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Permit .., , CITY OF TIGARD ,i , DEVELOPMENT SERVICES PLUMBING PERMIT A 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # PLM98 - 0373 DATE ISSUED: 10/1:/98 PARCEL: 1S135DC -04400 SITE ADDRESS...: 12085 SW LINCOLN AVE SUBDIVISION • ZONING: R -4.5 BLOCK • LOT • JURISDICTION: TIG 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 • 1 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: Repair of sink pipe that was draining into crawl space. Owner: FEES RAY DUEY type amount by date recpt 12085 SW LINCOLN PRMT $ 25.00 DEB 10/12/98 98- 309898 TIGARD OR 97223 5PCT $ 1.25 DEB 10/12/98 98- 309898 Phone #: 620 -9180 Contract or MICHAEL K CO PLUMBING P 0 BOX 23008 TIGARD OR 97281 Phone #: 639 -3189 $ 26.25 TOTAL Reg #..: 000678 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Misc. Inspection 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 9521- You say obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. AM Issued �. �C/ /1 Per m ittee Signature: '.-�_. +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ • .:ITY OF TIGARD Plumbing Application Reed By ( . 3125 . W HALL BLVD. Commercial and Residential Date Read /o •-/ a - -9( . :GARD, OR 97223 Date to P.E Date to OST 503) 639 -4171 Permit s 100 -ic - cm 7 Print or Type Related SWR s Incomplete or illegible applications will not be accepted Called Name of Development/Project FIXTURES (Individual) _ , . QTY _ PRICE AMT Job ¥ Sink / 9.00 "'�. Address Street Address Suite Lavatory 9,00 1 1 2. 0 8S S a.�) t v%C o f fJ Tub or Tub/Shower Comb. 9.00 Bldg * City /State Zip Shower Only • 9.00 Water Closet 9,00 • Name 'K 70 u.€-‘-% Dishwater 9.00 Owner Mailing Addre3s .! J Suite Garbage Disposal 9.00 I .c sr S%."..) L.,.�cpl,J Washing Machine • 9.00 C / /State Zip Phone Floor Drain 2" 9.00 .. 1 t gcs r t Cor 9'7223_ 1 91 P O 3' 9.00 Nam I Sow _ 4' 9.00 Occupant Mailing Address Suite Water Heater 9.00 . Laundry Room Tray 9.00 City /State Zip Phone Urinal 9.00 • Name �n v Other Factures (Specify) / 9.00 mtLkdQ.` ci Cis Y\u lM q ! `�- _5/471 r ' Aria./ , p ' Aria./ f ./ �4r�rwa 9.00 . Contractor Mailing Address Suite , 9.00 i Po aDtc ,�.30O ruAn/[ -r 9.00 , ,� •l Ci /State Zip • Phone n O4' 9-12ariI (031 -31P5 9.00 Ofe4on I Const Cont. Board Liss Exp. Date 9.00 I Attach Copy of O - 74, , 7 - 7 9.00 f Current Plumbing Lic. s Exp. Date Sewer -1st 100' 30.00 i: Licenses eP G. -333 P .3 Sewer -each additional 100' 25.00 ll COT Business Tax or Metros Exp. Date �.S S� Water Service - 1st 100' - 30.00 Name Water Service - each additional 200' 25.00 �I Architect storm & Rain Drain - 1st 100' 30.00 u Storm & Rain Drain - each additional 100' 25.00 a or Mailing Address Suite I' Mobile Home Space 25.00 Engineer City /State Zip Phone Commercial Back Flow Prevention Device or Anti - 25.00 Pollution Device . • Describe work New O ition 0 Alteration 0 Repair 0 Residential Beddow Prevention Device' 15.00 to be done: Residential Non - residential 0 Any Trap or Waste Not Connected to a Fixture • 9.00 I • Additional description of work Catch Basin 9.00 -4-P A ■ Insp. of Existing Plumbing • 40.00 ..,per/hr Existing use of Specially Requested Inspections 40.00 . :uilding or property Rain Drain, single family dwelling 30.00 • . Proposed use of Grease Traps 9.00 building or property • • QUANTITY TOTAL . Are you capping . moving or replacing any fixtures? Yes a No a • I s om etr i c or riser diagram is required it Quanity Total Is > 9 • f li (If yes see back of form) 'SUBTOTAL . _ Co 1 I hereby acknowledge that I have read this application, that the information �•? ' given is cored, that I am the owner or authorized agent of the owner. and 5% SURCHARGE that plans submitted are in compliance with Oregon State Laws. /' -' PLAN REVIEW 25% OF SUBTOTAL Sig ry of Own /Age Date Yrbduro total > 9 r� /P/ �.; -"i� TOTAL : - 2(o / L J<f act P erson Name Phone . •Minimum permit fee is 325.5% surcharge, except Residential Badcflow - Av�� e'/11r, tF LP3�i- .3 //'q Prevention Device. which is 315.5% surcharge / L:%dstsapIrnapp.doc 8/96 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 39-4171,,, BUP 13l Date Requested /0 AM PM Location /(,)-o E (Sal Suite MEC Contact Person �� i � L / 1/ J - - - � ' Ph PLM ,X-03 7-3 a!Z Contractor GtJ'C C' 1/1.2 CC)'117J8�[ &- l / "_,e) Ph 6 3y.-- 3 /cS7 SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation Ftg Drain � SGN /'� Q % _ J FPS Crawl Drain Inspection Notes: Slab SIT Post & Beam l i Fi�IA - D , I t D RAi J Ext Sheath /Shear /� Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS T FAIL UMBING Post &eam Under Slab Top Out Water Service Sanitary Sewer Rain Drains �rna PART FAIL A NICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE 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 i O 1 Other Date 1 Inspector Ex Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.