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Permit x�~~~ • •TV OF � � ���� � � ������ PERMIT #. . . .�. . . : PLM96-69127 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/03/96 13125 SW Hall Blvd. Tigard, Oregon e7223°81*9 (503) 63e-4171 - ' PARCEL: 1S135CC-02500 SITE ADDRESS...: 10265 SW KATHERINE ST SUBDIVISION ^ GREENBURG HEIGHTS ADDITION ZONING: R-4.5 BLOCK..........: LOT.. ..... ^.....:11 • CLASS OF WORK..:REP 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)...: 100 DISHWASHERS ~ 0 RAIN DRAIN (ft)...: 0 Remarks: Water service first 100Ft. Owner: FEES JEFF ZWINGRAF type amount by date recpt 10265 SW KATHERINE ST PRMT $ 30.00 CJS 06/03/96 96-280104 5PCT $ 1.50 CJS 06/03/96 96-280104 TIGARD OR. 97223 Phone #: Contractor: - RESCUE ROOTER PO BOX 1728 WILSONVILLE OR 97070 ----- Phone #: 685-9050 $ 34.50 TOTAL • Reg #..: 44677 ------- REQUIRED INSPECTIONS ------- This permit is issued subject to the regulations contained in the Water Line 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 Signatur /__ Issued By _� (_ ^rnr/�� Call for inspection - 639-4175 • — - _- .. • City oNijgard PLUMBING PERMIT APPLICATION Planck/Rec. # 6}G- ,q /oy 1a4.2_5 SW Hall Blvd. • • Permit # RL wt96 - C I a7 Tigard, OR 97223 • (503) 639 -4171 MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE Name of Development New Single Family Residences Only ,-rh4 ai..i; i " Address `.�l ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00 Job 1D £ ee.,'A e . ❑ 3 BATH HOUSE $225.00 Address Ct zip Fee includes all plumbing fixtures in the dwelling and the first 100 feet ' m Q . - e - (2/: 9 2.a '� of water service, sanitary sewer and storm sewer. See fees below. Name (or n e of Busness) FIXTURES QTY PRICE AMT ..Co m P Sink 9.00 • Mailing Address Phone Lavatory 9.00 Owner Tub or Tub /Shower Comb. 9.00 City /State ZIP Shower Only 9.00 Water Closet 9.00 - Name (or name of business) Dishwasher 9.00 Garbage Disposal 9.00 Occupant Mailing Address Phone Washing Machine 9.00 Floor Drain 9.00 City /State Zip Water Heater 9.00 Laundry Room Tray 9.00 Name j Urinal 9.00 k r. Cc' -e_ R -r G✓ Other Fixtures (Specify) 9.00 Madng Address Phone 9 Contractor ) n 2 [+ S 5 L/ J. &47 -sec re /r 9.00 GtylState Zip 9 1 ^ /1 5 0,,t li, /k /", 9.?.a , 7 Sewer 1st 100' 30.00 State Registration No. coy Bus. Tax No. Sewer - ea. Addit. 100' 25.00 i/ y 6 �2-- Water Service 1st 100' ? C© J t 30.00 ^,:;,l 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 Flow Prevention Device or Anti - Pollution Device 9.00 Signature (m.ner or agent) Date Any Trap or Waste Not Connected to a Fixture 9.00 Describe work new 0 addition 0 alteration 0 repair0 Catch Basin 9.00 . to be done residential 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 backfiow prevention devices 15.00 Proposed use of building or property '(Except residential backfiow prevention devices) NOTICE °Minimum Fee $25.00 SUBTOTAL 4' o PERMITS BECOME VOID IF WORK OR CONSTRUCTION . AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PLAN REVIEW 25% OF SUBTOTAL TOTAL Special Conditions Date issued 6 96 by CTT$' CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639 -4175 Business Phone: 639 -4171 Footing Rain Drain Cover /Service FINAL: Foundation Water Line Ceiling - Plumb. Post/Beam Mech. Shear /Sheath Framing -Mech. PIbg.Und /Flr /Slab Plbg. Top Out Insulation - Elect. Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr /Sdwlk Reins. Other: Date: A.M. P.M. Entry: Address: / 0 a (v 5 a Tenant: Ste: MST: j Con /Own: T9c ��� 4 L1�LC� (1/1 MEC : ELM: o "�1��- ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: lnspec or: -4 Date: C 7- ? APPROVED DISAPPROVED /CALL FOR REINSP. CF CO