Permit __ ____ ___ _—
PLUMBING PERMIT w'
PERMIT #.......: PLM96-0051
DATE ISSUED: 06/24/96
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COMMUNITY DEVELOPMENT DEPARTMENT
PARCEL: 2S102CB-00100
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SIT� ADDRESS...: ' GRAY �/
SUBDIVISION ^ N IGARDVILLE ADDITION ZONING: R-12
. BLOCK..........: LOT....... ...... :41 �
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE....:ED WASHING MACH ~ 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:B2 FLOOR DRAINS......: 0 TRAPS ^ 7
STORIES ^ 0 WATER HEATERS.....: 0 CATCH BASINS.......: 0
FIXTURES --- LAUNDRY TRAYS.....: 0 SF RAIN DRAINS.....: 0
SINKS ^ 0 URINALS : 0 GREASE TRAPS.......: 0
LAVATORIES.....: 8 OTHER FIXTURES. ... : 0
TUB/SHOWERS ^ 0 SEWER LINE (ft )...: 0
WATER CLOSETS..: 9 WATER LINE (ft)... : 0
DISHWASHERS ^ 0 RAIN DRAIN (ft)...: 0
Remarks: Interior tenant improvement
Owner: --- ----- — FEES --------------
TIGARD TUALATIN SCHOOL DIST. type amount by date recpt
13137 SW PACIFIC HWY. PRMT $ 216.00 B 06/24/96 96-280934
PLCK $ 54.00 B 06/24/96 96-280934
TIGARD OR 97223 5PCT $ 10.80 B 06/24/96 96-280934
Phone #: 503-620-1620
Contractor: -- THERMAL MECHANICAL INC
4548 N ALBINA
PORTLAND OR 97217 —
Phone #: $ 280.80 TOTAL
Reg #..: 065429
------- REQUIRED INSPECTIONS
This peroit is issued subject to the regulations contained in the Rough—in Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Rough—in Insp
applicable laws. All work will be done in accordance with , Misc. Inspect ion
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 180 days.
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Permittee Signature: ~"�� ___ _ ____ ____
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Issued By: _ __� _
Call for inspection — 639-4175
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Tv M (V/ 3 ce llo ! :c? , w - ` , .-f t rC cA a ` ,)-0 - i &
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # 3 t 5 Z.C..
_ 13125 SW Hall Blvd. Permit # t°L -1 ' b _00 I
Tigard, OR 97223 iP Mfr- Ito - - i71 i
(503) 639 -4171
j MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
( ,V i of Oevs1opn" - New-Single Fam • Residences Only
/ , 6 0 '61)
" / /(: - 4Aes.7 P-Y 4 loot.
Pddt°aa 0 1 BATH HOU M SE $140:00 .-, ci.2 BATH HOUSE $195:00
ob 4 � 7 47 - - . O 3 BATH HOUSE $225:00 • '
Address c yisIote ZIP Fee includes all plumbing fixtures in the dwelling and the ,first 100 feet
/ 6..11 / C3' '97z2 of water service, sanitary sewer and storm sewer. 'See fees below.
Noma (m name of Busnes0 FIXTURES_ ' ' QTY PRICE, AMT
I/e 4a,- /0',12-t..4 2G7' J Sink ' • 9:00
Waling Address Lavatory 4 - ••, 9.00 '1 2..:-- "
Owner / f 3" 74 .W, ,h Tub.'er Tub/Shower Comb. `9.00
Qty/State Z9 Shower -Only - 9 . 0 0 _
72‘ ,621L g j7 / 2 1 Z Water Closet` q - '9.00 . / \
Noma (or name of bow..,) Dishwasher - .9.00 `
Garbage `Disposal. 9.00 -
Occupant Mang Addres.
Phone
Washing• Machine - 9.00
- • Floor Drain . , 9.00 '
Ot'' /State Z9 Water Neater - 9 :00
Laundry Room Tray - 9.00 '
Nam �� 7 Urinal - 9.00
W lA� Other F 'atures CSpecif�i) 9.00 ' ,
Mang Address Pb a . .
Contractor / / � f 9•�
���y '9:00
Gty,Stale Za,
�`�.,, 9:00•
,T'Y� N 4 1 A - 4 - , - A _ / 2 1 - 4 4 , . O 4 1 17217 Sewer 1st 100', , _ - `.. , .:1"30.00 .
State n� Rep �' frobon No °" eia Tao " Sewer - ea.' Addit_ 100' _ _ 25.00
aa.S1Z i Water Service 1st 100' - .. - - 3000
I hereby acknowledge that I have read this application, that the - •
Water Service ea: A " 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' Y =' 30.00
I am registered with the Construction Contractor's Board, that the „ . '
number given is correct. (If exempt from State registration, please Storrs & Ra1n ,Orals Adtl t 100' 25.00
give reason below.) MObit@ Home_Space' =25:00
Back Flak Prevention
1
// _ .bevice , or'Anti- Pollution Device 9.00 Ste, to (awes o< a nt) a My Trap or Waste Net
Connected to a Fixture 1 9.00 63
Describe work new 0 addition 0 alteration O repair 2/ Catch Basin 9.00
to be done residential 0 non - residential 12J Insp. of Plumbing 40.00/hr
Existing use of Specially Requested ,Inspections 40.00/hr
building or property f-4671 6,,,ti Rain Drain, single dwelling 30.00
Residential backfiow `prevention
devices 15.00
Proposed use of
building or property ci - - -
•(Except• residential backtlow
prevention devices)
NOTICE 'Minimum Fee 525.00 SUBTOTAL !! AA C
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE IQ 6
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED -- _ ,
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. rl CAI PLAN REVIEW 25% OF SUBTOTAL 5 V
m fr-v €. k 1 5*-& .Q- t. isti1- 5 s Ill 0 x '
NI 2 :t t
'j u.j.C. ' - utnird.. _ _ TOTAL r
Special Conditions --
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Date issued by -