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Permit CITY OF T I GARD PERM F�MB I NG PERMIT IT LU # • PLM96 -0156 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/18/96 13125 SW Hall Blvd. Tigard. Oregon 97223.8199 (503) 839 -4171 PARCEL: 251O28C—O73OO SITE ADDRESS...: 12604 SW PATHFINDER CT SUBDIVISION • NORTH TIGARDVILLE ZONING: R -4.5 BLOCK LOT :1 CLASS OF WORK..:NEW GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE °SF WASHING MACH 0 BACKFLOW PREVNTRS..: 1 OCCUPANCY GRP..:P1 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: Installing residential backflow device. Owner: FEES LYNN ROGERS type amount by date recpt 12604 SW PATHFINDERS CT PRMT $ 15.00 CJS 06/18/96 96- 280710 SPCT $ 0.75 CJS 06/18/96 96- 280710 TIGARD OR 97223 Phone #: Contract or: PRO LANDSCAPE PO BOX 5952 BEAVERTON OR 97006 Phone # : 504 - 642 -5452 $ 15.75 TOTAL Reg #..: 12174 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 RP /Backf low Prey applicable laws. All work will be done in accordance with Final Inspection approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for sore than 180 days. Permittee Signature: Q ;led Issued By: C. YYI .C.�i' Call for inspection — 639 -4175 City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # 96- D.8O7 /o 13125 SW Hall Blvd. Permit # yL m Qel" - p 1, Tigard, OR 97223 (503) 639 -4171 MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE tame a Ormapaa New Single Family Residences Only Manna ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00 Job 9 el (p 0(/ 5�. I a', ❑ 3 BATH HOUSE $225.00 Address MOW.. / rb Fee includes all plumbing fixtures in the dwelling and the first 100 feet Txtvut 02 9"7a, 3 of water service, sanitary sewer and storm sewer. See fees below. Nano (Q d B'°"°'l Q t FIXTURES QTY PRICE ANT <.g , P,. n e r. Sink 9.00 mono • ph. Lavatory 9.00 Owner / of (a 0 y S W Pa-M -f i hd er Cis Tub or Tub/Shower Comb. 9.00 Shower Only 9.00 T I 0 q ci 0 ( 17.2a3 Water Closet 9.00 Name x none Dishwasher 9.00 50( 3' e 4,5 Gth o t i Garbage Disposal 9.00 Occupant ,,, ,,,.,e Washing Machine 9.00 Floor Drain 9.00 wad. zio Water Heater 9.00 Laundry Room Tray 9.00 Nam. Urinal 9.00 P ro 1_ 6 no -c y e- Other Fixtures (Specify) 9.00 Contractor iut 9.00 P.©. )3 ox 5 9,5( Gig-5696 9.00 9.00 5e4 y e r to n 0 is 971)0( Sewer 1st 100' 30.00 w as i° Na Sewer - ea. Addit 100' 25.00 /0?/7471 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 I t' u /` - « 4,____s,. ( / Back Flow Prevention p -�7'�6 Device or And-Pollution Device 9.00 scrimp (maw at Iwo °ib Any Trap or Waste Not Connected to a Fixture 9.00 Describe work new I& addition 0 alteration 0 repair 0 Catch Basin 9.00 to be done residential e2._ non - residential 0 Insp. of Exist. Plumbing 40.00fir Specially Requested Inspections 40.00/hr Existing use of ` • Rain Drain, single family dwelling 30.00 building or property �l Residential backflow prevention devices 15.00 Proposed use of building or property '(Except residential backflow prevention devices) NOTICE 'Minimum Fee $25.00 SUBTOTAL ‘5,1g) PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE / •' 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 a cP • S Special Conditions Date issued (- / (9- q< b L J5 CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639 -4175 Business Phone: 639 -4171 Footing Rain Drain Cover /Service FINAL: Foundation Water Line Ceiling lu Post/Beam Mech. Shear /Sheath Framing -Mech. PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect. Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr /Sdwlk Reins. Other: Date: CzD / 4-0 l 7 0 A.M. P.M. Entry: Address: / ---C& 0 "t / ?�t Tenant: Ste: MST: BUP: Con /Own: MEC: PLM: ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: ' - Ins Datei:i( PROVED _ DISAPPROVED /CALL FOR REINSP. CF CO