Permit � ~/
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��� OF � � ��P� � BING PERMIT z����� � �K � ��[NL�� -�'� � � �������k�`=�� PERMIT # ^ PLM96-0213
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/24/96
1u1oaow Hall Blvd. Tigard, Oregon 97223°8199 (503) 639-4171
PARCEL: 2S104CA-10100
SITE ADDRESS...: 13721 SW JENNA CT
SUBDIVISION....: HILLSHIRE ZONING: R-7 PD
BLOCK ^ LOT ^101
_
CLASS OF WORK..:NEW 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.......: 0
FIXTURES LAUNDRY TRAYS.....: 0 SF RAIN DRAINS.....: 0
SINKS ^ 0 URINALS ^ 0 GREASE TRAPS ^ 0
LAVATORIES ^ 0 OTHER FIXTURES.''.: 0
TUB/SHOWERS....: W SEWER LINE (ft)...: 0
WATER CLOSETS..: 0 WATER LINE (ft) : 0
DISHWASHERS ^ 0 RAIN DRAIN (ft)...: 0
Remarks: Installing a residential backflow device.
Owner: — — FEES
KRIS REEB type amount by date recpt
13721 SW JENNA CT PRMT $ 15.00 CJS 07/24/96 96-282013
5PCT $ 0.75 CJS 07/24/96 96-282013
TIGARD OR 97223
Phone #:
Contractor:
PRO LANDSCAPE
PO BOX 5952
BEAVERTON OR 97006 — ---
Phone #: 504-642-5452 $ 15.75 TOTAL
Reg #..: 12174
------- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP/Backflow Prev
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. -_— ------
--
'c'_� --' -
Permittee Signature: _��Ll\�L�
Issued By: C
Call for inspection — 639-4175 .
•
City of Tigard • OK_ PLUMBING PERMIT APPLICATION Planck/Rec. # 38 C2
131.25 `SW Hall Blvd. Permit # il in 9G- D
Tigard, OR 97223 - DJ
(503) 639 -4171 .
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Nee'e of Daveteanent New Single Family Residences Only
Address ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job \ ❑ 3 BATH HOUSE $225.00
Address i ^ ` L7 � .I l �� n � m Fee includes all plumbing fixtures in the dwelling and the first 100 feet
l (J C) W co '1 � of water service, sanitary sewer and storm sewer. See fees below.
Name (° °em. a e ' FIXTURES QTY PRICE AMT
K.Y\ 5 4 Sink 9.00
� /� Lavatory 9.00
Owner
Mains ) 9 ) r ) 2_1 S ✓� (--p�� � n Q, C ' Tub or Tub/Shower Comb. 9.00
City/State Shower Only 9.00
�mmrd ®� 9/ 2 �3 Water Closet 9.00
Nom (or name of , Dishwasher 9.00
Garbage Disposal 9.00
Occupant ,, ,,,,,w Plume Washing Machine 9.00
Floor Drain 9.00
Ctly S" m y Water Heater 9.00
Laundry Room Tray 9.00
Name 14 Z Urinal 9.00
\°-lxvt.Q Q » J(tn.CP Other Fixtures (Specify) 9.00
",i,° oaaea �y/� /? 9.00
Contractor P -v. 66x \ 7 Si �. ,VI/ l - 4 �-
c� C i / `^- („ 9.00 . 9.00
Sewer 1st 100' 30.00
State Regan No. r V �j. „ � f O can e°a. Tao No. Sewer - ea. Addit. 100' 25.00
� Fo'5 ' -1 ( j , (003 ' .t- Water Service 1st 100' 30.00 -
I hereby acknowledge that I ave read this application, tha 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
NV\ \ Vd \k c G-' Device or Anti- Pollution Device 9.00
7 . - rte-- _ DiLe Any Trap or Waste Not
l / Connected to a Fixture 9.00
be work new addition 0 alteration 0 repair 0 Catch Basin 9.00
to be done residential 0 non - residential 0 Insp. of Exist. Plumbing 40.00/hr •
Specially Requested Inspections 40.00/hr
Existing use of
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention ,�
devices 1 15.00 !J ;
Proposed use of
building or property
'(Except residential backtlow
prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL /5--; e')
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE ,
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL I S' 2 S_
Special Conditions
Date issued 7 96 by C 1 -S
CITY OF TIGARD BUILDING INSPECTION DIVISION MST — ----\:;i:
24 -Hour Inspection Line: 6394175 Business Line: 639 -4171
j j BUP
Date Requested' L / e i d AM PM BLD
Location /37 , Te011 Ct Suite MEC
Contact Person • Ph, PLM 9(,-00 a I g
Contractor Ph SWR
BUILDING F q ,p :� °' : q , r Tenant/Owner ELC
Retaining Wall ELR
Footing
Foundation NOT REQUESTED FPS
Ftg Drain FOUND DURING RESEARCH SGN
Crawl Drain Ir
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post &. Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
. - ' 6... F . 1 "/ Insulation
Drywall Nailing -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling 7 ! %% -p• -
Roof �_. �y/ , / i , , y ,z---f,-.,- ,� l% ,�f -0i',
Misc: �' - ..i ce • ', / ' ",
Final
PASS PART FAIL
os eam
Under Slab
Top Out /
Water Service
Sanitary Sewer 6f-D
Rain Drains
PART FAIL
' " "= HANICAL
Post & Beam
Rough In
Gas Line.
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin •
[ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA i I .
Approach /Sidewalk 'A i f 1 j , r' : , if � � 0 6
Other Date I a1 Inspector x / ' Ext
Final t. /t !,i ..
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.