Permit v
C ITY OF TIGARD PLUMBING PERMIT
i" DEVELOPMENT SERVICES PERMIT #: PLM2005 -00390
e --- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/16/2005
PARCEL: 2S 102BC -00200
SITE ADDRESS: 10215 SW WALNUT ST ZONING: R -4.5
SUBDIVISION: PP1994 -004 LOT: 004 JURISDICTION: TIG
Project Description: Sewer repair.
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: 8 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
CHARLES WOODARD Description Date Amount
10215 SW WALNUT AVE
PO BOX 23303 [PLUMB] Permit Fee 8/16/2005 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar1 8/16/2005 $5.80
Phone : 503 239 - 8801 Total $78.30
Contractor: •
APOLLO DRAIN + ROOTER SERVICE
2208 NW BIRDSDALE #8 REQUIRED ITEMS AND REPORTS
GRESHAM, OR 97030
Phone : 503- 239 -8801
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 ; • 9 or 1- 800 - 332 -2; .
Issued By: OA _ / � . ��` Permittee Signature: . 0 i •-
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.
FROM APOLLO DRAIN 503 - 669 -9568 (MON)AUG 15 2005 16:20/ST.16:19/No•6812889838 P 1
r
Plumbing Permit Ap i cation= 0� rn
City of Tigard ° �' l._ L r Uat s /4 9 5" f3 Permit No.: {�1y17x05 _.,,,z;•390
13125 SW Hall Blvd., Titnrel. OR 97123 Y i
J 200 Phut Rev
Phone: 503.4)39.41'71 Fax: 503.598.1960 - •,,, i DaDate/By: Ot Permit No.:
24- Hour Inspection Line: 503.639.4175 „kW: - ll Date Rawly /4y: • • 65 See Page 2 for
Into•na: www.ei.tigard.or,us .,ry nr TI _ ■ Rll Notified/MNhod: `� -� Supplemental Ipforotation
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❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. Thal
Q2 Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 U. for each utility connection)
:iin.. �,',4' rw i',r'V tw l ' i' f Y:',1 a4; ?":".' F , Alh >. µ • ti � irk y .� � ,
.:.z,-. "-.� ar r. ;ri l r 7 .:ri .. :.U. � � ' • . t r r l � r l ,, . � ~'~ r+'n ` 4 } ? : . .C: •. SFR (1) bath 249.20 .. ��(( t�7t JJ
S2.L ��.._. Y .a .t7ttC'..Y :$.. ..':'t. -e..., r .c. �:Y. ,..4 ...1 „�.t....
I. and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
• �1 a•,�r y krf ,si r, ti • - ;i x. -7:41 .F e 'u a'ra-? ; ; .ug ?*fi; :u + .; Firs sprinkler ( sq. I Page 2 -
�•^...t . ?i'e C'i .r ! :t, , ' %y !: i'r1 ik , A tl,ry .. , .,o d.r. !
, tw.�:� ZY..x++.- st:a::7S}ir1 :nt: ...:.:,s,..�;11✓ r..�` ltir2 . �r:! acxtlauswSa '^x::i: � Site utilities
Job site address: I 1 5 2 . 1 5 S .) Lt)at).rtu. si- Catch basin or area drain 16.60
City /State/ZIP: - V (1)( Q CreL. -1 121 Drywell, leach line, or trench drain 16.60
Suite /bldg. /apt. no.: Project name: Footing drain (no. linear R.: _� i Page 2
Manufacturod home utilities 110.00
Cross street/directions to job site: Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear fl.: S ) I Page 2 '5G
Storm sewer (no. linear ft.: _ ) Page 2
Water savicc (no. !Mar ft.: ) Page 2
Subdivision: I Lot no.: _
Tax map/paruel no.:
Fixture or item
! FS t� i7 i'4 rt 1 rL c^t, rn��/^ srrr r�tt2 ^� t r . 1s� (( l
Absorption valve 16.60
?
au'Stp o . t L 1 rr t t t 4 1� t, t I, . ' f`y
r , :"LL tv:: "� St; ::_ � ±...t.•^ ..1..vs,V ;&'A' s 1�s+z" (.:___ ^..I'Va .:. . S : S,� :.::: ' Backlluw pr venter Page 2
Set Jf S eif . V a Cs `rC.la. r Backwater valve 16.60
Clutha, washer 16.60
Dishwasher 16.60
�;^r CrY t rr m t �• T*-* ' rl Drinking fountain . 16.60
r'.•Ifa'162, :y•'r .1 r r•1 , .ti t ' xt } .Mr t5 tar + L' li1, .4)t•-
.1 rr!A. dth .14. : :; F . . r _r" , ..`fce?:'nY1R17. , :kt , 5. :itiuc u r , J t' ,. ?cn,- ,.6.ih .i „ M,:k�tc_>_4, 34.. ,, , Eicctor:Jaump 16.60
Name: ( GS w d pt.✓rt►
Expansion tank 16.60
Address: 1 42,pnt 5 Sw G ) flt ..^I VT Fixturc/scwcr cap 16.60
City /State/ZIP: '"j I c-3 p D T1 a' )_3 Floor drain/floor sink/hub 16.60
Phone: (5503) (p 3q- I S 3,... ( ) Garbage disposal 16.60
v > xr1 * ;� rn rrrnr. uia 1 t Hose bib 16.60
' {! : �''_ __'l i ,.` '( t � t. , 3,!!rt Ile A,b .. ,MI �'3: a '■ • .., .,' - ! . }_... '^.ices zwm�:2v:.4.kv....'. IOC make. 16.60
Business name: - -
Interceptor/grease trap 16.60
Contact name: Modical gas (value. S ) Page 2 -
Address: Primer 16.60
City/State/ZIP: Root'drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: ( ) I Fax: : ( )
Tub /shower /shower pan 16.60
E-mail: Urinal 16.60
-
/ a ct , *t l' (i =_, �t �,`t r }�y t i a .1M yl 111,(.�
r ._V+S ^r1a�{ISYt .1, ����, T'+ Af.' 11t�rylrL�f�C. 1'.. 1� .��r11..��: ✓,lf:J�Ytiw:.l+ Water t.l,Ntt 16.60
Business name: 1 i Q D rar n Water hatter 16.60
Address: 120 MVO e t rciSCta,I.G r Other:
City/State/ZIP: G lm en0 - Subtotal 5'5
Minimum permit fat: $72_50
Phone: (rte ) 2 .... 1 CI -• eft( I Fax: ( ) ( , s t , . Residential backtlow minimum permit foe: S36.25 12_
C'C:B Lie.: .4 Q. ( Plumbing Lt •. o.: . 533 Rs Plan review (25% of permit fee)
^ State surcharge (8% of permit foe) S. 8-0
Authorized signature: . of . 7 � _ °; TOTAL PERMIT FEE 7/. 30
Print name: - ✓l) y") _ n d i Date z - Ili .. 65 This permit application expires ifs permit is not obtained within
�� ttf 180 days after it has been accepted as complete.
*Fee methodology act by Tri- County Building Industry Service Board.
1 ttuiIdin0H4rmits rrLM- i'ermitApp.doc 0605 4404616r( 10r0:VccMiWEs)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00390
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/16/2005
Phone: (503) 639 -4171 :07„, , ill +l
Inspection Requests (24 Hrs.): (503) 639 -4175 ,, ` __..
INSPECTION WORKSHEET FOR DATE: 8/17/2005 TIME: 7 : 05AM PAGE: 90
SITE ADDRESS: 10215 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: PP1994 -004 LOT #: 004 TYPE OF USE:
PROJECT NAME: WOODWARD
DESCRIPTION: Sewer repair.
OWNER: WOODARD, CHARLES PHONE #: 503 - 239 -8801
CONTRACTOR: APOLLO DRAIN + ROOTER SERVICE PHONE #: 503- 239 -8801
Inspection Request Scheduled For: Date: 8/17 /2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
505 Sanitary sewer 013671 -01 503 - 239-8801 Y
Corrections /Comments /Instructions:
1 • \ I\-)
. .' /
i
I
/ // /
i ii /
•
N I_ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' ?7 Date: / Phone #: (503) 718-