Permit CITY OFTIGARD
; DEVELOPMENT SERVICES PLUMBING PERMIT
I j l l� PERM
PERMIT #.......: PLM97 -0184
13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 DATE ISSUED: 05/23/97
PARCEL: 1S125DA -10700
SITE ADDRESS...: 06623 SW KINGSVIEW CT
SUBDIVISION ° CHARLES ESTATES ZONING: R -4.5
BLOCK LOT °002 JURISDICTION:
CLASS OF WORK..:ALT 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...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE ift)...: 0
DISHWASHERS ° 0 RAIN DRAIN (ft)...: 0 .
Remarks: install residential backflow device
•
Owner: FEES
DOREEN KISS type amount by date • recpt
6623 SW KINGSVIEW CT PRMT $ 15.00 TAT 05/15/97 97- 294637
TIGARD OR 97223 5PCT $ 0.75 TAT 05/15/97 97- 294637
Phone #: 293 -5139 •
Contractor—
GEORGE MORLAN PLUMBING
5529 SE FOSTER RD
*SEE ALSO MORLAN PLUMBING*
PORTLAND OR 97206
Phone #: 771 -1145 $ 15.75 TOTAL
Reg #..: 002007
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP /Backf low Prey
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspect ion
—
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 Signature: _ 44
A..e....
Issued By:
Call for inspection — 639 -4175
I
CITY O PLUMBING PERMIT
%��,.� >�
DEVELOPMENT SERVICES PERMIT Hall Blvd., Tigard, ( )
PARCEL: 1.S125DA -10700
SITE ADDRESS...: 06623 SW KINGSVIEW CT
SUBDIVISION.....: CHARLES ESTATES ZONING: R -4.5
BLOCK LOT °002 JURISDICTION:
CLASS OF WORK..:ALT 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...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS ° 0 RAIN DRAIN (ft)...: 0
Remarks: Install residential backf'low prevention device
Owner: FEES
DOREEN KISS type amount by date recpt
6623 SW KINGSVIEW PRMT $ 15.00 JSD 05/15/97 97- 294637
TIGARD OR 5PCT $ 0.75 JSD 05/15/97 97- 294637
Phone #: 293 -5139
Contract or
GREENSHIELDS LANDSCAPES •
1121 ROYAL CT
WEST LINN OR 97068
Phone #: 656 -2131 $ 15.75 TOTAL
Reg #..: 5101
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP /Backf 1 ow Prey
Tigard Municipal Code, State' of Ore. Specialty Codes and all other Final Inspect ion
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 Sign t a - -' Zi'
Issued B, �i ►r"'t
Call for inspection — 639 -4175
C TY OF TIGARD Plumbing Application Recd By`
1125 SW''HALL BLVD. Commercial and Residential Date Rec (2
�-
GARD, OR 97223 Date ;o P c A r%
03) 639 -4171 Date to DST v
Permit a 0-4 -- J1
Print or Type Related SWR x
Incomplete or illegible applications will not be accepted Called QTZ
Name of DevelopmenuProlect FIXTURES (individual) QTY I PRICE AMT
Job Sink
9.00
j S ddress Lavatory
Address 66 S. � r s tiles I 9.00
• 41 f J et ruo or Tub/Shower Como. I 9.00
Bl.tg a A/ ate / •Zip Shower Only. 9.00
lime l / Ke. "2 C Water Closet r 9.00
r Dishwasher I 9.00
Owner Mailing Address /r / r Suite Garbage Disposal 9.00
6C 7.57 ). ,A)cpc) Act. Washing Machine
9.00
rState dip Phone Floor Drain 2" I 9.00
! r /, / 0,- ,W -6727
Na a 3" 9.00
•
4 9.00
Occupant Mailing Address Suite Water Heater ' 9.00
• Laundry Room Tray 9.00
City/State Zip Phone Unnal
9.00
�
Nae / Other Fixtures (Specify) 9.00
J ,�i : c &r � iPc� f i 9.00
Mailing A ress
■
i
V/ CC/t
Contr actor 9� Suite 9.00
76 rD°I" U ye 2 Ge- 9.00
iPnor to issuance CiryrState f Zip Phone
applicant must (,?J ' rM„,/ •l7J6 6 ,c2-(7/ I 9.00
provide all -Oregon Const. Cont. Board Lic.2 Exp. Date I I 9.00
contractors / /5-1/5-1e, I ?
� L/- ?c) -9g
�- CC J �" ' 9.00
license Plumbing Lic. * Exp. Date Sewer - 1st 100" 30.00
information
for COT COT Business Tax or Metro x Exp. Date Sewer -each additional 100' 25.00
database). Water Service - 1st 100' I 30.00
Name • Water Service -.each additional 200' I 25.00
Architect Storm & Rain Drain - 1st 100' 30.00
Or Mailing Address .I Suite Storm & Rain Drain - each additional 100' I 25.00
Mobile Home Space { I 25.00
Engineer City/State Zip Phone 1 25.00
9 I Commeraal Baca Flow Prevention Device or Anti-
Pollution Device
•
:escr:be work New 0 Addition 3 Alteration O Repair O Residential 3ackflow . revention Device' / I 15.00
o
cc cone: Residential c Non - residential J Any Trap or Waste Not Connected to a F ixture 4
9.00
= cdr.:onal descn uoiwcnc� I
//� r ��� I Catch Basin I 9.00
TA)5 (esA w ..e, v i CL
, t inso. of Existing - •umoing 40.00 i
/, /c .P4 - C e 0 Srr!e• d -7 ( I oenhr
i
Existing use of Specially Requested Inspections I 4 0.00 I
•
udding or property l
cer, hr
Rain Drain. single family dwelling I 30.00
Proposed use of Grease Traps I I 9.00
cuilding or property
QUANTITY TOTAL I I
Are you caooing . moving or replacing any fixtures? Yes y .
No Isometric x nser.diagram s eouired .0uanrcy'rctai 's > ?
(If yes see back of fount 'SUBTOTAL / //I
hereby a nawiedge that I have read this application. that the information ( , v
given is correct. that I am the owner or authorized agent of the owner. and 5% SURCHARGE
I ffff� /
that plans submitted are i mpliance with Or :gon State Laws. (�
$ignatur: • •wner/ nt Date /- PLAN REVIEW 25% OF SUBTOTAL I /
</ / _ �� Pecuirea only ! t cure ^y :oral: s > > _ /
� ' /- , L %/ - - TOTAL
��
�
:on Person Name Phone
1+� � c r 'Minimum permit fee is 325 - 5t surcharge. except Residential Backrlow
,( 6"..".,-/o s'
�U '/; 7�5 6 a (7/ Prevention Device. 'which is $15 - 5'.4 surcnarge
i:` 3196
•
'LEASE COMPLETE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced Qty
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)
:OMMENTS REGARDING ABOVE:
,
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: SI ` \ 9 A.M. P.M. MST:
Location: , , `1-- - ,.... ,...,__.•4 -a • BUP:
Tenant: i' Suite: Bldg: MEC:
Contractor: Phone: (a , — 0-131 PLM:' 7 Q / S 2..m
Owner: Phone: ELC:
ti , U� ��-6- -U r ELR:
I SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/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 Sewer 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 ...roved Approved Approved Approved
Appr /Sdwlk Not Approved . • wh. ..roved Not Approved Not Approved Not Approved
FINAL I 1 FINAL FINAL FINAL
t l1. L 1 i'' �.
Ae ll
A / A'/
6 f .
( --- --- 0- Y li " -A-7----jw.
,_,..
..,_
CL 5,p.._
.•.,
ef
0 Call for reinspection CI Reinspection fee of $ required bef ore next inspection O Unable to inspect
J / / ��
Inspector: Date: ,. /....
CCC Y /
/ ! q7 Page 1.. of
•