Permit CITYOFTIGARD
t,/
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PLUMBING PERMIT
PERMIT #........ 7 - z`;:.
639 -4171 DATE ISSUED: 08/24/95
PARCEL: 1S136D5 -•'7J0cS0QI
SITE ADDRESS...: 11.119 OW PACIFIC I WY
SUBDIyISION ZONING: C -G
BLO::R LOT •
CLASS CF WORK..:ADD GARBAGE DISPOSALS..: MOBILE HOME SPACES.:
TYPE OF USE. ,...:CON WASHING MACH • BACKFL.OW PREVNTRS.. :2
OCCUPANCY C;RP'.. ;A3 FLOOR DRAINS TRAPS
STORIES -1 WATER HEATERS CATCH BASINS
FIXTURES - -- - - - - - - -- LAUNDRY TRAYS SF RAIN DRAINS
SINKS -1 URINALS GREASE TRAP'S.......: 1
LAVATORIES.. ..:v OTHER FIXTURES 4
TUB/SHOWERS • SEWER LINE (ft)
WATER CLOSETS. .:3 WATER LINE (fit) •
DISHWASHERS • RAIN DRAIN (ft) •
Remarks: Add it ion of men's bathroom.
Owner : - -- -- -• - - -- - - - - -- - FEES - -- • --
GAL VAN GUITRAN PARTNERSHIP type amount by date r
11619 SW PACIFIC HWY PRMT $ 211.00 JSD 08 /24/95 95-269766
PICK $ 52.75 JSD 06 /24/95 95 -a- 6 7c -
TIGARD OR 97223 SPCT $ 10.55 JSD 08/24/95 95- 269766
Phone #: 2t3 -341..
Contractor: - - - - - -- •
CHRISTIAN PL.UMiriING
22919 SW STAFFORD RD
TUALAT I N OR 97062 • •- -----
Phone #: 503-771-9449 $ 274.30 TOTAL
Reg L. : 42671
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the PLM /Underfloor -_
Tigard Municipal Code, State of Ore. Specialty Codes and all other Top-out Insp
applicable laws. All work will be done in accordance with Inspect existing
approved plans. This permit will expire if work is not started Insp existing/ca
within 180 days of issuance, or if work is suspended for more Final Inspect ion
than 180 days. _
Per Si ■ • 'e:
—
Issue LI Fly . �' •
Call for inspection - 639 -4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit # Pt- M'IBS -Oaab
Tigard, OR 97223
(503) 639 -4171 lk
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name of Divilcdment New Single Family Residences Only
1/6 t / S. tO. R CA: j C, Hu() i
_ �� �(i�� O 1 BATH HOUSE $140.00 2 BATH HOUSE $195.00
Job
0 3 BATH HOUSE $225.0 0
Address no Fee includes all plumbing fixtures in the dwelling and the first 100 feet
of water service, sanitary sewer and storm sewer. See fees below.
Name (or name o1 01Aaess) FIXTURES QTY PRICE AMT
Sink 1 / 9.00 Cf
me" Address Phone Lavatory _3 9.00 2 7
Owner Tub or Tub /Shower Comb. 9.00
'')"state DA Shower Only 9.00
• Water Closet 9.00 2
Name (ei name W biome) Dishwasher 9.00
Garbage Disposal 9.00
Occupant U. , Address Flume
Washing Machine 9.00
Floor Drain / // 3 9.00 Z 7
C"y'Stafe m Water Heater 9.00
y//�� Laundry Room Tray 9.00
Name 1?/ / / y9
9 Urinal 9.00 / /
, h r &n /141 ?//2 ,.,.�, i >> xl / Other Factures (Specify) 9.00
Maine Address e / Si i,Lt /1/I /
Contractor r.
g 3 1 7c2 S. /,t>. SrAPP - O `d �� 1 • (7're_ASef Tr-Ar , 9.00 9.00
atyISete no 9.00
Ti 1 1 ,O / Or 9 7O6.:2_ Sewer 1st 100' 30.00
City Bus. Tan No. Sewer - ea. Addit. 100' 25.00
3 L/70 Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 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
give reason below.) Mobile Home Space 25.00
Back Flow Prevention
�� « e9-c=7-Q,5 Device or Anti - Pollution Device a. 9.00 /'"?
%ranee (cone, at agent) Date Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new 0 addition 0 alteration .0 repair 0 Catch Basin 9.00
to be done residential 0 non - residential 0 Insp. of Exist. Plumbing 40.00/hr L1 0
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 f ,
'(Except residential backflow e
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL 1 - i, �
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 7 st .9., I ��
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE ( I��II� i
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED •
- - FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS J COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
Vy
TOTAL fi1M - -
Special Conditions
N
Date issued by
CRY OF TIGARD BUILDING INSPECTION NOTICE e
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection:
Footing Susp. eiling Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough -in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing e itum64 ) '
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. - Elect.
Date Requested: /04/5' J / Time: AM PM
Address: /k / 1
Builder: Permit #: Q(j/14 ¶ 50 Z 2
THE FOLLOWING CORRECTIONS ARE REQUIRED:
ao �Il/% x zh � 4F ,-,..
In pector. Date: /U /��D
G j�_\PPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
6/16/99 Activities for Case #: PLM95 -00226
2:06:21 PM •
Assigned Hold Updated •
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC007 APPlication received 8/21/95 JDA PASS JDA 8/21/95 Mike S. received call from TV
• Water District, saying that G.
Morlan truck was on site, and
that they did not have
information this. The Building
plans were issued on 5/4/95
and Mike did not review as the
plans were not forwarded by
Plans Examiner to him. Mike
will inform G. Morlan /Mazatlan
that a PLM is needed..
PLMC799 Final Inspection 9/29/95 MS NR MRS 9/29/95 not complete
PLMC720 PLM /Underfloor 8/21/95 8/28/95 MS PASS MRS 8/29/95
PLMC725 Top -out Insp 8/21/95 9/7/05 MS PASS MRS 9/8/95
PLMCO50 (F) Ready to issue 8/21/95 JDA PASS JDA 8/21/95
PLMC060 (F) Issue permit 8/24/95 JSD JD . 8/24/95
PLMC725 Top -out Insp 9/26/95 ' MS V PASS MRS 9/26/95
PLMC800 Case Finaled 10/3/95 MS PASS MRS 10/3/95
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