Permit , , A
CITY OF TIGARD
„,,„, ,„, A DEVELOPMENT SERVICES PLUMBING PERMIT
4"" l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE I ISSUED: 04/15/98 8 -0098
PARCEL: 2S103CA -01800
SITE ADDRESS...: 13470 SW HOWARD ST
SUBDIVISION....: WOODCREST ZONING: R -4.5
BLOCK..........: LOT :003 JURISDICTION° U�RB l
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -SF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 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 ° 0
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 50
DISHWASHERS ° 0 RAIN DRAIN (ft)...: 0
Remarks: Installing 50' of water service
Owner: FEES
TONY TUCKER type amount by date recpt
13470 SW HOWARD DR PRMT $ 30.00 B 04/15/98 98- 304965
TIGARD OR 97223 5PCT $ 1.50 B 04/15/98 98- 304965
Phone #:
Contractor
CHRIST PLUMBING
23172 SW STAFFORD RD.
TUALATIN OR 97062
Phone #: 503- 638 -8231 $ 31. TOTAL
Re g #..: 000426
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Service I n
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final I n s pe ct i o n
applicable laws. All work will be done in accordance with
approved plans. This peruit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952- ma1 -0010 through OAR 952 -8801 -0080. You lay
obtain copies of these rules or direct questions to DUNE by calling
(503)246 -1987.
Issued B y:,. �� Perm i t t e e Si gnat um e- - /II * 6' 4 '-
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Application Rec'd By !
3125 SW HALL BLVD. Commercial and Residential Date Recd tt
TIGARD, OR 97223 Date to P.E.
6394171 Date it DST
503)
Permit # 1- , ` 1$ " ,,e
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project On back Indicate Work Performed by fixture.
Job ..FIXTURES ;(Individual) , q ,:p PRICE •_AMT -„
Address Street Address I Suite Sink 9.00
I 1 3 y 3 70 0' 1-Jdwccrol n v- Lavatory 9.00
1 Bldg # City /State
,1 .0c,,re0 u Zip 9 ?,-2- Tub or Tub /Shower Comb. 9.00
�
I Name Shower Only 9.00
{ �o-ro c.r --re-cc 14 t v - Water Closet 9.00
Owner Mailing Address J Suite Dishwasher 9.00
/ 3 9'o 5 vJ llowc. c r Garbage Disposal 9.00
S City/State Zip Phone
i l 'cc ✓4 OR 972 -23 .J n-3 515 7 Washing Machine 9.00
j Narive Floor Drain 2" 9.00
f <5 tgilm e_ 3" 9.00
? Occupant Mailing Address Suite 4" 9.00
I City/State Zip Phone Water Heater 0 conversion 0 like kind 9.00
Laundry Room Tray 9.00
■ Name Urinal 9.00
W'is'h I 1/ 3 AfIvut R.) Other Fixtures (Specify) 9.00
t Contractor Mailing Address / Suite 9.00
02,17 a.. SW 5
Prior to permit City/State Zip Phone 9.00
issuance, a copy 'Ctcc 14,-, OR 97o &•)-- 77,/ - 9 `/ (l 9 9.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date 9.00
required if L / 4 7 / Lp/2.219,V Sewer - 1st 100" 30.00
expired in COT Plumbing Lic. # Exp. Date
database 3 - P 1 3 G/ :301 � � Sewer -each additional 100' 25.00
Name Water Service -1st 100' / 30.00 3 0 C
Architect Water Service - each additional 200' 25.00
Or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00
Storm & Rain Drain - each additional 100' 25.00
Engineer City/State Zip Phone Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New 0 Addition 0 Alteration O Repair ' Pollution Device
to be done: Residential Non - residential 0 Residential Backflow Prevention Device` 15.00
Additional description of work: Any Trap or Waste Not Connected to a Fixture • 9.00
�
, ' 0 Catch Basin 9.00
fro 5 ' ""`i IN 0) � j b t u /tt.7 b -4. .5-e yJ C . Insp. of Existing Plumbing 40.00
per/hr
Existing use of Specially Requested Inspections 40.00
building or property _ per/hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL •" , M `i' x'
I hE:rc y,. diagram is acknowledge that I have read this application, that the information Isometric or riser dia " As
,rrect, that I am the owner or authorized agent required if Quanity Total is > 9 • ., :s f4 ., , . '.' ' 1: :.. -,.,
g ti., �' 9 ent of the owner, and 9 *SUBTOTAL '; ;= �,� °;. ;� - .:� .�:`:,),
t:.. q ; • - su are iin with Oregon State Laws. = � s, • ,.' i'
S, g cf Owner/Agent en ` � ' t "" Date .,,V!4,11.:,,,' a : ? , �. c:.rr .-
p 5% SURCHARGE Vat-,,k. - `=
tif. son Name PLAN REVIEW 25% OF SUBTOTAL A „4 W, RA ' +' Z� '1,f-'-..4 .
Phone Required only if fixture qty. total is > 9 ;- 1 4' y ✓fi"'' . 'C ?ti i'.d`:' .I0 S-',' ' .
iyv 77/` ?Y`11 TOTAL =, .i' - ` a �5`7'c
z .itgr -_5 , %. = ;j4- ---
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
i:.doc 5,37
PLEASE COMPLETE; `
..::.. :.:.
< >::<:.;; .> `.;:::::.:N
Sink _ ..... ... _....
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
•
1ldsts■plmapp.doc 5/97
SEPTIC SE V/2C
RO.8OX 1130
WILSONVILLE, OR 97070
(503) 682-1929 FAX (963) 570-0773
CUSTOMERS ORDER NO. PHONE - DATE
L Cls�
NAME
ADDRESS � / /
n
3V70 , Lam' , /ree,2li cr y,
/r EjG� IIJ 6,1e 9 ?73
SOLD By/ CASH C.O.D. CHARGE ON ACCT. MDSE. RET'D. PAID OUT
QTY. DESCRIPTION PRICE AMOUNT
/6911 ii'
7
TAX r
RECEIVED BY
TOTAL C
All claims and returned goods MUST be accompanied by this bill
im-T / To Reorder THA` K YOU
&IIR 2% P'33 x roat2s.m
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