Permit .
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A CITY OF TIGARD
,,,,„, „,;,., DEVELOPMENT SERVICES PLUMBING PERMIT
PERMIT # : PLM98-0169
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13125 SW Hall Blvd., - — �"-- ''' DATE ISSUED: 06/15/98
PARCEL: 1S125DA-11200
SITE ADDRESS...: 06614 SW KINGSVIEW CT
SUBDIVISION....: CHARLES ESTATES ZONING: R-4.5
BLOCK..........: LOT.............:007 JURISDICTION: TIG
------- - • _ - --
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: Add residential backflow prevention device.
Owner: ------------- -. - -- FEES
SALLY BOWELS type amount by date recpt
6614 SW KINGSVIEW COURT PRMT $ 15.00 GEO 06/15/98 98-306525
TIGARD OR 97223 5PCT $ 0.75 GEO 06/15/98 98-306525
Phone #: •
Contractor------- - -------
GREENSHIELDS LANDSCAPING
1121 ROYAL CT
WEST LINN OR 97068 -------------- ------------
Phone #: $ 15.75 TOTAL
Reg #. 000112
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP/Back flow Prey __
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 mnre ____ __ ___ ____
than 188 days. ATTENTION: Oregon law requires you to follow roles _ ___. _________ ___
adopted by the Oregon Utility Notification Center. Those rules are _ ___ ____
set forth in OAR 952-0001-0010 through OAR 952-8081-120:». You may ____ '
obtain copies of these rules or direct questions to OUNC by calling : __ ____
(503)246-1987.
� ____ _ . _
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________ _ _ _
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Issued B ��N�- ' � Permittee Signatur A , �� '_~ `
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++++++++++++.4+++++++++++++++++++++++.4-44.4.4-4-++++ ++++++ +++++++++++++++++++++++++++++++++++++++++++++++++++++++
++++++++++++++++++++++++++++++++.++++++++ +
Call 639-4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
CITY OF-TIGARD Plumbing Permit Application Plan Check #
13125 SW HALL BLVD. Commercial and Residential Rec'd By
TIGARD, OR 97223 Date Rec'd
(503) 639 -4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit #,Z1 -e 4'9
Related SWR #
Called
Name of Development/Project On back indicate Work Performed by fixture.
Job 4 v C:✓ /r s FIES individual"
..,, UR�, b�.r.�� „�.��)���1� � '• 9 PRIC =WO
AMT3u,
Address /// Street Address r 9
Suite Sink '
6 6/ 9 ' 7 /f C9 /eW 9.00
La vatory 9.00
Bldg # �04/State Zip Tub or Tub /Shower Comb. 9.00
• rP "' O r
Nam / , Shower Only 9.00
/KA-- � J,( # it 1 f� '/ Water Closet 9.00
Owner Mailing Address / Suite Dishwasher
�/ s.oa
6 / /.. 4 ft C ) ' C F-
, Garbage Disposal 9.00
50 /State Zip Phone Washing Machine 9.00
Na Floor Drain 2" 9.00
• 3" 9.00
Occupant Mailing Address Suite
4" 9.00
City /State Zip Phone Water Heater 0 conversion 0 like kind 9.00
Laundry Room Tray 9.00
Nam" / r Urinal 9.00
/ cz fl 6 c civS'L /cr c Other Fixtures (Specify) 9.00
Contractor Mailingddress Suite
9.00
/ /.2(/4 r 7,
9.00
Prior to permit City/State Zip Phone
lN
issuance, a copy C���;�N ■ 9704 ----5-4---(72( 7/ Sewer -1st 100' 30.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. ate / Sewer - each additional 100' 25.00
required if /1)/ ' " 97 Water Service - 1st 100' 30.00
expired in COT Plumbing Lic. # Exp. Date ((( Water Service - each additional 200' 25.00
database
Name Storm & Rain Drain - 1st 100' 30.00
• Architect Storm & Rain Drain - each additional 100' 25.00
Or Mailing Address Suite Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Engineer City/State Zip Phone Pollution Device
Residential Backflow Prevention Device* / 15.00
Describe work New 0 Addition 0 Alteration 0 Repair O Any Trap or Waste Not Connected to a Fixture 9.00
to be done: Residential A, Non - residential 0 Catch Basin 9
7ionaIdp7nofworlc r r I Insp. of Existing Plumbing 40.00
/'-(, ,,,FU J r rt rr 7, o ‘v per/hr
Specially Requested Inspections 40.00
per/hr
Rain Drain, single family dwelling 30.00
Existing use of
building or property Grease Traps 9.00
Proposed use of QUANTITY TOTAL : ,A . "' 1 ' y
building or property Isometric or riser diagram is required if Quanity Total is > 9 40 41 '
*SUBTOTAL _ ` xf
I hereby acknowledge that I have read this application, that the information
given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE "`'
that plans submitted are in compliance with Oregon State Laws. w
SI ture OwnerI ent "PLAN REVIEW 25% OF SUBTOTAL
9 Date f �
Required only if fixture qty. total is > 9 ��� � �,
/. / f/ 6''' �'/e TOTAL y +�
tact Person Name Phone _ ", ` �'+
/ �/ 6 - 'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
�l u fj �jC r--ris-�4r„ 7 v'( ? / Prevention Device, which is $15 + 5% surcharge
/ "Ail New`Commercial Buildings require plans with isometric or riser diagram
and plan review
lAdsts\plumbapp.doc 515/98
PLEASE COMPLETE:
New Moved Replaced .::fRemoved/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:
.•
Istskplumbapp.doc 5/5/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
D6611 atte Requested b �,, �jM PM BLD
Location a') GG� L .bt) 1 1 Suite MEC
Contact Person i Ph PLM ci/1 -a16
1f
Contractor I•kc -9 • ! 'OW Ph C5 ( &) SWR
BUILDING` Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN •
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
'Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation �
Drywall Nailing f2j( p L �'Cl -� „e„.„
Fi rewaII
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
_ Final
PASS T FAIL
--- Post & Beam
Under Slab
""• Top Out
. Water Service
Sanitary Sewer
_Bain Drains
Fiii—
PART FAIL
ME, ANICAL e ' F
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL •
ELECTRICAL .; ` s” =k w
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 Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA /— 4 2‘4- — — — — —
Approach /Sidewalk g '
Other Date Inspector Ext
Final
PASS ' PART FAIL DO NOT REMOVE this inspection record from the job site.