Permit - I1YOFTIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 9722368199 (503) 639-4171
PLUMBING PERMIT
PERMIT # : PLM94-0256
639-4171 DATE ISSUED: 11/28/94
PARCEL: 2S111BD-01400
SITE ADDRESS...: 14985 SW 98TH AVE
SUBDIVISION ^ ALDERBROOK FARM ZONING: R-3.5
BLOCK..........: LOT.............:6
_
CLASS OF WORK..:NEW GARBAGE DISPOSALS..: MOBILE HOME SPACES.:
TYPE OF USE....:SF WASHING MACH.......: BACKFLOW PREVNTRS..:
OCCUPANCY GRP.. :R3 FLOOR DRAINS.... ... : TRAPS.... ...... ...
STORIES........: 1 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 (ft),.. . :100
DISHWASHERS ^ RAIN DRAIN (ft)....:
Remarks: INSTALLING WATER SERVICES AND STORM LINE RAIN DRAINS
Owner: --- — FEES -----
CINDY LEITNER type amount by date recpt
14985 SW 98TH AVE PRMT $ 25.00 BLT 11/22/94 .
'SPOT $ 1.25 BLT 11/22/94 .
TIGARD OR 97224
Phone #: •
Contractor: -- —
OWNER
Phone #: $ 26.25 TOTAL
Reg #..: --
REQU IRED INSPECTIONS
This permit is issued subject to the regulations contained in the Top—out Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance with Water Line Insp __
approved plans. This permit will expire if work is not started _
within 180 days of issuance, or if work is suspended for nore
than 180 days. _
Permittee Signature:
Issued By:
• Call for inspection — 639-4175
•
•
INSPECTION NOTICE
City of Tigard Building
13125 SW Hall Blvd. Tigard, Oregon 972
Inspection Line (R7,- • •ne): 639. Business Phone: 639 -4171
Inspection: ` ._ �4.1*
Footing . Und Mech. Rough -in Appr /Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post /Beam Struct. San. Sewer Framing -Bldg.
Post /Beam Mech. Rain Drain Insulation - Plumb.
Plbg. Underfloor at er / L Gyp. Bd. -Mech.
Date Requested: /1( /i / 7 Time: AM PM
Address: / '7 9 q / l) V Permit #:-/7? 94 .0 2
6. 9- tS/ 7
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Aar
Inspector: . � - Date: (// g/ -
J
= 'OVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
City d iTigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit # rim q4- U LS G
Tigard, OR 97223
(503) 639 -4171 ; .,V
U MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name of Development New Single Family Residences Only
Address ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job I w ❑ 3 BATH HOUSE $225.00
Address cnyrstate ZIP Fee includes all plumbing fixtures in the dwelling and the first 100 feet
of water service, sanitary sewer and storm sewer. See fees below.
Name (or name of Business) FIXTURES QTY PRICE AMT
CA 4u Lei T der Sink 9.00
Mang Address / Phone Lavatory 9.00
Owner I Li 4 q C S W 8 Tub or Tub /Shower Comb. 9.00
City /State Z Shower Only 9.00
I ( 4 °g ° 22 " I Water Closet 9.00
Name (or name of business) Dishwasher 9.00
.€_-- 4:07\re.- Garbage Disposal 9.00
Occupant Main9 Addre,s Phone Washing Machine 9.00
Floor Drain 9.00
City/State ZIP Water Heater 9.00
Laundry Room Tray 9.00
Name Urinal 9.00
Other Fixtures (Specify) 9.00
Mailing Address Phone 9.00
Contractor
9.00
City /State rw 9.00
Sewer 1st 100' 30.00
State Registration No. City Bu,. T No. Sewer - ea. Addit. 100' 25.00
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 I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm & Rain Drain 1st 100' 30.00
I 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
C ,, (af it- 2 Z -IV Device or Anti - Pollution Device 9.00
Signature (owner or agent) ( Date Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new 0 addition 0 alteration 0 repairAC Catch Basin 9.00
to be done residential GI 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 backflow
prevention devices)
NOTICE `Minimum Fee $2 00 UBTOTA��
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 1l
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF ��4� C 5% SURCHARGE J
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL '�r-
Special Conditions _
� ^ l.�
Date issued by `` / / / /,,JJ