Permit A CITY OFTIGAR
PERM LUMMBING PERMIT
• PLM97 -0457
,p DEVELOPMENT SERVICES DATE ISSUED: 11/17/97
AL ''1L 13125 SW Half BNd., Trend, OR 97223 (503)63941n
PARCEL: 2S104CB -01300
SITE ADDRESS...: 13179 SW ASCENSION DR
SUBDIVISION • HILLSHIRE WOODS ZONING: R -7 PD
BLOCK LOT •029 JURISDICTION: TIG
CLASS OF WORK..:ADD GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE.... :SF WASHING MACH......: 0 BACKFLOW PREVNTRS..: 1
OCCUPANCY GRP..:R3 FLOOR DRAINS • 0 TRAPS • 0
STORIES • 0 WATER HEATERS • 0 CATCH BASINS • 121
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0
SINKS • 0 URINALS • 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; Add residential backflow prevention device to an existing single family
dwelling.
Owner: FEES
WINDWOOD HOMES INC type amount by date recpt
14076 SW BENCHVIEW TERR PRMT $ 15.00 GEO 11/17/97 97- 300988
TIGARD OR 97224 SPCT $ 0.75 GEO 11/17/97 97- 300988
Phone #:
Contractor
CEDAR LANDSCAPE
14375 SW PATRICIA AVE
HILLSBORO OR 97123
Phone #: 503 -628 -3411 $ 15.75 TOTAL
Reg #..: 000058
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Misc. Inspect ion
Tigard Municipal Code, State of Ore. Specialty Codes and all other RP /Backflow Prey
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for lore
than 1:` days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-8011 -0010 through OAR 952-0001-0000. You say
obtain copies of these rules or direct questions to OUNC by calling
(503)215 -1987.
Issued By _ _ Per - mittee Signature),‘ 0 GV'�^ —
Call 639 - 4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
=ITY OF TIGARD Plumbing Application weer
2125. SW WALL BLVD. Commercial and Residential Owe Rafe
•1GARD, OR 97223 oa. to P.E.
'03) 639 -4171 Ogle to
eau• .'L F .. 5
Print or Type Rend SwR,
Incomplete or illegible applications will not be accepted cared
Naas 1f ./F ^ . 1 . L� r t 7
Job I�.//JZ, ny�- Woods - .
Address soul Address shmM ■
1 317,' s lo/,4sca�,Siat: at. I or T .
e'dg ® a Only shower 9.90
Name I 7 ?IRA CV. g 7223 Witte Closet
Oleheasher 1• w5 rood u .Ie..I 998
Owner Mein Address
Gee Memel 900
Westing Medina a 9.0
CawSlele 210 Peons Floor Orern r r o
Mime Y " ago
Occupant Main, Aloe." - Seals Wager ester 9.00
C>ty>Seree Ill Phone Laard!y Room Tray 9.00
Urine 9.00
Name
Cam Fbdlaer ) 00
CebArZ LA Sib Sc.t • zdc. 0.90
Contractor Mo+w Ached Smite 9.00
tPrlo► b tgealrge /`!3 to S � PI►>'R Ale 9.011 aopreere must *Mato pll 97/23 6 2 1 - if N Phone
stems. of Oregon Coret. Coro. Bomb roes Exp. Oate ago
cenesaos 5 6 -- 54' 0.00
Imam tifa mh Punt/ft Uc • S Exp. Oats Sheer - to 100• 10.00
AZ/ 1 $" b - Y•) saw • seen edataw 100' 29.00
tor COT COT the r ass Tax or metro* . Exp. Date Pastor Sen ioa -1st 107
30 .00
fame We sr service - each adtrtonel 207 25.00
Architect Sloan a Rain brain -1st 107 •30.00
or Meing Mimes Shale Sloan i Rain ()rein - each add9bna 107. 25.00
Mobile Home Spam *00 '
Engineer Phone CCuinm moist w
fl Pwmo n Osvim An
or t. 23.00
. Oesahbs wort New 0 Addition 0 meridian 0 Repair 0 Reg4erMtal Beddow Prevention Onace' 15.00 /-42..
, se ran. Redeemed 0 No .r aide,mb 0 My Trap or Waste Not Connected to a Patin 9.00
macaw daoipeon of work Catch Basin 9.00
. of Existing Pbenbing 40.00
P
-mane use of d 40.00
Adding or OAPfay Rein Omar. single roily dealing 30.00
3 m.poad use of Grosse Traps 9.00
suiting or property
QUANTITY TOTAL s f ° : �i
are you • moving o r re p t s a n g any taunts? Yes ❑ No o bomeao et me Imam n s wise a ane" Tots is 2 f •ti vi i iR': .
b yes a* back of lone) 'SUBTOTAL : a .,
swum adrnoeleog. Memos hens read this applkalon. that the a foimabon !74.,.. _ ' ?r J
,nee is comsat. that 1 an the Aimee or authodaed agent of Me owner. and 5% SURCHARGE ;.: •-;
PUS Awe submitted ti m m
e in moaoe with Oregon Stare Laws.
' eu -
PLAN REVIEW 25% Oft SUBTOTAL
` '� Cate Reea0 eamy r Mao a s. hoer is 2 f
` /u .. -e-- 44-h i //-/7- 97 TOTAL - . , - , '
• aateet Person Items Phone 41--r
'Aentnham panel teas 525 • 5% starJhamoe. except RaaderrW e.awow -
v 4 " )/ktre LtJa ct 70.3 - .2S PsrmallOn Orrice. which is $15.5% surcharge
1411napp.doc 12/96 (dst)
'LEASE COMPLETE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced Qty
Sink
Lavatory ----
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 28
3'
d'
Water Heater •
Laundry Room Tray
Urinal
Other Factures (Specify)
'OMMENTS REGARDING ABOVE:
l.•\pimapp.doc 12196 (dst)
St, ,
5-2-11
063q/ A 11/1(141 .
a CITY OF TIGARD BUILDING INSPECTION DIVISION
1 24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
, i 1
Date Requested: 5--.1-5?-78 • AM. P.M. ' MST: e f 7-nist/
Location: 1 3 1 " 7 q 41A) alCiAtidarK) BUP:
Tenant: Suite: Bldg: MEC:
Contractor:
hi $ i / i ' Phone: 750- 4375 PuP1-2=47
Owner: Phone: ELC:
La Ck...e10)( : Gr L ID ELRq 7-1)3,11,
4(20;S srt
BUILDING (kan'f) PLUMBING CHANICAL ELECTRICAL • SITE
Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm •
Footing Roof UndFl/Sffiti Rough-In Ceiling Water Line
Slab Framing Top Out 0,./ Gas Line Rough-In UG Sprinkler
Foundas:so hunt Won Sewtral— 6fr/ H Hood/Duct Reconnect Vault
Bsmt Damp Dryv all Storm Fwnace Temp Service MISC. •
Masonry Ceilil Rain Drain A/C UG Slab
Sheaf:Sheath Fire SpkIr/Alm Crawl/Found Dr Heat Pump . Low Volt
—.......
• PFrav - • Approved .1.- . . ■ - 4
" , 1101
A9rfr/SdwIk Not .1 ...4 ved 1 '' .I..!:. ., -, ved ' i A i ., . .ed ofsr- • Approved
1111LUALL,' LillaTr..a....L 6 La% ' , F I 0 G.- ' I AL
it ra WNW P Mftrire A a sm. ' ,
IMMEllik II e i I - ,
!JIM_ — ....VIIAINIW-_.! .-.._ 4 - ' '
IIIIIIIIMMIli I I I l l II li /
'44411111111. .
. ,
. .
, .
O Call for reinspection b Remspection fee o($ required before next inspection 0 Unable to inspect
Inspector 4. /1"/ , Date: ,5 ":-.. 7 --7 ' 9
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