Permit C ITY OF TIGARD : PLM96 -
PLUMBING PERMIT
PERM I T # 0266
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 09 / 1 x/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 231 10GD -00700
SITE ADDRESS...: 15440 SW ROYALTY PKWY
SUBDIVISION • ZONING:
•
BLOCK • LOT •
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -SF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 FLOOR DRAINS • 1 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: Alteration of a 4" floor drian.
Owner: -• - - -- FEES
JOHN BUD IHAS type amount by date recpt
15440 SW ROYALTY PKWY PRMT $ 25.00 CJS 09/10/96 KING CITY
5PCT $ 1.25 CJS 09/10/96 KING CITY
TIGARD OR 97223
Phone #: 620 -0811
Contractor:
ABLE MECHAN I CAL, I NC.
PO BOX 7176
BEAVERTON OR 97007 ---
#: 503 -640 -4141 $ 26.25 TOTAL
Reg #.. : 69114
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.
Permittee Signature: _ _
o„‘Z I ssued By: _YL� (�Cx _ — — --
Call for inspection - 639 -4175
CITY OF TIGARD Plumbing Application Rec'dByC&
13125 SW HALL BLVD. Commercial and Residential Date Recd ?- b- et 6
TIGARD,. OR 97223 Date to P.E.
Date to DST
(503).639 -4171 Permit a# R - - i) 2•56
Print or Type Related SWR # N/a
Incomplete or illegible applications will not be accepted Caned Plc,' 7,-ey
Name of Development/Project .. F.IXTURES' ,(itldivldual),i "'"` ?- j a ,;F�,t„ ; grY. P RICE , ;.?AMT
Job Sink 9.00
Address Street Address Suite Lavatory 9.00
1 YI'IO .5w / / . , I PO f E ri 4 • , Tub or Tub /Shower Comb. 9.00
Bldg # ty /State 'V Zip Shower Only 9.00
7 tingct pq 97;11(1 Water Coedit - 9.40
e e
Dishwater - 9.00
r�
Owner Mailing Address ,., Garbage Disposal 9.00
I �(U , I.J 1.-0‘.., um co4k( Washing Machine 9.00
City /State Zie " 7 Phone 1 Floor Drain 2" 9.00
Kit1Q CAI t otcriaa'I _ Goao -(W1) 3' 9.00 I
Name _
�Qrr�, a __ I
9.00 gcx
Occupant Mailing Address - Suite Water Heater 9.00
Laundry Room Tray 9.00
City /State Zlp Phone Urinal 9.00
Name
- Other Fixtures (Specify) 9.00
Abe (Y e,hck h c ca k _ItAr.._ . 9.00
Contractor _Mailing Address t Suite 9.00 [ ....
' i-? -u 'It? 6 t _ 0.00
ity /State Zip Phone
en e/ % Of 970...)1 1 (94J-41y` 9.00
9.00
in
Oreg, i i Cont. Board LIc.rF Exp. c Date
q t 9.00
Attach Copy of �ona
�uff U
Current Plumbing L,;c. # Exp. 19ate Sewer - 1st 100' 9.00
Licenses 34 -a a o Pe) 1 I i abl q(d Sewer - each additional 100' 30.00
COT 1 C 8S Businass Tax or Metro Exp• Dot i! ' 7 • f ! / gb Water Service - 1st 100' 25.00
Name Water Service . each additional 200' 30.00
Architect Storm & Rain Drain - 1st 100' 25.00
Or Mailing Address g,,;t Storm & Rain Drain • each aaattlonal 100' / 30.00
Mobile Home Space • 25.00
Engineer City /State Zip Phone Commercial Beek Flow Prevention Device or Anti- 25.00
Pollution Device
Describe work New 0 Addition 0 Alteration All Repair 0 Residential Backfiow Prevention Device• 15.00
to be done: Residential 0 Non - residential 0 Any Trap or Waste Not Connected to a Fixture 9.00
Additional description of work Catch Basin 9.00
r Insp. of Existing Plumbing 40.00
CollVeli OI N 430 C S per hr
Existing use of Specially Requested Inspections 40.00
per hr
building or property
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL °: �? ::;
Are you capping any fixtures? Yes 0 No 0 Isometric or riser diagram le required ItOusnity is } 9 :,r ,,;
I hereby acknowledge that I have read this application, that the Information *SUBTOTAL l'SI ,.T"`� . f 16
given is correct, that I am the owner or authorized agent of the owner, and `>j ;',,...a:
mat plans submitted are in compliance with Oregon State Laws. 5% SURCHARGE :MA ' ;'''',
Signature of Owner /Agent Date '= ' -5 Sri*
PLAN REVIEW 25% OF SUBTOTAL , ei. °'y;ts; '
1
ql Iq t L: r:` •d..
Required only if nat ure Qty. total Is 2 9 :>� ,,.4'. +�:.,' . �;
Con et orlon Name n TOTAL i': r ,:� „.. '
Phoney..,:.
• 1' 1 r i V "(I+•I } *Minimum permit fee is $25 + 5% surcharge. except Residential Backflow
,Uiststplmapp.doc 8/96 -- - Prevention Device, which Is 515 + 5% surcharge
•
4/19/00 Activities for Case #: PLM96 -00266
5:47:43 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA007 Application received 9/6/96 CJS RECD CJS 9/10/96
PLMA050 (F) Issue permit 9/10/96 CJS PASS CJS 9/10/96
PLMA055 (F) Reprint Permit 9/10/96 CJS 9/10/96
PLMA800 Case Finaled 9/20/96 MS PASS MRS 9/23/96
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