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Permit ' PLUMBING PERMIT Cl1Y OF � PERMIT #....... : PLM96-0269 DATE ISSUED: 09/12/96 ' COMMUNITY DEVELOPMENT DEPARTMENT 1u1uoew Hall Blvd. Tigard, Oregon o72u°m1wm (503) 639-4171 PARCEL: 28113AD SITE ADDRESS...: 16920 SW 72ND AVE SUBDIVISION....: ROSEWOOD ACRE TRACTS ZONING: C—G BLOCK ^ LOT..... ...... ..:30 _ CLASS OF WORK..:NEW GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE :COM WASHING MACH......: 0 BACKFLOW PREVNTRS..: 1 OCCUPANCY GRP..:B FLOOR 0 TRAPS..............: 0 STORIES........: 0 WATER HEATERS ^ 0 CATCH BASINS ^ 0 FIXTURES — LAUNDRY TRAYS : 0 SF RAIN DRAINS ^ 0 SINKS ^ 0 URINALS ^ 0 GREASE TRAPS ^ 0 LAVATORIES ^ 0 OTHER FIXTURES ^ 0 TUB/SHOWERS : SEWER LINE (ft ) ...: 0 WATER CLOSETS..: 0 WATER LINE (ft)...: 0 DISHWASHERS....: 0 RAIN DRAIN (ft)...: 40 Remarks: LIMTED SITE PERMIT: Grading ONLY on private only. No site utilities allowed. 1 Owner: — FEES BINGHAM PROPERTIES ' type amount by date recpt 3939 NW ST HELENS RD PRMT $ 25.00 TAT 09/12/96 96-283896 5PCT $ 1.25 TAT 09/12/96 96-283896 PORTLAND OR 97229 Phone #: 224-2676 Contract or: , DENNIS' 7 DEES LANDSCAPING 7355 SW JOHNSON CREEK BLVD • PORTLAND OR 97208-9328 — Phone #: 503-777-7777 $ 26.25 TOTAL Reg #..: 5009 REQUIRED INSPECTIONS ------- This pernit is issued subject to the regulations contained in the RP/Backflow Prev Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection applicable laws. All work will be done in accordance with _ approved plans. This pereit will expire if work is not started within 180 days of issuance, or if work is suspended for more _ than 180 days. • Permittee Signature: - — — Issued By: _ _ ______ _ ____ Call for inspection — 639-4175 --y City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # ' 13125 SW Hall Blvd. • Permit # PLIVt` -0,R 6q Tigard, OR 97223 SI rt6 - G0o7 (503) 639 -4171 MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE r I l r a» + /' 0 1 � J - New Single Family Residences Only .0 lam(' Y c ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE 3195.00 Job S I&) 1 2 ❑ 3 BATH HOUSE 3225.00 Address u vsn.. n Fee includes all plumbing fixtures in the dwelling and the first 100 feet 1 lGO J ; l � 77.7 t4 of water service, sanitary sewer and storm sewer. See fees below. I Nom (ot. an oo (itio / ( , " FIXTURES QTY PRICE AMT ,faP Ia.Y' n I . �l i rfre(? Sink 9.00 :FiC M.snp Aae« w'°"' Lavatory 9.00 • Owner I r 11 ��� �� • . � � � �i e • • -2-40-u4 Tub or Tub/Shower Comb. 9.00 Shower Only 9.00 T0 r�, n 27 Water Closet - 9.00 "'om r°' mow e ' °i°° ", t / �/7 ' ' Dishwasher 9.00 Occupant _ i "' 1w t Ce Garbage Disposal 9.00 "'"'p A°° Washing Machine 9.00 / 7 2-0 (SW 7 2-D-4 Floor Drain 9.00 m _ Water Heater 9.00 l2 Lk '/, 0 R g7zz,4-1 Laundry Room Tray - 9.00 Urinal 9.00 • 1Ir vi }1,i, c ) % 7Y LANAI(' 0/116 Other Fixtures (Specify) 9.00 roam . ess R+i° 9.00 Contractor 1 - I -Th 7 1 � F)r� nF� Jioh ncnvl Lyk . el vd 9.00 °"'t'" , 9.00 - PO K+Alil ] , OR g 7 / JJ ^ Sewer 1st 100' 30.00 state Rspiitro1an No. °t' Bo. Tot "' Sewer - ea. Addit 100' 25.00 5 1)9 (51,16 -1 Water Service 1st 100' 30.00 I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00 information given is correct, that 1 am the owner or authorized agent of the owner, that plans submitted are in compliance with State laws, that Storm & Rain Drain lst 100' 30.00 1 am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit. 100' 25.00 number given Is correct. (If exempt from State registration, please give reason below.) Mobile Home Space 25.00 Back Flow Prevention •�4 ���( � ,( %L/ L// 1U �� Device or Anti-Pollution Device , 9.00 �- 5 ipi'o`° (*.sou ° "p° °"° Any Trap or Waste Not Connected to a Fixture • 9.00 Describe work new` addition 0 alteration. 0 repair 0 Catch Basin 9.00 to be done residential 0 non - residential 0 Insp. of Exist. Plumbing 40.00/hr Specially Requested Inspections 40.00/hr Existing use of building or property Rain Drain, single family dwelling 30.00 Residential backflow prevention devices 15.00 Proposed use of building or property '(Except residential backtlow prevention devices) NOTICE *Minimum Fee 325.00 SUBTOTAL. R J/j4L 5- PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE 77ii - r J 1, � CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED r f7 FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PLAN REVIEW 25% OF SUBTOTAL TOTAL 0 91 Special Conditions Date issued by