Permit PLUMBING PERMIT /^^
PERMIT # ^ PLM96-69170
GITY � TIGARD DTE ISSUED: 06/25/96
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL: 25114BC-00700
S SITPAni4g Aew�� 49125/6
SUBDIVISION....: PICKS LANDING NO.1 ZONING: R-4.5
BLOCK : LOT ^62 /6/35_
^^^^^^^^^^ •
_ ����_ - -
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE....:SF WASHING MACH ^ 0 BACKFLOW PREVNTRB..: 0
OCCUPANCY GRP..:R3 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 water heater
Owner : FEES
PAT FROST • type amount by date recpt
10185 SW RIVERWOOD LN PRMT $ 25.00 JSD 06/25/96 96-280969
5PCT $ 1.25 JSD 06/25/96 96-280969
TIGARD OR 97224
Phone #
Contractor:
GAROKEN ENERGY COMPANY
3975 SW 113TH
BEAVERTON OR 97005 •
Phone #: � $ 26.25 TOTAL
Reg #..: 043124
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 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.
Permitt Signature. — --' — ---
Issued oc
' Call for inspection — 639-4175
--
City of i'igard PLUMBING PERMIT Planck/Rec. #
13125 SW Hall Blvd. APPLICATION Permit # I'a- 0 ' -16. - -U
Tigard, OR 97223
(503) 639 -4171
Nem. of DInviownent Descnpbon
ORS 814 - 21-610 QTY PRICE AMT
' J{03.K
Job /0/ e6 UQYco 1. FIXTURES
Address , Lp Si 7.50
1 )jam 1 {� % 70021/ Lavatory 7.50
rdam. or nave a Tub or Tub/Shower Comb. 7.50
Or, 1D5 T Shower Only 7.50
`""g 1d° Phone Water Closet 7.50
Owner /v/ ,5i,,) deYGwJ (ep Dishwasher 7.50
`'heSr'e Lp Garbage Disposal 7.50
j` a-3/c/ ' 76? / Washing Machine 7.50
m ama """' °' Floor Drain 7.50 '
&1vlivLe_ Phone Water Heater / 7.50 7, co .
Occupant Laundry Room Tray 7.50
Urinal 7.50
` Lp Other Fixtures (Specify) 7.50
7.50
NaAe 7.50
_ G G } %+i - 7.50
Contractor ° .1 � St //3-K C lp 7, O�� MISCELLANEOUS
(M,„,„ Lp 1
r a V4t3 () / 7,n5 Sewer 1st 100' 30.00
S. a.guaa°n N°. CPy' a,.. Tao N °- Sewer - ea. Addit. 100' 15.00
g3)(91-7 / - ' Water Service 1st 100' 20.00
I hereby acknowledge that I have read this application, t at a Water Service ea. Addit. 200' 15.00 •
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 I Storm & Rain Drain 1st 100' 30.00
am registered with the Construction Contractor's Board, that the number Storm & Rain Drain Addit. 100' 15.00
given is correct. (If exempt from State registration, please give reason
below.) Mobile Home Space 25.00
// / g-(� Back Flow Prevention
9■- ((J,t,t} �p'a - 4 Device or Anti- Pollution Device 7.50
•r •*+e•' I Vale Any Trap or Waste Not
Connected to a Fixture 7.50
Describe work new{ a ition U alteration U repair U • Catch Basin 7.50
to be done residential non- residential 0 40.00
Insp. of Exist. Plumbing per hr
40.00
Specially Requested Inspections per hr
Existing use of ' /�� Rain Drain, single family
building or property 51 i^,c (L .f/\ dwelling 15.00
J Residential backflow prevention
devices 15.00
Proposed use of ,
building or property
'(Except residential backilow
prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL
•
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5% SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF �'z�
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED .
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25% OF SUBTOTA
COMMENCED.
• TOTAL ?(p,
Special Conditions -
Date issued by
luiPLUMBpAfT
worecorndev
5/23/00 Activities for Case #: PLM96 -00170
2:17:42 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA007 Application received 6/25/96 JSD PASS JD 6/25/96
PLMA799 Final Inspection 6/26/96 TLP PASS RDP 10/23/97
PLMA740 Misc. Inspection 6/25/96 6/26/96 TLP PART TLP 6/26/96 water heater to be installed and
inspected
PLMA040 (F) Ready to issue 6/25/96 JSD PASS JD 6/25/96 Need CCB /PLM info
PLMA050 (F) Issue permit 6/25/96 JSD PASS JD 6/25/96
PLMA743 Gas Line 6/26/96 6/25/96 TLP PASS TLP 6/26/96
PLMA800 Case Finaled 12/15/97 HAP PASS DGW 12/15/97 closed by review
Page 1 of 1