Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00075
DATE ISSUED: 2/10/2006
" 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 111 CB -01703
SITE ADDRESS: 10128 SW LADY MARION DR ZONING: R -3.5
SUBDIVISION: HOOD VIEW LOT: 2 - JURISDICTION: TIG
Project Description: Replacement of sewer.
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: 100 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
KAREN CORRIGAN
10128 SW LADY MARION DR Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 2/10/2006 $72.50
[TAX] 8% State Surcha 2/10/2006 $5.80
Phone : 503 -598 -4732 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.
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Issued By: Permittee Signature: _
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 Application • FOR OFFIC._, USE ONLY
City of Tigard NOISING ON G , %t1Et RaeciveA '1 [ /) ��l y��
Hail 81vr1., Tigard, OR 97223 GHY911 �O �� gntdltyyT (/ U {�V Permit NOT
1` b , `a )6 wOi.)
13125 SW
Pion Review J
Phone: 503.639.4171 Fax: 503.598.1960 � G^,r „ 1 „ nee /Oy Other Penult No. o7-- Lf '
24- Hour Inspection Liner 503.639,4175 9002 6 l ,4 M 1-)ate Rondyf y; lu� I E l See Page 2 for
Internet: www.ei.tigard.or.u.n Noti6cd /Method:
i Supplemental Information
TYPE OF At ',A130914 FEE^ SCH . LULE
❑ Now construction • molition Por special information use checklist
--- - 15cscri • *cm OE . Ea. Total
A t Addition /alteration /replacement. ❑ Other: New 1 - 2- family dwellings (includes 100 ft. fur each utility connection)
C'ATECO.R'f OF CONSTRUCTION SFR, (1) bath 249.20
- 7 I - and 2 family dwelling ❑ Commercial /industrial SFR (2) bath 350,00
❑ Accessory building 0 Multi- family S (3) bath 399.00
Master builder
Each additional bath/kitchen 45.00
El O ther:
Fire sprinkler ( sq.:f.) Page 2
JOB SITE 1NPOR111?.TION AND LOCATION Site amities _
Job site address: /0/R2 gt .i:Lid / 04/ Catch basin or arcs drain 16.60
City / State/ZIP; arJ G ,i/ . B--- -(� / !' ice`) Drywcll, leach line, or french drain 16.60
Suite/bldg. /apt. no.: Project name; eneel '� Footing drain (no. linear fl.: ) Pagc 2
Manufactured homc utilities 110,00
Cross street: /directicros to, job site:
Manholes 16,60
i 1 ,� i�. fir- Rain drain connector 16.60
1/ /% wl4n � �; P7 Sanitary sewer (no. linear ft.: /AO rtsi Page 2 i 4t,,. 19
Storm sewer (no. linear It,: , ) Page 2
Subdivision Lot nn.: Water service (no. linear ft.; ) Page 2
Fixture or Item
Tax map/parcel no,: Absorption valve 16,60
DESCRTPTTON OF WORE _ Backflpw preventcr Page 2
.0 / ' . ' V • / Backwater valve 16.60
A , /�.lL� ` / . ' S .mod; Clothes washer 16.60
Dishwasher 16.60
l/V [kinking fountain 16.60
PROPERTY OWNER / ❑ TENANT
r , Ejectors/sump 16.60
Name;
I/ Expansion tank 16.60
Addrress; i . a;' .A e• � / /�. r ./I 0 Fixture /sewer (1
er cap 16.6
City /State /ZIP; / Y Floor drain/floor sink /hub 16.60
Phone; 6?9„... Fax: ( ) Garbage disposal 16.60
4 APPLICANT ❑ CONTACT PERSON Hose bib 16,60
Ice maker 16.60
Business name: Wolcott Plumbing dba .lack Hawk Plumbing Intcrce tor/ citsetra P 16.60
/r , : ., f P E�
Contact: name; l f// Medical gas (value; $ ) Page 2
Address: 1075 W Histo - olumbig River Hwy Primer 16.60
City /Si:a1.eaZ.lP; Troutdale, OR 97060 ' Roof drain (commercial 16,60
Phone: (503) 235 -8784 .- Fax; : (503) 491 -2932 Sink/basin/lavatory 16.60
'rub/shower /shower pan 16.60
E -mail.
Urinal 16.60
CONTRACTOR _ Water closet 16.60
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Business name: Wolcott Plumbing dba Jack Hawk Pin Tobing Water heater 16.60
Address: 1075 W Historic Coln River Hwy Other:
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City /State/ZIP: Troutdale, OR 9'7060 Subtotal
Minimum permit fee; $72.50
Phone: (503) 235 -8784 Fax: (503) 491 -2932 Residential backflow minimum permit fee; $36,25 6. ` 4 0
CCB L.ic,: 23847 . Plumbing Lie, no.: 26 -208 PR Plan review (25 %ofpermit fee)
State surcharge (ii% of permit fec) 16
A.uthorized_aigrtaturc; _ . 0/ . TOTAL PE.RMiT ltre i
Print name; _' �� y Date; E' Thus permit application expires if a permit is not .. • "i■
180 flays after it h•;slvcn accepted as comp elm.
' *Fee methodoloev act by TYi r,ounty Building Inclustiw Service Board.
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CITY OF TIGARD `. F'L al
BUILDING DIVISION , `- PERMIT #: 2006 -- Oo J 75
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 844
Inspection Requests (24 Hrs.): (503) 639 -4175 • !i
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /6 / 8' fae41 L CLASS OF WORK:
SUBDIVISION: G' I LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 -/ -O G Pour Tim : ,
Code # Inspection Description Confirm # Contact # Message
-s X 35 -- 8 - 7 8' 4 1
Corrections /Comments/ Instructions:
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E `. PASS. ___ IN PARTIAL-APPROVAL — ❑ CANC L 1 __ _ -NO ACCESS
FAIL % CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / ) VC ' Date S Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006.00075
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/10/2006
Phone: (503) 639 -4171 " +m� ,i
Inspection Requests (24 Hrs.): (503) 639 -4175 j
INSPECTION WORKSHEET FOR DATE: 2/20/3007 TIME: 7 :09AM PAGE: 42
SITE ADDRESS: • 10128 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: HOOD VIEW LOT #: 3 TYPE OF USE:
PROJECT NAME: CORRIGAN
DESCRIPTION: Replacement of sever. 2/9/07, Correction: this is new sanitary sewer service, not replacement. ,
Septic tank must be pumped, filled and inspected.
OWNER: CORRIGAN, KAREN PHONE #: 503 - 598 -4732
CONTRACTOR: WOLCOTT PLUMBING CONTRACTORS PHONE #: 503-667-1781 .
Inspection Request Scheduled For: Date: 2120/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 043580 -01 503- 235 -8784 Y
Corrections /Comments /Instructions: ,
f /
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PASS 7 PARTIAL_ APPROVAL __ ❑ CANCEL _ _ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ', ./(.7 Date: - - U D 7 Phone #: (503) 718- f � L /5
11711 I
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CITY OF TIGARD
BUILDING DIVISION _ „, PERMIT #: PLN12006-00075
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/10/2006
Phone: (503) 639-4171 . 4 ,21111lit
Inspection Requests (24 Hrs.): (503) 639-4175 - -
INSPECTION WORKSHEET FOR DATE: 2/21/2007 TIME: 7100AIVI PAGE: "10
SITE ADDRESS: 10128 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: HOOD VIEW LOT #: 3 TYPE OF USE:
PROJECT NAME: CORRIGAN
DESCRIPTION: Replacement, of sewer. 2/9/07, Correction: this is new sanitary' sewer seivice, not replacement.
Septic tank must be pumped, filled and inspected. • • -
OWNER: CORRIGAN, KAREN PHONE #: 503-598-4732
CONTRACTOR: WOLCOTT PLUMING CONTRACTORS PHONE #: 503
Inspection Request Scheduled For: Date: 2/2112007 Pour Time: •
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 04364-01 503-235-6784
Corrections/Comments/Instructions:
Thr s2 2 (,
I P SS n PARTIAL APPROVAL __ 0 CANCEL _ I I NO ACCESS
I I FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: ) 14. \i Date: — )0 Phone #: (503) 718- •
1