Permit • CITY OF TIGARD
A DEVELOPMENT SERVICES PLUMBING PERMIT
y- ,TI�I!— 1 3125 SW Hail Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # • PLM9E -0335
DATE ISSUED: 11/08/96
44� PARCEL: 1S136AD- 043@0
SITE ADDRESS...: 11477 SW PACIFIC HWY
SUBDIVISION • VILLA RIDGE I/Q
OyING: C —G
BLOCK • LOT • 2
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:B 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 (ft)...: 0
Remarks: Install hot water heater
Owner: FEES
MARK BANNING type amount by date recpt
11477 SW PACIFIC HWY PRMT $ 25.00 JSD 11/08/96 96- 286299
5PCT $ 1.25 JSD 11/08/96 96- 286299
TIGARD OR 97223
Phone #:
Contractor:
GEORGE MORLAN PLUMBING
5529 SE FUSTER RD
*SEE ALSO MORLAN PLUMBING*
PORTLAND OR 97206
Phone #: 771 -1145 $ 26.25 TOTAL
Reg #..: 200734
REC!UIRED 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.
I
Permittee Sign- ure: \ P 01,14
9 .`.
Issued B4 mmfi—
all for inspection — 639 -4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125' 'SW Hall Blvd. Permit # PL - -033
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
016v# I d 2 rA l 5
Name o10eielopment New Single Family Residences Only
1161\ fl tYA._ t P 40M (ani
Address ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job 1 1411 S 1 o►C`+ +C t -l\A+ n ❑ 3 BATH HOUSE $225.00
Address tate r � Fee includes all plumbing fixtures in the dwelling and the first 100 feet
for 1 l a►n d Qi 91111-? of water service, sanitary sewer and storm sewer. See fees below.
Name (or name of Bisiieu{ FIXTURES QTY PRICE AMT
v\ k ¶ () °\ OA Sink 9.00
( rang Address phone Lavatory 9.00
Owner I 14/7 S y 1 / Tub or Tub /Shower Comb. 9.00
CayIStete Shower Only 9.00
Water Closet 9.00
Name (or name of tees) Dishwasher 9.00
►J
Occupant Gnfl \ S PPAOm(aVsr Garbage Disposal 9.00
"iv Addreu phoAe Washing Machine 9.00
1 14 11 W PaC 1 (c, � vq j Floor Drain 9.00
CayIState Water Heater I 9.00 9,00
P o' ICI nn o Ov 91/103 Laundry Room Tray 9.00
Name Urinal 9.00
G en M of kan Q 't) Other Fixtures (Specify) 9.00
Hang Address • J phone 9
Contractor 1'1 - Z5 S Q(ac r c I -\ w
(� . 9.00
City/State rm J 9.00
1 d , OV 91 ill' Sewer 1st 100' 30.00
State Re ' a No. Cdr s TaY Sewer - ea. Addit. 100' 25.00
O a, 34 L UGC Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' - t 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
giv- reason below.) Mobile Home Space 25.00
O Back Flow Prevention c - - 9 Device or Anti - Pollution Device 9.00
Signe o or agent) Date Any Trap or Waste Not
Connected to a Fixture 9.00
De • • = work new 0 addition 0 alteration 0 repair Q Catch Basin 9.00
to be •one 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 f 1 55,00 2
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE 4 1,0S / �
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL 2C7 ,a5 66 (
Special Conditions
Date issued by
3/22/00 Activities for Case #: PLM96 -00335
5:57:46 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 11/8/96 JSD PASS JD 11/8/96
PLMC005 Permit Created 11/8/96 JSD PASS JD 11/8/96
PLMC799 Final Inspection JT 3/1/99 3/1/99 inspection request
(research) sent to George
PLMC740 Misc. Inspection 11/8/96 JD 11/8/96
PLMC060 (F) Issue permit 11/8/96 JSD PASS JD 11/8/96
PLMA850 Expired by limitation 3/22/00 HAP DONE No Hold AKJ 3/22/00
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