�{��� State surcharge (8% of permit lee) 9 6 V
Authorized signature: C _t - U.tJ J ""
TOTAL PERM IT FEF. `.2 di
Print name: . prnh Gh ncr [: $ - 2.2 - I This permit application expires If a permit Is not obtained Ilithin
180 days after It has been accepted as complete,
*Fee methodology net by Tri- County Building Industry Sen•ice Board.
i !Wilding Pam.. PI \t- PowitApp 06 05 440-11,16.1 (*OM tt'hnt
CITY OF TIGARD
•
• BUILDING DIVISION * . PERMIT #: PLM200�00409
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/5/2006
Phone: (503) 639 -4171 �.a t
Inspection Requests (24 Hrs.): (503) 639 -4175 - ' �I I
INSPECTION WORKSHEET FOR DATE: 9/15/2006 TIME 7:06AM PAGE: 85
SITE ADDRESS: 09686 SW SATTLER ST CLASS OF WORK:
SUBDIVISION: DARMEL LOT #: 012 TYPE OF USE:
PROJECT NAME: FURLOTT
DESCRIPTION: New SF sewer connection & reverse drains.
OWNER: FURLOTT, ROD PHONE #: 503 -62A -9439
CONTRACTOR: APOLLO DRAIN + ROOTER SERVICE PHONE #: 503 - 239.8801
Inspection Request Scheduled For: Date: 9/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
350 Septic tank 036582 -01 503 - 239-8801 N
Corrections /Comments /Instructions:
J je(7(.., e
0 e /�� . 1 / I/ /IA' At / -E ` . _.1 t i 4,0:_..,
AMIIIIIMIWAMIIIIIIIIID
6(/(1 / ( 1 /
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❑ PASS RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
)<e/ Date: 976 d Phone #: (503) 71 S- 2 3/
CITY OF TIGARD
, ... Qf3cj
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171y1l�i
Inspection Requests (24 Hrs.): (503) 639 -4175 '`__..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: O R (a, E 6 a l e` CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Regyiest Scheduled For: Date: Pour Time:
Code # Ins ection Description Confirm # Contact # Message t.(.._ et,„,,,,, . 9„., -scici e
Corrections /Comments /Instructions:
P
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1Z Date: L v ° ? Phone #: (503) 718-