Permit . CITY OF TIGARD PLUMBING PERMIT
?;" jll DEVELOPMENT SERVICES DATE ISSUED: P2M5 9 999 0434
+L 6- ' ` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09685 SW JOHNSON ST 016 PARCEL: 2S102BA -01400
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: R -12
BLOCK: LOT: 054 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS TRAPS:
STORIES: WATER. HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace electric water heater.
FEES
Owner:
Type By Date Amount Receipt
BALL, ROBERT D PRMT GEO 12/15/199E $50.00 99- 320436
WEISE, IRA AND SHERRY 5PCT GEO 12/15/199E $4.00 99- 320436
WEISE, DAVID ET AL
PORTLAND, OR 97210 Total $54.00
Phone 1:
Contractor:
GEORGE MORLAN PLUMBING + APPLIANCES
9806 SW TIGARD STREET
CCB (EXP 6/2002) REQUIRED INSPECTIONS
TIGARD, OR 97223
Phone 1: 624-6895 Misc. Inspection
Reg #: LIC 000027 Final Inspection
PLM 026 -60PB
ORIGINAL .
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other 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. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: S Permutes Signature: ___..-7/4,41.-
toe.ff Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
r•e�l
DEC -09 - 1999 13 :44
on ■ . ...il . ovr11ra• r IL lhIIJIUa I VI IIIIL /1.1J1J1160LIU11
13125 SW HALL BLVD. RECEIVED Commercial and Residential
'IGARD, OR 97223
503) 639-4171 ' • . DEC 1 3 1999 1
Print or Type � `pO ` � 3 /
Iigra applications will not'be accepted
L O/0 # /05 3 90
Name of DevelopmenUP ct XF I �:`
aydard Dark r- ,1e� T
Job Sink 11.50
Address tre Address-. 1:1 pi- Lavatory 11.50
LJ? 8 5 "`&' 7th/urn( / 69 Tub or Tub/Shower Comb. - 11.60
Bldg it I City/State Zip
i ! ! ; ,irr 97 .23/ Shower Only 11.50
,, + Water Closet 11.50
7 [� `r M IQ YI f' '�I Dishwasher 11.50
Owner )4 aUing dress Suite Garbage Disposal 11.50
�� Phone Washing Machine 11.50
�- P703/ Floor Drain/Floor Sink 2 11.50
Name 3' 11.50
4' 11.60
Occupant Mailing Address 1 Suite Water Heater 0 conversion X like kind / 11.50 // 60
Gas piping requires a separate mechanical permit.
City /State Zip Phone Laundry Room Tray 11.50
■ Urinal 11.50
. Na r Lon / Other Fixtures (Specify) 16.00
Contractor 0Ad sik. � �rnl Sum _
Prior to permit C taste ri .. 'lip Phone Sewer -1st 100' 38.00
Issuance, a copy I 4Or: 9 7 Y_ .
Sewer - each additional 100 32.00
of all licenses are Or Cones. C tnt. Board licit o
required If 77' E X 0,0 Water Service - 1sf 100' 38.00
expired In COT Plumbing Lkt. T Exp�Da a Water Service - each additional 200' 32.00
database s - (.1 , Q P� (J l
Storm & Rein Drain - let 100' 38.00
Name Storm & Rain Drain - each additional 100' 32.00
Architect Mobile Home Space 32.00
Or Melling Address : Suite
Commercial Back Flow Prevention Device or Anti- 32.00
Pollution Device
Engineer G / /State Zip Phone Residential Backflow Prevention Device' 19.00
(Irrigation timing devices require a separate
Describe work to be done: restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes 1K No 0 Any Trap or Waste Not Connected to a Fixture 11.60
Residential 0 Commercial 0 Catch Basin 11.50
Additional desa 1pUon of work: ,
Insp. of Existing Plumbing 50.00
repLoc.e. eLec. tJct. -er A ea,'k( per/hr
Vs you capping, m ving or replacing any fixtures? Specially Requested Inspections 50.00
Yes /Q No 0 per/hr
Rain Drain, single family dwelling 45.00
f yes, see back of form to Indicate work performed by Grease Traps 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
YORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
hereby acknowledge that I have read this application, that the information Isometric or riser diagram is requlrod If Quantity Total la > 9
Ivan is correct, that I am the owner or authorized agent of the owner, and 'SUBTOTAL ?..7 OG
hat plans submitted are In compliance with Oregon State Laws.
:..;.,
Ipn of mrJAge Date = , �� -`
• to 5 ere Name Phone "PLAN REVIEW 2 &% OF . .,: ' -: ;; Y
i %Ci �GL. /
✓ .S. c/ -CO() UBTOTAL . ° ::":-.,:"
, � • . N. . a Required I re d only k fixture q total la > 9 '� �� i �
� r > ` . * c : i . TOTAL QD
h , ,4,. 1 . f 'Minimum permit fad is S50 + 5% surcharge, except Residential BaCkflow
t 31. SI + • y i -1; r (� c- ;c, t `c y l\ ? , �I r f: ° Prevention Device, which is 526 + 5 %surc a e
y i�'1�1 , YZ . ; - .t, ,,, „� v , r, � y % ' . f : " All New Commercial Buildings require plans with isometric or riser diagram
. and plan review
tfonnslpkaaspp,dot 5/28r99
-
TOTAL P.al