Permit PLUMBING PERMIT /*/
PERMIT #.......: PLM96-0072
' ^
CITY OF TIGARD DATE ISSUED: 05/14/96
COMMUNITY DEVELOPMENT DEPARTMENT
1o1osmw Hall Blvd. Tigard, Oregon er22o°o1mo (503) 639-4171 PARCEL: 25114AB-10900
SITE ADDRESS...: 16142 SW 93RD AVE
SUBDIVISION....: KNEELAND ESTATES NO.2 ZONING: R-4.5
BLOCK..........: LOT ~138
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CLASS OF WORK..:ADD GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 .
TYPE OF USE -SF WASHING MACH......: 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:A1 FLOOR DRAINS ^ 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 ^ 1
TUB/SHOWERS....: 0 SEWER LINE (ft)...: 0
WATER CLOSETS..: 0 WATER LINE (ft)...: 0
DISHWASHERS....: 0 RAIN DRAIN (ft)...: 0 4 60. 4 „
Remarks: PLUMBING FOR FURNACE/AC to 100K BTU, Air hand to 10,0� CFM, an
°��
gas piping to four outlets. ~~
Owner: — FEES —
RUSS,JANET BEARDSKY type amount by date recpt
16142 SW 93RD AVE PRMT $ 25.00 JMH 05/14/96 96-279403
5PCT $ 1.25 JMH 05/14/96 96-279403
TIGARD OR 97223 •
Phone #:
Contractor:
CLIMATE CONTROL HEATING & A/C
3315 NW 26TH AVE
PORTLAND OR 97210 — • ----
Phone #: 503-233-4393 $ 26.25 TOTAL
Reg #..: 62196
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line
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 permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
- than 180 days. •
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Permittee Signature:
~
Issued By: ^^ �'' �� `^/'� s
� Call for inspection — 639-4175
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04/05/96 14:50 23` 503 684 7297 CITY OF TIGARD 0 002/002
City Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # 7LAk9 007,7-'
13125 SW Hall Blvd. Permit #
Tigard, OR 97223
r; 0
(503) 639 -4171 ^
' \ MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
a o ,...,,... New Single Family Residence Only
i A A. , l ' L 1 G
JOb I! Z S Iv q r 11 .
' ❑ 1 BATH HOUSE $140.00 p 2 BATH HOUSE $195.00
0 3 BATH HOUSE S2?5.00
Address m plumbing includes all pbing fixtures in the dwelling and the first 100 feet
-- 11 ,t r/� , I � of water service, sanitary sewer and storm sewer. See tees below.
.a.. (or ?Om c v.wir...l ' FIXTURES • CITY PRICE AMT
`~J Sink ' 9.00
6-49M-- Lavatory 9.00
Owner
Tub or Tub/Shower Comb. 9.00 ..r
aver. a o Shower Only 9
Water Closet 9.00
- - - Penn (4.......1 enrols) Dishwasher 9
-
Garbage Disposal 9.00
Occupant , ROMP Washing Machine 9.00
i
Saar Drain 9.00
worm ra Water Heater 9.00 CI „ a)
Laundry Roam Tray 9.00
Urinal 9.00
'' (' g:A
al Other Factures (Specify) 9.00
9.00
Contractor 1�� law 2 9.00
'- 9.00
arril.i or «r D Sewer let 100' 30.00
env Tn err. Sewer • ea. AdOlt 100' 25.00
l Q 2.101 I f J LI t9 Water Service 1st 100' d�t T i 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Ad 200 25.00
information given is correct that I am the owner or authorized agent of Storm & Rain Drain tst 100' 30.00
the owner, that plans submitted are in compliance with State laws, that
I am registered with the Construction Contractor's Board, that the Storm 8 Rain Drain Addy 100' 25.00
number given is CoreCt (If exempt from State registration, please Mobile Home Space , 25.00
give reason below.) co Bad( Flow prevention
e (1 ye� Device or Anti - Pollution Device 9.00
aoo.
o. t d
�� x " Any Trap or Waste Not
�= Connected to a Fixture 9.00
P' -'1 9.00
Describe work r1=`• `►: -damn (S akerati Q r epair O Caten Basin
to be done reside 4al .t non - residential 0 Insp. of Exist Plumbing 40.00rhrr
Specially Requested Inspections 40.00Ihr
Existing use of Rain Drain, single family dwelling 30.00
building or property
Residential backflow prevention
devices 15.00
Proposed use of
building or property , .
'(Except residential bacMlow
prevention devices) .
,,,.
NOTICE 'Minimum Fee $25.00 SUBTOTAL 2s,
PERMITS BECOME. VOID IF WORK OR CONSTRUCTION 5% SURCHARGE •••.. r
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS. OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS pL}iN REVIEYV 25% OF SUBTOTAL .
COMMENCED.
TOTAL • (y,,
Special Conditions /iV / i r(i pii------- Date issued by i..
_
5/1/00 Activities for Case #: PLM96- 00072
1:55:24 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA007 Application received J *H 4/10/96
PLMA799 Final Inspection J *H 4/10/96
PLMA057 Issue plumbing signature form 4110/96 JMH PAID J *H 4/10/96
PLMA743 Gas Line 4/10/96 JMH J *H 4/10/96
PLMA050 (F) Issue permit 5/14/96 JMH PAID J *H 5/14/96
PLMA740 Misc. Inspection 2/18/00 2/18/00 2/18/00 JMT DONE No Hold JMT 2/18/00 research inspection request
PLMA850 Expired by limitation 3/21/00 HAP DONE No Hold AKJ 3/21/00
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