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Permit DEVELOPMENT SERVICES PLUMBING PERMIT PERMIT # PL 0312 CITY OF TIGARD .... . � h�� J� tg� 5 SN/Ha0BAm���uiOR97�O�8� - Tigard, ' ' ( J P DATE ISSUED: 10/21/96 A - /0 /�» PARCEL: 1S134CD-01600 SITEADDRESS...: 11770 SW KATHERINE ST ' ��^� SUBDIVISION.... | : LERON HEIGHTS NO.3 ZONING: R-4.5 BLOCK. . ........ : LOT... .. .... .. . . :51 --- - ---- - • - �_ CLASS OF WORK..:REP GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE ^SF WASHING MACH ^ 0 BACKFLOW PREVNTRS..: 0 OCCUPANCY GRP..:A1 FLOOR DRAINS - 0 TRAPS.........,....: 0 STORIES........: 0 WATER HEATERS.....: 1 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)...: 0 DISHWASHERS.. .:0 RAIN DRAIN. <ftf' •0 Remarks: WATER HEATER REPAIR . Owner: ----- - - ------------- FEES - --- KAY SHIRK type amount by date recpt 11770 SW KATHRINE PRMT $ 25.00 TAT 10./21/96 96-285444 ' . 5PCT$' 1,25` TAT .10/21/96 96-285444 TIGARD OR 97223 . Phone #: 646-2500 Contractor: ------ - ------- COLUMBIA HEATING PO BOX 230397 TIGARD OR 97281-0397 . - - ------ ------ Phone #: 624-2704 $ 26.25 TOTAL Reg #..: 76359 ' � REQUIRED INSPECTIONS -- This.permit is issued subject to the regulations contained in the Water Line Insp Tigard Municipal Code, State of Ore. Soecialty Codes and all other Water Service In _____ . applicablelaws. All work will be done in accordance. with • •Rough-in Insp approved plans. This permit will expire if work is not started ' PLM/Underfloor within 180 days of issmmce, or if work is suspended for more Top-out Insp than 180 days. Final Inspection _ ---- -- • _ __ ::t:::1 / / ., , . _- _ ' '�v '� J _ ________ _______ Gall' for inspection' _` 639-4175 ' --- '' -------- - -- -----'- - - - - - . . City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # - 131'25' SW Hall Blvd. Permit #°#91 Tigard, OR 97223 eL01 o`(O '' 0- (503) 639 -4171 MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE o' De "oornen k New Single Family Residences Only Address 7 t'1 ^ J � � ❑ 1 BATH HOUSE $1 40.00 ❑ 2 BATH HOUSE $195.00 Job / / ❑ 3 BATH HOUSE $225.00 Address / ; te ar� ���a3 nP Fee includes all plumbing fixtures in the dwelling and the first 100 feet of water service, sanitary sewer and storm sewer. See fees below. Name o name of Business) FIXTURES QTY PRICE AMT JQ, 5h�/K ( Sink 9.00 Madng Addr Phone Lavatory 9.00 Owner / /776 6LO, ka /A-aut Tub or Tub /Shower Comb. 9.00 City/State ZIP Shower Only 9.00 J ' a,� 9 7 ,2,23 Water Closet 9.00 Name (or me of bushes) Dishwasher 9.00 Garbage Disposal 9.00 Occupant Making Address Phone Washing Machine 9.00 Floor Drain 9.00 Cdy /State Zip Water Heater ) 9.00 Cj On Laundry Room Tray 9.00 Name , Urinal 9,00 0 61,ia-- ge Other Fixtures (Specify) 9.00 Mailing Address Phone 9 Contractor O i 3 )397 (0 , J �/J 9.00 City/State )10 / /V 17j/ 7 / 9.00 �I '// Sewer 1st 100' 30.00 State' tradon No. City Bus. Tax No. Sewer - ea. Addit. 100' 25.00 7k554 '53( / 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 S 16/7 Back Flow Prevention Device or Anti - Pollution Device 9.00 Signature (owner or agent) Date Any Trap or Waste Not Connected to a Fixture 9.00 Describe work new 0 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 15.00 Proposed use of building or property '(Except residential backflow prevention devices) NOTICE °Minimum Fee $25.00 SUBTOTAL O GV 75 , PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE /...25 CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED - FORA PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS a COMMENCED. PLAN REVIEW 25% OF SUBTOTAL TOTAL Z.626 Special Conditions Date issued by 5/19/99 Activities for Case #: PLM96 -00312 2:36:49 PM I Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes PLMA007 Application received TAT 10/18/96 PLMA130 Plumbing Undersl 10/21/96 TAT 10/21/96 PLMA710 Water Line lnsp 10/21/96 TAT 10/21/96 PLMA711 Water Service Insp 10/21/96 TAT 10/21/96 PLMA715 Rough -in lnsp 10/21/96 TAT 10/21/96 PLMA720 PLM /Underfloor 10/21/96 TAT 10/21/96 ' PLMA725 Top -out lnsp 10/21/96 TAT 10/21/96 PLMA799 Final Inspection 10/21/96 1/12/99 MST PASS MRS 1/12/99 inspection request (research) sent to Hap W PLMA050 (F) Issue permit 10/21/96 TAT PASS TAT 10/21/96 PLMA800 Case Finaled 1/19/99 JT 1/19/99 • Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 9 AM PM BLD Location I I i © Ka S Suite MEC Contact Person Ph PLM 'ee 03/ • Contractor Ph SWR BUILDING = =` °: p ° Tenant/ /L 592 - 3L� ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain 4 2a fr t-e/ SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL Post & Beam Under Slab Top Out Water Service • Sanitary Sewer Ra' • i rains i fi%VP' PART FAIL CHANICAL`'` °r .a x Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL: °' F ' : y Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL • Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Other oach /Sidewalk l tP-) In spector r f / i /` Exti Date v Final PASS PART FAIL DO NOT REMOVE this inspection record. from the job site.