Permit • 4 '�;
0
CITY TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2006 -00515
44-
- - ° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/26/2006
PARCEL: 2S114BC-03100
SITE ADDRESS: 16633 SW RIVERWOOD PL ZONING: R -7
SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT: 068 JURISDICTION: TIG
Project Description: Replace 70' of 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: 70 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
KEVIN BREEN Description Date Amount
16633 SW RIVERWOOD PL
TIGARD, OR 97223 [PLUMB] Permit Fee 101261200E $72.50
[TAX] 8% State Surcharl 101261200E $5.80
Phone : 503 869 - 4726 Total $78.30
Contractor:
WOLCOTT PLUMBING CONTRACTORS
PO BOX 20698 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97294
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 ! - .. 69 • : 1 = 00- 332 -2344.
Issu : d By: , �,, _ j Permittee Si ; na ure: �� % � ,c --
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.
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Plumbing Permit Application FOR OFr•IC'L USE ONIA
City of Tigard `I Re ... „Jr /
13125 SW Hall Blvd, Tigard, OR 9 r.�, V D°rcm a4 ,o(� ' x Permit No.; C , /I i ,0 Jr / '�
Phone: 503.639,4171 Fax: 503,59 e ; % i . • Plan Review
24- Hour Inspection Line: 503.639,41 q b` 20 i� .. ; � � I I D" 1'' _ � Permit No,;
Internet: tvww.ei,tigard.orms D M Dam Ready/By: , n
�� • Notified/Method: /t See Page 2 Coy
:11 .4,,,r,,:'',10 11, q „, x .� }_ r t ee Supplemental totarmatien
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Nt w , 11 }. ill. 1, t � , ;'v. rn .+ Si a. r;,, .r w , . , „,'- j�. ,: ",.. i ,1 ; :,1-' .!`;,',41',1.:::.::;;', � '= :'!"
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const ruction D • ' . . ,
BV Demolition For . eelst in ornratio„ use checklist
Description
Addition/altctation/replaccment ❑ Other v . Ea. Total
New 1- 2- family dwellings (inclWd
w rV. �.s, es 100 ft. for each utility
: ' :..•.,; ' i.i i!tG"00' .047,.V�4/ <. .;:ra:ri;� <,,j ��,, {:r2? utility connection)
�.'. ' ,. . •,:` '�;•� _,: � ;; ............ . , , .I.'� � +� t p!;,�,�y „,; r �... �:r!: SFR bath • - .... ,
�• ::. '•5`:a'; ?a; a;-, � � 24920
I- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath — 350.00 -
.0 Accessory building ❑ Multi - family SFR (3) bath 399.00
❑Nagler builder ❑ Other Each additional bath/kitchen • 45 00
”
,, ws,r °,;:rl ';,, :; r .:.' � Fire sprinkler ( sq. ft,) Page t
' } 'f' V ,%`'''!� ; 7'':i:�i40; L'.�il+l+,,p A�x..litit
�'it,:'S a ( "; l�fi.*:.Y �''� 'n J: % +;:}e, l �- ,+sue,
.. ...i vS •'���1.•v ^ :v_r .r:� .r',`•i`n� L-r � •..
^I i' f: ��� 91te utilities
� �A . . ..', j �.r . �. T., �r� •, Pt.Y•.iw st •
.Job site address: / 3 i
° IN ., a I ,.,- I��� UM Catch basin or area drain 16.60
•
City /State/ZIP; ,G• 0 a C O Drywell, leach line, or trench drain 16.60 -
Suite/bldg. C pt-- no.: Project name : Footin drain (no, linear ft.: ) — Page 2
Cross strcet/directions to job site: . _ Manufactured home utilities r l 10,00
Manholes 16.60 -
• CO A i i I • ' =MI Raiifdrain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no, linear R: __.) Page 2
Subdivision: • tI Lot no.: Water service (no: linear ft,r`• ' •' ' wifi ��
Tax map /parcel no,: r Fixture or item
I) FIB�ILiI'41�!FB' V{C6f' 1:. ; ,,
Absorption valve 16.60
1 `; : � Bacict]ow preventer Page 2
7 ' ki it t J I ,N'ygliga Backwater valve In 16.60
• Clothes washer 16.60 —
Dishwasher 16.60
•;.°2 .'P.'R'Or.B'R;X •Otil1?NIIR::. .. :, i , ..!;': D rinkm fountain
• -'• S
all 16,60
Name: I t ^� ' 6jcctors /sump 16.60
_ Expahsaien'tank 16.60
address: j, Cr Le 53 ' s w . i 1 viwp Q Fixture/sewer cap • 16.60
City/State/ZIP: (A i 0 t Floor. drain /floor sink/hub 16,60
Phone: (' DS to 6 I( paX; ( ) Garbage disposal • 16,60
y f' " •+:+:,. .i;f .I + ,.., :,,•` Hose bi
I`. iii`+ ; ;`� t l t- y•T:Vg4 • i '. S ,. I ?I;:•.,.. ;1'; ' ,. _ • ' 1' 7 1 :ui'• bib 16,60
,., � " —,• ., .. .. •. I �Y1! ",���F1'lr= •IGF.!�I��li j ),
Ice mak • 16.60
Business name: WOLCOTT PLUMBING dba JACK ROWK PLUMBING ArA , mi ',r / greas e trap 16.60
' Contact name: Y '4 .
'� ) yUY Medical gag. (value:, $ ) Pa e 2
�1 t;
Address: r �7�( C� Primer ��� 16.60
City /StateJ'" O/�,� =— te r De cif? 2LL/ . Roof drain (commercial) . W 16,60
r Phone: 503 235 -8784 • Sink/basin /lavatory • / 16.60
( ) Fax: (503) 491 -2932 ., /
E -mail: Tub /shower /shower pan 4/ Iwt( i 16,60 .
s :;�� -, � I 16.60
:, ;..:.. ' ` ' . ' 1.,:i.1‘..-•::'::;:'.:.
: Water i.� �Ol 16,60 •
Business name: WOLCOTT PLUMBING dba JACK FIOWIC PLUMBING , rock Water h . t��� 16.60 �
v x 20(9 9� - � -
'� 0 �� "1:40.4-
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Address:
i. , . City /Si -- Pbe f,A fro o • ' -I / L � , in {mum permit fee $72.30 .. t
Phone: (503) 235 -8784 Fax: (503) 491 -2932 illbliWG,ii .w ,r ' , ' um F - -
CCB.I:.ic.: 23847 4 • Plilmbing Lic. no.; 26..208 113' • Plan review (25 °'n of permit fee) :
Authorized signature: • T/ State surcharge (8% of permit fee
.f
� . 4 .4 , TOTAL PERMIT FEE i re , '
Print name: � suL4 A A • h,.) G Date: 10 /� This permit application expires if a permit is not obtained '� rlt '' ''
W 180 days after it has been accepted as complete:
. '
Itie
*Foe methodology act by Tri- County Building Industry Service Board.
I:l aullding TermirrlPLM.PcrmitAp,d ocom • 440-0616T(1 /D2/COMN/an)
CITY OF TIGARD
BUILDING DIVISION r 4 PERMIT #: PLM2006.00615
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/26/2006
Phone: (503) 639 -4171 �e P,�1l
Inspection Requests (24 Hrs.): (503) 639 -4175 ... _..�
INSPECTION WORKSHEET FOR DATE: 10/3012006 TIME: 7:05AM PAGE: 26
SITE ADDRESS: 16633 SW RIVERWOOD PL CLASS OF WORK:
SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 068 TYPE OF USE:
PROJECT NAME: BREEN
DESCRIPTION: Replace 70' of water service.
OWNER: BREEN, KEVIN PHONE #: 503 - 869-4726
CONTRACTOR: WOLCOTF PLUMBING CONTRACTORS PHONE #: 503-235-87t34
Inspection Request Scheduled For: Date: 10/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 039000-01 503-235 -8784 Y
Corrections /Comments /Instructions:
/
d , /. .
—
rp.--
ui,A, /
,.? 4Ass ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Ill / Date v U Phone #: (503) 718 - "