Permit w' ,
C ITY OF TIGARD PLUMBING PERMIT
�r DEVELOPMENT SERVICES PERMIT #: PLM2006 -00354
,.� I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/21/2006
PARCEL: 25111 AA -00900
SITE ADDRESS: 08860 SW MCDONALD ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT: JURISDICTION: TIG
Project Description: Water service 100'
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: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
KAISER, BRUCE A AND
EVELYN A Description Date Amount
8860 SW MCDONALD [PLUMB] Permit Fee 7/21/2006 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 7/21/2006 $5.80
Phone : 503- 639 -0318 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: G�
Y .(
' 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.
•
Piumbin. Permit / r� L AC 'x,',!. rot?, Oi FICF,. 1 :51; oN[.v
City of Tigard , E L) Re V . ( j► o(% ��� Permit N > .341:1..- f oat 13125 SW Hall Blvd., Tigard; OR 6 J Pisa
Phone: 503.639.41'71 Pax 1 49 .i�6 90 % ? : `. s . {c, DatB . e Other Permit No.:
24 Hour inspection Line: i�/ �F T �q 6
. 4. 41. 177 .1 1 1 '1':‘
{� r,� ++
IM Date Ready/By: n" Ed See Page 2 for
w.
internee wwc a, /� � D Notified/Method: Supplemental Information
T1 PE 1'n°' FEE* SCHEDULE -
❑ New construction ❑ Demolition For special information use checklist
Description . I Oty• ( .a�_ Total
Addition/alteration/replacement 0 Other: New 1.2- family dwellinga (includes 100 R. for each utility connection) .
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
VI- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building El Multi - family SFR (3) bath 399.00
❑ Master builder El Other Each additional bath/kitchen 45.00
Fire sprinkler ( - sq. ft.) Pagc 2
.DOB SITE iNFORMATION AND LOCATION
Site utilities
lob site address: S 2O 5W l v ' �L) JC ! it, ST Catch basin or arm drain 16.60
City /Statc/ZIP: T G f �.i� Ors_ 9)71... Drywall, leech line, or trench drain 16.60
Suite/bldg./apt. uo.: Project name: I SE1 Footing drain (no. linear It: - ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
X Rain drain connector 16.60
Sanitary sower (no. linear it: ) Page 2 �j
a Storm sewer (no. linear R:� Page 2 i U v
g Lot no.: Water service (no, linear ft711) I UU Page 2 -6 ap pa
Fixture or item
Tax x m map /pa
Tax no.: Absorption valve 16.60
DE ION OF WORK Backflow preventer Pagc 2
Lau ' Ile/ _ -_.- 1. t✓ Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNER I ❑ TENANT Drinking fountain
� n � EjeEj ectors/sump 16.60
ors/sump 16.60
Nam C: l CJC. Expansion tank 16.60
Addre3s: i //`�}}� tl� S Fixture/sewer c ap 16.60
City /Statc/7.TP tJ r Floor drain /floor sink /hub 16,60
Phone: Cos � � 03 Fax: ( ) Garbage disposal 16.60
- APP1,.WANT ❑ (:ONT ACT PERSON Hose bib 16.60
ice maker 16.60
Business name: Wolcott Pia gibing db Jack Iliowk Plumbing --.
Interceptor /grease trap 16.60
Contact name /U4 YJ( n`, - � Medical gas (value: $ ) Page 2
Address: 1075 W Historic Columbia River Hwy Primer 16.60
City/State/ZiP; Troutdale, OR 97060 Roof drain (commercial) 16.60
Phone: (503) 235-8784 I Fax: : (503) 491 -2932 Sink/basin/lavatory .16.60
Tub /shower /shower pan 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Wolcott Plumbing dha .lack Hawk Plumbing Water heater 16.60
Address: 1075 W Historic Columbia River Hwy Other: 6
Subtotal
City /State/ZtP: Troutdale, OR 97060 Minimum permit fee: $72.50
��
Phone: (503) 235 -8784 Fax: (503) 491 -2932 Residential backflow minimum permit fee: $36.25
CCB Lie.: 23847 / / A Plumbing Lic. no.: 26-208 PB Plan review (25% of permit fcc)
/ / - State surcharge (8% of permit fee) 5'
tu
Authorised SignarC;�i L TOTAL Pf;RMI'f FEF,.
Print name: / / ; si„i,r Date: t Arf tb This permit appllcatton expires if a permit is not obtained withi
180 days after it has been accepted as complete.
*Fcc methodology set 1w Tri- County Buildine Industry Service Board.
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: PLM200& -00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/21/2006
Phone: (503) 639 -4171 :alit
Inspection Requests (24 Hrs.): (503) 639 -4175 _�' . __.
INSPECTION WORKSHEET FOR DATE: 8/1/2006 TIME: 7 PAGE: 84
SITE ADDRESS: 08860 SW MCDONALD ST CLASS OF WORK:
SUBDIVISION: EDGEWOOD LOT #: TYPE OF USE:
PROJECT NAME: KAISER
DESCRIPTION: Water service 100'
OWNER: KAISER, BRUCE A AND, PHONE #: 503 - 639.0318
CONTRACTOR: WOLCOTT PLUMBING CONTRACTORS PHONE #: 503
Inspection Request Scheduled For: Date: 811/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 034061 -01 503 - 235 -8784 N
Corrections /Comments /Instructions:
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../ . /.ALA L AP ,ice/ _ t< <ii ` /`- /l
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ill I k /- v Date: i 6 " Phone #: (503) 718- `/3