Permit •
CITYOFTIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PLUMBING PERMIT
PERMIT # PLM94 -0199
639 -4171 DATE ISSUED: 09/06/94
PARCEL: 0S000XX -00000
SITE ADDRESS...: 13660 SW PACIFIC HWY
SUBDIVISION ZONING:
BLOCK • LOT
CLASS OF WORT'...: REP GARBAGE DISPOSALS..: MOBILE HOME SPACES.:
TYPE OF USE •MF WASHING MACH • BACKFLOW PREVNTRS..:
OCCUPANCY GRP..:R1 FLOOR DRAINS • TRAPS •
STORIES • 2 WATER HEATERS CATCH BASINS •
FIXTURES LAUNDRY TRAYS SF RAIN DRAINS
SINKS • URINALS • GREASE TRAPS •
LAVATORIES OTHER FIXTURES °
TUB /SHOWERS SEWER LINE (ft) °10
WATER CLOSETS..: WATER LINE (ft)
DISHWASHERS • RAIN DRAIN (ft) •
Remarks: sewer repair
Owner: FEES
FIR GROVE APTS type amount by date recpt
PRMT $ 30.00 — 09/06/94 94
SPCT $ 1.50 — 09/06/94 94
00000 -0000
Phone #: 000 - 000 -0000
Contractor:
B AND B SEPTIC AND SEWER
10959 SE 92ND
PORTLAND OR
Phone #: $ 31.50 TOTAL
Reg #..: 79653
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Top —out Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other F i n a l 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.
Permittee Si n tune:
Issued By
Call for inspection — 639 -4175
r
City.. of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit # pi-h. 94 °l99
Tigard, OR 97223
(503) 639 -4171
•
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
,^.. New Single Family Residences Only
❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job 0 S S G J i4e_a_ i ❑ 3 BATH HOUSE $225.00
Address mow. ab Fee includes all plumbing fixtures in the dwelling and the first 100 feet
,e:g r ^ j , of water service, sanitary sewer and storm sewer. See fees below.
rftiri (et name el ) FIXTURES QTY PRICE AMT
Sink 9.00
gan Address Nene Lavatory 9.00
Owner Tub or Tub/Shower Comb. 9.00
al zip Shower Only 9.00
Water Closet 9.00
N.... (or name a/ tween°° Dishwasher 9.00
Garbage Disposal 9.00
Occupant ,,,,, Ad*. Plum Washing Machine 9.00
Floor Drain 9.00
mv°State no Water Heater 9.00
Laundry Room Tray 9.00
Name Urinal 9.00
•
,?c f <ja Sf K Other Fixtures (Specify) 9.00
P"°" 9.00
Contractor
/(2V 5 92 ‘ Tg - M? 9.00
C"y''Stat° no 9.00
/6(7 d Sewer 1st 100' J 30.00 G
. N0. Catr Sus. Ts No. Sewer - ea. Addit 100' 25.00
q 6c 3 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
Device or Anti- Pollution Device . 9.00
Signature teener • 7 fans Any Trap or Waste Not
/ / 9 / /Y4/ Connected to a Fixture 9.00
Describe work new 0 - . • on 0 alteration 0 repair,ef Catch Basin 9.00
to be done residential 0 non - residential 0 Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr
Existing use of �;/
building or property `'`1f Rain Drain, single family dwelling 30.00 •
Residential backflow prevention
devices 15.00
Proposed use of
building or property Q
'(Except residential backflow
prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL -
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE ) x��
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 3 ?,.r°
Special Conditions
Date issued by
INSPECTION NOTICE -'2-7---
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspectfd, Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection "'(/ 4 ; Z 2 2 - - _
Footing Plbg. Underslab Mech. Rough -in Appr /Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
i
Post /Beam Struct. San. Sewer / ) Framing -Bldg.
Post /Beam Mech. \Rain Drain Insulation - Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: /C -j 9 Time: AM PM
Address: /2/o' (� . o ( ScC/ / Permit (j 211-7( ' -- 6/ 1 1f
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i i /�� ��
Inspector: 1 V7* / Jno Date: AV '''..
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.