Permit •
A A. CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00432
s=� ' II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/19/2006
PARCEL: 2 S 114 B B -11900
SITE ADDRESS: 10441 SW TITAN LN ZONING: R -12
SUBDIVISION: SWANSONS GLEN NO.2 LOT: 060 JURISDICTION: TIG
Project Description: 35' water service.
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: 35 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
GREG KLUM
10441 SW TITAN LN Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 9/19/2006 $72.50
[TAX] 8% State Surcha 9/19/2006 $5.80
Phone : 503- 620 -5797 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: Zp e.
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 r , ng Permit Application, FOR OF I: FIC' USE. ONLY
City of Tigard Htv Reeeived PcnnitNo.. \ //
13125 SW Nall Blvd., Tigard, OR 97223 ' l ` a 4.. 1� ! _1/ 'Y
[a. ; ;1 ;h Plan Other Permit No..
Review
Phone: 503.639.4171 Fax; 503.598.1960S E P 1 8 2006
24- Hour Inspection Line: 503.639.4175 � . j j mri.
Internet; www.ct.tigard,or.us CITY OF TL it . - - Date Ready/By: 0 Sec Page I for
6 gg1
i N Mhod• Supplemental Informed
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❑ New construction ❑ Demolition Par special informazinn zixe checklist
Description I Qty. I Ea. E Total
1 2t4ddition/alteration /replacement ❑ Other: Ncw 1- 2- family dwellings (includes 100 ft. for each utility connection)
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;t.: ! 1 ' , r' liiti.a : i..: i :1;I i'4 t {> t I SFR (I) bath 249.20
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yr1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
/❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
p { Fire sprinkler (sq. ft.) Page 2
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Job site address: l Q 4 1 5,3 ` t q vx 1--,1■.. • Catch basin or arca drain 16.60
City /State/ZiP: .e ` ,. 0 0,,r 1 C2r(__ 11-2....z.:4 Drywell, leach line, or trench drain 16.60
Suitcbbldg. /apt no.: Project name: a cALStcy C<u w�yvtt� hog drain (no. linear R.: _� Page 2
1 Manufactured home utilities 110.00
Cross strcctt/directions to job site:
Manholes 16.60
d u�S C v:tr � , e " ec,"215-- r i . t Rain drain connector 16.60
C_.(4.55 - la Z1' Wpm Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: 1 Page 2
Subdivision: I_ Lot no.:
Water service (no, linear ft.; 36 err Pagc 2 f '55
Fixture or item
Tax map/parcel no.:
t ,. ; , i I' .;��' •a - 1 : ,�I II' ''l!� �y� •,:•: ; 4 . r:1 ....h - +:i { - �u' . , ; ;tll I' Absorption valve 16.60
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_ _ 3y r C.1.3 ctse stv%.Ld Backwatcrvalve 16,60
Clothes washer 16.60
Dishwasher 16.60 _
,..., ,, ,>:,t, '; '. ti iyN�a �,,��, iii$ : a:: .iii I � Ti ii r'y,:,, - .,..., r ::;" •„ i1 P , 11ti Drinking fountain 16.60
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- ,�. Y r.�.. . �;: ......... _i - 7r ;`:r I'r'.1 -11417 j cctors/sump 16.60
Name: - >'r � 1e_... Expansion tank 16.60
r Address: E01-14 ' S 6 ` � � .- Fi cap 16.60
City/State/ZIP:: c j.... ow_ 9. 0 ZZ Floor drain /floor sink/hub 10.60
Phone: (2i) ('p e- 5 1 17 (7 Fax: ( ) Garbage disposal 16.60
G
r: Hose bib 16.60
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I maker 16.60
Business name: WOLCOTT PLUMBING dba JACK HOWK PLUMBING
t ,\
_ Interceptor /grcasc trap 16.60
Contact nose: ..Li . e _l• - _c ‘J`P"" Medical gas (value: $ ) Page 2
Address: 1075 W HISTORIC COLUMBIA RIVER HiGFW►'AY Primer 16.60
City/State/Z1P: TROUTDALE OR 97060 Roof drain (commercial) 16.60
Phone: (503) 235 -8784 I Fax: : (503) 491 -2932 Sink/basin/lavatory 16.60
Tub/showcr/showcr pan 16.60
E -mail: Urinal 16.60
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5', ifi '' f.M ,' •. 1 . 1 i I4'1 �,1 !; i hi,IIiIli if lI Y ,Ill;;; jiT`.i1y'f t t i 1 ' Water cl wt 16.60
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Business name: WOLCOTT PLUMBING dba JACK HOWK PLUiBING Water heater 16.60
Address: 1075 W HISTORIC COLUMBIA RIVER HIGHWAY Other;
City /State/ZIP: TROUTDALE OR 97060 Subtotal
Minimum permit fcc: $72.50 1 ,5Z
Phone: (503) 235 -8784 Fax: (503) 491 -2932 Residential backflow minimum permit fee: $36.25
CCB Lic.; 23847 - ---.. Plumbing Lic. no.: 26-208 PB
Plan review (25% of permit fee)
Authorized 9j tIrYC - v -- - State surcharge (R% of permit fcc) :J 4 ats
C L TOTAL PERMIT FRE <
Print name: J „lc e-CL-1 .....-> Date:/ 1231 (3 t This permit application expires if a permit Is not obtained within
180 days after it has been accepted as complete.
'Pcc methodology sct by Tri -County Building Industry Service Board.
1; 16u11dinOvermfta1Pt .M.PemdtArtp,dne OG/05 440.4616T(10/07/COM/WBB)
•
mot.
CITY OF TIGARD r
BUILDING DIVISION PERMIT #: PLM2006- 00432
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9!19/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/25/2006 TIME: 7:01AM PAGE: 42
SITE ADDRESS: 10441 SW TITAN LN CLASS OF WORK:
SUBDIVISION: SWANSONS GLEN NO.2 LOT #: 060 TYPE OF USE:
PROJECT NAME: KLUM
DESCRIPTION: 35' water service.
OWNER: KLUM GREG PHONE #: 503- 620 -5797
CONTRACTOR: WOLCOTT PLUMBING CONTRACTORS PHONE #: 503 - 235.8784
Inspection Request Scheduled For: Date: 9/25/2006 Pour Time:
Code # Inspection Description Confirm # C # Message
330 Water service 037083 -01 503 - 235.8787 Y
Corrections /Comments /Instructions: l c)
l
r
'ASS L PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �� ) Date: . / v Phone #: (503) 718 -