Permit CITY OF TIGARD LU1BINS PERMIT
f�l� DEVELOPMENT SERVICES PERMIT ISSUED: p 03/09/98 _ 00S3
PARCEL: 251028n-02300
SITE ADDRESS...: 10005 SW JOHNSON ST 4
SUBDIVISION--; NO. TIGARDVILLE ADD':TICN! AMEND. ZONING: R-4.5
BLOCK........... LOT..............:015 JURISDICTION: TM
CLASS OF WORK.. :ALT CrR!3P.(3E DISPOSALS.: A 0 MOBILE HOME SPACES,,.: 0
TYPE OF USE....:SF WASHING MACH--; .. n a 0 BRCKF► OW PREVNTRS.. p 0
' OCCUPANCY GRP. _ : R3 FLOOR DRAINS....... 0 TRAPS, ..:..., ....... . 0
STORIES......... 0 WATER HEATERS...... 0 CATCH BASINS......... 0
FIXTURES______.__..___._..__. LAUNDRY TRAYS.....: 0 Sc RAIN DRie'I "'!S.. . n
SINKS.........: 0 URINALS...........: 0 GREASE TRAPS.......: 0
LAVATORIES....: 0 OTHER FIXTURES....: k'+
TUB, SHOWERS...: 0 SEWER LINE (ft) ...: 1 00
WATER CLOSETS.: 0 WATER LINE (.:'t) ‘ ... ° 0
DISHWASHERS....: 0 RAIN DRAIN (ft)...: 0
Remarks: Enright
Owner: ---- _ -__ -• - FEES ---
BRENDAN ENRIGHT type aPncunt by date recpt
10005 SW JOHNSON PRMT $ 30. 00 JSD 03/09/98 98- •303935
TIGARD OR 5PCT $ 1.50 JSD 03/09/98 98-303935
Phone $: 678 -5275
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Contractor-- _..___. -------
BOX RESCU}Ej ROOTER
PO 1 728
w:LSONVI° - 'LI= OR 97070
Phone #: 685 -9050 $ 31.50 TOTAL
Ren #.. a 000446
— REC!U I RED INSPECTIONS ----- -
This permit is issued subject to the regulations contained in the Sewer Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work wit be done it accerdar=ce with
approved plans. This permit will expire if work is not started •
within 180 days of issuance, or if work is suspended for nore •
than 180 days. ATTENTION: Oregon lar-: regtaires you to follow rules _
_.._..
adopted by the Oregon Utility Notification Center. Those rules are � •
set forth in OAR 952-M01-001@ through OAR 952- 0001 -8080. You nay
obtain copies of these rules or direct questions to 3IJMC by calling
W3)246-1987.
I s s �_r e d B y a_ ,. .rte 4010 ''e r m i t t e e Signature:
_ ...;_ i- z--!-- F .-F-I--I-++. {_.i^_ }+.1..jr t- -� -W { --±.. +4-++±±++++±+++++±++± ±±++++±++± +++++++±+±±+ +±+±+±+±+
Call 639-4175 by lino p.m. for ap inspection needed the next business day
-: - h- F. fi.. 4.- d--:^- 1-- r--' ri°-`- t-- 4-- 1--:--}. sr- 9-- d- .i- -9-..f-..,}..;.1--f--}.-I -^i -1--..-h-1--t.- ti^°T--F-I-'-f . -..!- ° i - +•:^^'.._I..^i ^..I..'Q_'F'J... _• f••_ I I^_I^ ^:^_I_.AY.^I...{'.J...}.. ,._ I '_L{...(...iLJ....(.._(....(.++
'ITY OF TIGARD Plumbing Application Recd By ,
3125 SW HALL BLVD. Commercial and Residential DateRec'd iLu ,
f IGARD, OR 97223 Date to P.E.
Date to DST
(503) 6394171 • Permit* raal / 3'
Print or Type Related SWR#
Incomplete or illegible applications will not be accepted Called r l
Name of Development/Project On back indicate Work Performed by fixture.
Job / FIjURESl(indtvlduai) •' k , "° m91)' « P.,R10E `AMT
• Address Street Address Suite , ( / Sink 9.00
/ 03 0' d S SWW 5 �/C' ✓� / Lavatory 9.00
Bldg # C /State Zip Tub or Tub /Shower Comb. 9.00
Name
' " C ,�1Q Shower Only 9.00
E Ar0 f 4) L%.44 I/ 6 (i--1 Water Closet 9.00
Owner Mailing Address Suite Dishwasher 9.00
i0O0 Svc JG'F/t/ u Garbage Disposal
9.00
City /State Zip Phone
1-) ,y 7 r � -- Washing Machine 9.00
• Name Floor Drain 2" 9.00
• S A v- L 3" 9.00
Occupant Mailing Address Suite 4" 9.00
-g A-v" Water Heater 0 conversion 0 like kind 9.00
City /State Zip Phone
Laundry Room Tray 9.00
Name _ Urinal 9.00
I R -� 4 C .C'G 1 Other Fixtures (Specify) 9.00
Contractor Mailing Address Suite
r0 64 X )72,9 9.00
Prior to permit City/State Zip Phone 9.00
issuance, a copy p/1 L SG' , ✓ in 1,4 e -' ; y 2 /1 7 2 9.00
j of all licenses are Oregon Const ontOoard Lic.# Epp ate 9.00 /
required if 0 r 1P ! 7 „/
Sewer -1st 100 2 r r 30.00 /J /�
expired in COT Plumbing Lic. # Exp.
/ � ate
database 2i) - % 6 is _3/3 Sewer - each additional 100' 25.00 _ ✓}
�� _
Name Water Service - 1st 100' 30.00
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 0 Repair 0 Pollution Device
to be done: Residential 0 Non - residential 0 Residential Backflow Prevention Device' 15.00
Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00
Catch Basin 9.00
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
hereby ITY TOTAL v" a
. ereby acknowledge-that I have read this application, that the information 9 i < ti ,. F . r
` � ' n is correct, that I am the owner or authorized agent of the owner, and
r g ; )lar Isometric or riser dia ram is required Qua Total is > 9 k
4.
*SUBTOTAL ID , '`-
'
submitted are in compliance with Oregon State Laws. QUANT j �� "�• , '1
0 of Owner/Agent Date :t ' -
�G °' 4 ,, --- 1 -2--- r/7/9 5 % SURCHARGE 4 . 44 ,4 �� i t V Z,
P LAN REVIEW 25% OF SUBTOTAL 'isE a : ,- "`•
'o+ , lrson Name " " - a
Phone Required only if fixture qty. total is > 9 x�,� � �:,��«tM.. .k`a, <.< , i.:
TOTAL (
'* �t' A 1[ T'>
'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
.Dp.d• c 5/97
PLEASE COMPLETE:
• •
................................................................................................................................... Replaced Removed/Capped
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:
lAdsts1p1mapp.doc 5/97
3 -9
Cam
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639-4175 Business Phone: 639 -4171 .
Date Requested: 3 — 10 — - i A.M. P.M. MST:
I0C)0 S — A - -u I
Location: / , 4 ?-- BUP:
Tenant: � Suite: Bldg: MEC:
Contractor: L'_d . u ' 1, (. JL 6.4,;(4.4 Phone: PLM: 4 7eP00
Owner: Phone: ELC:
c �i� — / 7t1 U ' 7 ) � / ELR:
(/ / %' f _� ? SIT:
BUILDING BLDG (co I' PLUMB I i• HANICAL ELECTRICAL SITE
Site Post/Beam 'ost/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved . Approved Approved . Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL ��+Il�ATp j FINAL FINAL FINAL
mss/
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O Call for reinspection �,, O Reinspection fee of $ yieVyP, required before next inspection 0 Unable to inspect
Inspector: </ _ 1t%(r""y, Date: Page of