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Permit CITY OF TIGARD �a�,,,,d� n , DEVELOPMENT SERVICES PLUMBING PERMIT �� IP �ti� �I. PERMIT # PLM98 -0137 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 05/13/98 PARCEL: 25104CA- 01900 SITE ADDRESS...: 13739 SW LAUREN LN SUBDIVISION • HIL.LSHIRE ZONING: R -7 PD BLOCK • LOT -019 JURISDICTION: TIG CLASS OF WORK..:ADD 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: Installation of backflow prevention device. Owner: FEES EMANOIL LEASEU type amount by date recpt 11349 SW 135TH ST •PRMT $ 15.00 DEB 05/13/98 HAND RECT TIGARD OR 97223 5PCT $ 0.75 DEB 05/13 HAND RECT Phone #: Contractor OWNER Phone #: $ 15.75 TOTAL Reg #..: 000000 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the RP /Backflow 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 more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952- 0301 -0080. You may • obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. Issue y: Permittee Signature: f51-j-84'CC( ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + +++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + ++ ++ + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Plumbing Permit Application PlanChe 13125 SW HALL BLVD. Commercial and Residential Rec'd By Le.._ TIGARD, OR 97223 Date Rec'd 5 (503) 639 -4171 Date to P.E. Print or Type Date to DS f Incomplete or illegible applications will not be accepted Permit #L) - ti0 Related SWR # Called Name of Development/Project On back indicate Work Performed by fixture. Job '` .7-7 .A-S Cam FIXTURES (individual) QTY PRICE AMT Address Street Address • Suite Sink 9.00 \ 731 Sub t. 4 144 Lavatory 9.00 Bldg # City /State Zip Tub or Tub /Shower Comb. 9.00 � Name k6 i � 5721 Shower Only 9.00 l` SCE - Water Closet 9.00 Owner Mailing Address Suite Dishwasher 9.00 . 1 b 7 35 Sou L*-ti' I•A OCne Garbage Disposal 9.00 City/State Zip Phone ' i1 El ti011 ! 9 7Z23 5 7.9-4 © 9z Washing Machine 9.00 Name Floor Drain 2" 9.00 CAVIVY VrL C " 3" 9.00 Occupant Mailing Address Suite 4" 9.00 Water Heater 0 conversion 0 like kind 9.00 City/State Zip Phone Laundry Room Tray 9.00 Name ��y� � Urinal 9.00 Fncieityt V ( "'" � Other Fixtures (Specify) 9.00 Contractor Mailing Address Suite SitiV r-14- 9.00 Prior to permit City/State Zip Phone issuance, a copy Sewer - 1st 100' 30.00 of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date Sewer - each additional 100' 25.00 required if 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' I 15.00 /5"-6c' Describe work New 0 Addition 0 Alteration 0 Repair 0 Any Trap or Waste Not Connected to a Fixture 9.00 to be done: Residential 0 Non - residential 0 Catch Basin 9.00 I Additional description of work: Insp. of Existing Plumbing 40.00 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 building or property Isometric or riser diagram is required if Quanity Total is > 9 *SUBTOTAL , c: c . / i 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 f that plans submitted are in compliance with Oregon State Laws. `Signature of Owner /Agent Date "PLAN REVIEW 25% OF SUBTOTAL Required only if fixture qty. total is > 9 f S-( - �' TOTAL /5 , 7,5 Contact Person Name Phone S / S 79e, 'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow Prevention Device, which is $15 + 5% surcharge "All New Commercial Buildings require plans with isometric or riser diagram and plan review I:\dsts\plumbapp.doc 5/5/98 PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed /Capped Sink Lavatory Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I. \dsts\piumbapp.doc 5/5/98 CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: (j -/4 4 i A.M.1 /� P.M. MST: Location: / 3 73 q' 4.‘,0 �' cM u . - `O BUP: Tenant: Suite: Bldg: MEC: 2 Contractor: ,/L .. /L ._ ._ / , 0.1/A4.4 et/ L.' Phone: - 1 S 7,7 07 PLM: 78-013 7 Owner: Phone: ELC: ELR: • SIT: BUILDING BLDG (con't) "PLUMBIN MECHANICAL ELECTRICAL SITE Site Post/Beam 'Post/Beam Post/Beam Cover /Service Sewer /Storm Footing Roof UndFl/Slab Rough -In Ceiling Water Line Slab Framing Top Out Gas Line Rough -In UG Sprinkler Foundation Insulation Sewer Hood/Duct - Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab / .�� Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt Ze-{;1,. Approved fov Approved Approved Al.. ov - Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved FINAL 1 FINAL FINAL FINAL O Call for reinspection - - - - einspection- fee -of -$ - - 7Jire d bef -- — - - - O Unable to inspect - spector: Date: 1 q Page of