Permit CITY OF TIGARD
tOMMUNUTY DEVELOPMENT DEPARTMENT
1u1osaW*mx Blvd. Tigard, Oregon e7223°8199 (503) 639-4171
PLUMBING PERMIT
PERMIT #. . . . . . : PLM94-0270
639-4171 DATE ISSUED: 12/13/94
PARCEL: 2S101DB-00101
SITE ADDRESS...: 07420 SW HUNZIKER ST #S. B
SUBDIVISION....: ZONING: C—P
BLOCK..........: LOT.............:
__________
CLASS OF WORK.. :ALT GARBAGE DISPOSALS..: MOBILE HOME SPACES.:
TYPE OF USE....:COM WASHING MACH.......: BACKFLOW PREVNTRS..:
OCCUPANCY GRP.. :B2 FLOOR DRAINS. ... .. . : TRAPS............ .
STORIES........:2 WATER HEATERS— ...:1 CATCH BASINS.....
FIXTURES --- LAUNDRY TRAYS ^ SF RAIN DRAINS.....
SINKS... .......: URINALS ^ GREASE TRAPS.....
LAVATORIES. . . . . :1 . OTHER FIXTURES.
TUB/SHOWERS.... : SEWER LINE (ft)
WATER CLOSETS— :1 WATER LINE (ft)
DISHWASHERS— .: • RAIN DRAIN (ft).
Remarks: Quantum— tenant modification— adding office and ADA restroom
Owner: ------- ------ FEES
RAY HALLBERG type amount by date recpt
1710 NE 82ND AVE PRMT $ 27.00 JF 12/13/94 -
5PCT $ 1.35 JF 12/13/94 — •
PORTLAND OR 97220
Phone #:
Contractor: —
RAYBORN'S PLUMBING, INC.
19990 SW CIPOLE ROAD
TUALATIN OR •97062 -------
Phone #: 692-4139 $ 28.35 TOTAL
Reg #..: 87852
------- REQUIRED 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
approved plans. This permit will expire if work is not started _
within 180 days of issuance, or if work is suspended for more __________
than 180 days.
••--
•
Permittee Signature:
l ad e Issued By:
Call for inspection — 639-4175
•
City , of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # • •
1312'5, SW Hall Blvd. . Permit # p iffi9'qr ar) 5'
Tigard, OR 97223
(503) 639 -4171 4 , ,
MINIMUM $25.00 PERMIT FEE + ST. SURCHARG
La 9u -1` ,
NaAe 0r osveropm"" New Single Family Residences Only
•
H U,niZr-4K�u �
2. 8+4SZN PU42A
AdOfess ❑ 1 BATH H OUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job 7%4 Z S.L.J. Nu,Auf & ❑ 3 BATH HOUSE $225.00
Address Gty,state av Fee includes all plumbing fixtures in the dwelling and the first 100 feet
- T - S -640.0 i OR_ ,. • • of water service, sanitary sewer and storm sewer. See fees below.
Name (or name of Business) FIXTURES QTY PRICE AMT
Sink - 9.00
Mating redress . Lavatory f 9.00 d . 0 cl
Owner • , ° Tub or Tub /Shower Comb. 9.00
City/State E Shower Only 9.00
.. Water Closet I 9.00 9, ( I / o '':
Name (a name of business) Dishwasher 9.00
Occupant Garbage Disposal 9.00
wing Ad'°" -Phana - Washing Machine
• 9.00
Floor Drain 9.00
ctlylstate ,• - EP Water Heater 1 9.00 9 0v': ;
Laundry Room Tray 9.00
Name t Urinal 1, 9.00 ,.
KA V (7O(t.M `L um 6.L'ik.. Other Fixtures (Specify) 9.00
Mang Address 9.00
Contractor f.D. t011, 4 Gi 2.4139 ,( 9.00 f
f city /State ZIP, 9.00
- �t4.$1Uteo 1 Q �,. 9 - 1o4,7_ Sewer 1st 100' 30.00 .
$late Regfot"n'" Na. My Bus. Tax Ne. Sewer - ea. Addit. 100' 25.00
Sy,- t bkil 715 - 2, 1806 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 FI Prevention
q .J . a t2.1g94 Device or ti- Pollution Device 9.00
sign a (owner or agent) Dots
, Any Trap or Waste Not
•
Connected to a Fixture 9.00
Describe work new 0. addition 0 alteration " «x:._ repair .0 Catch Basin 9.00
to be done residential 0 non - residential " , n'x,: .,.„,,,;=. ".
>,;� ; "•=
_:.. Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00 /hr
•
Existing use of
building or property Cb tK n•..e,��4.- L ' Rain Drein, "single family dwelling 30.00
Residential ' prevention
•
devices 15.00
Proposed use of I ,
building or property t)
°(Except residential backflow
• prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL 27 Da :'
e
PERMITS BECOME VOID IF WORK OR CONSTRUCTION '
AUTHORIZED IS NOT COMMENCED WITHIN •180 DAYS, OR IF 5% SURCHARGE 3
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED I t
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
Special Conditions
•
TOTAL • D .- 3
Date issued b
Ei
INSPECTION NOTICE
City of Tigard Building Department .) f �l/
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec- O- Phone): 639-4175 Business Phone: 639 -4171
/ -
Inspection: - �.�C -O /n _
Footing Plbg. Underslab Mech. Rough -in Appr /Sdwlk
Found. Plbg. Top Out Gas Line �F7iNA5
Post /Beam Struct. San. Sewer Framing -Bldg.
Post /Beam Mech. Rain Drain Insulation 0601
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: / ) / 5�1 / ? Time: S AM - PM
--- -�
Address: La / / 4 -C4 t J L) Permit #:�Li i / 4 ,"� 6 : D-7 2°J
Builder: �0 1 t� T///3I'
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspecto : ; ° ?c Date: 5
7 APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.