Loading...
Permit CITY � A- DEVELOPMENT SERVICES 4 V 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PLUMBING PERMIT PERMIT #.......: PLM96-0225 DATE ISSUED: 10/15/96 PARCEL: 1S135AB-00100 SITE ADDRESS...: 10255 SW 90TH AVE SUBDIVISION....: TOWN OF METZGER ' ZONING: R-4.5 BLOCK..........: LOT.............:5 CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE. . . . :ED WASHING MACH.. . ��.: , 0' BACKFLOW PREVNTRS. . : 0 OCCUPANCY GRP..:E1 FLOOR DRAINS....: 0 ' TRAPS ^ 0 STORIES........: 0 WATER HEATERS.....: 1 CATCH BASINS.......: 0 FIXTURES LAUNDRY TRAYS - 0 SF RAIN DRAINS.....: 0 . . . .'. . : ' 0. '' GREASE TRAPS.......: 0 LAVATORIES ^ 0 OTHER FIXTURES....: 0 TUB/SHOWERS : 0 SEWER LINE (ft)...: 0 ' WATER CLOSETS..: 0 WATER LINE (ft)...: 0 DISHWASHERS....: 0 • RAIN DRAIN' (ft)'. .'. : 0 Remarks: Installing water heater Owner: --- — , FEES ------- TIGARD—TUALATIN SCHOOL DIST type amount by date recpt 23J ' PRMT $ 25.00 JMH 10/15/96 96-285182 13137 SW PACIFIC HWY 5PCT $ 1.25 JMH 10/15/96 96-285182 TIGARD OR 97223 Phone #: 620-1620 Contractor: — ^ CONTRACTOR NOT ON FILE Phone #: $ 26.25 TOTAL Reg #..: REQUIRED INSPECTIONS -- This permit is issued subject to the regulations contained in the Rough—in Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM/Underfloor applicable laws. All work will be done in accordance with Top—out Insp approved plans. This permit will expire if work is not started' ' Final Inspection within 180 days of issuance, or if work is suspended for more than 18N days. • -- --- I Permittee Signature: ^-----� . . ` v � f Issued By: x �~� ' -4. A - 4 Call for inspection.— 639-4175 . . iI iS - r - 10 City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # 13125 SW,-call Blvd. Permit # L _ 10- 922 Tigard, 'OR 97223 (o -03715 (503) 639 -4171 MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE Name of Development New Single Family Residences Only p ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00 Job i O Z c� c) 5 4� !O A@, ❑ 3 BATH HOUSE $225.00 ■ Address cit /stele zip Fee includes all plumbing fixtures in the dwelling and the first 100 feet I l q rx t (( C) , z of water service, sanitary sewer and storm sewer. See fees below. Namelokname of Bon ,e FIXTURES QTY PRICE AMT - riot n.Y ( 5 it 4 Z3 3- Sink 9.00 Marling Padres, Phone Lavatory 9.00 Owner 13 1 3 7 co c „.e. i C A (,, zo _ 1 15747 Tub or Tub /Shower Comb. 9.00 Gty /state za Shower Only 9.00 - 5Tar - di 0 9 7 ZZ3 Water Closet 9.00 Name rattlame of business) Dishwasher 9.00 Garbage Disposal 9.00 Occupant Mailing Address Phone Washing Machine 9.00 Floor Drain 9.00 cty /State ZIP Water Heater I 9.00 6f, 00 Laundry Room Tray 9.00 Name r Urinal 9,00 i�1^- v∎ --So- OE\ w IS '--1,&..Q J-r�Q . Other Fixtures (Specify) 9.00 7n g Address Pn 9.00 Contractor l � I (o 4 -8Y2 Z 17 ©l, SE a-w`terma 4-iniA.Rf a J 9.00 C ty /State ZiP 9.00 f-i. h_4`)( v4) L P . r) R r7ZZZ Sewer 1st 100' 30.00 State Regotratien No. City Bus. Tax No. Sewer - ea. Addit. 100' 25.00 L 53 2.0 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 Device or Anti - Pollution Device 9.00 Signs a 4 e m agent) ) Any Trap or Waste Not .. r ( � ( 20 '71Z:7-19.6 Connected to a Fixture 9.00 Describe work new 0 addition 0 alteration es repair 0 Catch Basin 9.00 to be done residential 0 non - residential jigs Insp. of Exist. Plumbing 40.00/hr Specially Requested Inspections 40.00 /hr Existing use of building or property 5Q If(( Rain Drain, single family dwelling 30.00 Residential backflow prevention devices 15.00 Proposed use of Can � / building or property 5 0 L 1 '(Except residential backflow prevention devices) NOTICE *Minimum Fee $25.00 SUBTOTAL Q 5 OO> PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE I. ,3r. - CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25% OF SUBTOTAL COMMENCED. /// TOTAL 4'- Special Conditions • Date<issr I /a3k0' by gL - • 5/12/99 Activities for Case #: PLM96- 0 9:47:39 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes PLMC003 Application received 7/31/96 7/31/96 MRS 12/18/96 PLMC005 Permit Created 7/31/96 7/31/96 BON 7/31/96 PLMCO50 (F) Ready to issue 8/1/96 B PASS • BON 8/1/96 PLMC067 Issue plumbing signature form 10/15/96 JMH PASS DST 10/15/96 PLMC060 (F) Issue permit 10/15/96 JMH PASS DST 10/15/96 PLMC800 Case Finaled 12/18/96 MS PASS MRS 12/18/96 • • • Page 1 of 1