Permit CITY OF TIGARD PERM I P # LUMBING PERMIT
° PLM96 -0064
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/05/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 2S 109DD -06500
SITE ADDRESS...: 12780 SW PRINCE ALBERT CT
SUBDIVISION ZONING:
BLOCK • LOT _
CLASS OF WORK. °:NEW GARBAGE DISPOSALS °: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -SF WASHING MACH 0 BACKFLOW PREVNTRS..: 1
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 • 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: Installation of an irrigation system
Owner: FEES
CONROY type amount by date recpt
12780 SW PRINCE ALBERT PRMT $ 25.00 JDA 04/05/96 KING CITY
5PCT $ 1.25 JDA 04/05/96 KING CITY
KING CITY OR 97224
Phone #:
Contractor:
DANIEL MAYER
20878 SW LONGACRE
ALOHA OR 97006 -•
Phone #: 848 -6012 $ 26.25 TOTAL
Reg # °.: 6694
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the RP /Back flow Pre v
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final I n s p e c t i o n
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 Signature: 1/1
Issued B y : /, . • it./
Call for inspection — 639 -4175
'r .
-+-- ''.-JRN -23 -' 00 MON 05:22 ID: FRX NO: _ _ r 0 I055 P02
?
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit # PI PIci - 6004
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
e.... a o.-1.-e Hew Simile Family Residences Only
•
Added. n ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195,00
Job Ll'i $d ` ii-LrkvikinPit O 3 BATH HOUSE 9225.00
Address m Fee includes all plumbing fixtures In the dwelling and Me first 100 feet
L C :r.. or Cf 7,2c-( of water service, sanitary sewer and storm sewer. See fly below.
ore,. edt pp of a w r FIXTURES QTY PRICE AMT
/4111r-A 0 >r c:a... Con ro Sink 9.00
wra Aam Plum Lavatory 8.00
Owner Ia.�P) � nca, Ativit Sao - /gg) Tub er Tub/Shower Comb. 9.00
weep m Shower Only 9.00
fi a, \ 0 `� 2,2� Water Closet 9.00
' w„ n,. (et n�. a g
egos.) . I Dishwasher 9.00
' Garbage Disposal 9.00
Occupant mug cam Raw ' Washing Machine 9 -0
Floor Drain 9.00
c.,, e... re Water Heater 4 9.00
Laundry Room Tray 9.
"- Soft 11 Urinal 9
• f11J H 1�(O kI n Other Fixtures (Specify) 8.00
9,00
Contractor '•- I 9.00
• � p 9.00
h a 0V q 1 Ode, ' Sewer 1st 100' 30.00
an. rom..d. No. ref auk. ra rd $ewer - ea. Addit. 100' 25.00
1 l 3 (0., Water Service 1st 100' 30.00
I he b age that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is coifed, that I am the owner or authorized agent of - - Storm & Rain Drain tat 100' 30.00
the owner, Chet Plans subs are in compliance with State laws, that
I am registered with the Construction Contractors Board, that the Storm & Rain Drain Ada. 100' 25.00
number given Is correct. (If exempt from State registration, please '
give reason below.) Mobile Home Space 25.00
Back Flow Prevention
e r,(6� /� ` 4 -s 3 ( Device or Anti - Pollution Device 9.00
rgy. a . Any Trap or Waste Not
vv Connected to a Fixture 9
Describe work new 0 addition 0 alteration O repair 0 Catch Basin 9.00
to be done residential 0 non - residential 0 Insp, of Exist Plumbing 40.001hhr
• Specially Requested Inspections 40.001hr
Existing use of '
Rain Drain, single family swelling 30.00
building or property
Residential back prevention
devices I 15.00
Proposed use of
building or property - (EEcept res backllow
prevention devices)
•
NOTICE 'Minimum Fee 526.00 SUBTOTAL a5.06
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5% SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF , ,
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25% OF SUBTOTAL
COMMENCED.
TOTAL dir2C
Special Conditions
�-�- - _._
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested dI AM PM BLD
Location L)7(1 / " � lJ i-t /6 K :l/1Geme. Suite MEC it
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing A� / ACX- for,, i (2e !G , • FPS
Foundation NOT REQUESTED
Drain
Crawl Drain In
FOUND DURING RESEARCH SGN
Cr
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
RT FAIL
LUMBIN
Under Slab
Top Out
Water Service
Sanitary Sewer
Rail Drains
��� PART FAIL
MECHANICAL
•
Post & Beam
Rough In
Gas Line 9
Smoke Dampers L
Final
PASS PART FAIL
ELECTRICAL
Service 111 J I
Rough In n n�
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 / M
Approach /Sidewalk
Other ns p D Inspector � Ext
Final
PASS PART FAIL . DO NOT REMO ' E this inspection record from the job site.