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Permit • CITY F T I GA R D PLUMBING PERMIT PERMIT #: PLM1999 -00193 ,� y n DEVELOPMENT SERVICES DATE ISSUED: 6/23/99 --I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12625 SW SNOW BUSH CT PARCEL: 1S133DA-08500 SUBDIVISION: AMART SUMMERLAKE NO. 2 ZONING: R -7 BLOCK: LOT: 145 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential backflow prevention device. FEES Owner: • Type By Date Amount Receipt PAUL DRAKE 12625 SW SNOW BUSH CT PRMT DEB 6/23/99 $25.00 99- 316345 TIGARD, OR 97223 MISC DEB 6/23/99 $1.25 99- 316345 Total $26.25 Phone 1: Contractor: NATURES PATH LANDSCAPING INC. 10623 NE FOX FARM ROAD DUNDEE, OR 97115 -0000 REQUIRED INSPECTIONS Phone 1: 680 -6040 RP /Backflow Preventer Reg #: LIC 6174 Final Inspection PLM 1204.1 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other 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. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued By: / Permittee Signature: Cal (503) 639 -4175 by 7:00 P.M. for an inspection needed e next business day (l4q,(a--e_e____ L/ed • • CITY TIGARD � t � ! PLUMBING PERMIT AVM 19 PERMIT #: PLM1999 -00193 y4, DEVELOPMENT SERVICES. DATE ISSUED: 6/23/99 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12625 SW SNOW BUSH CT PARCEL: 1S133DA -08500 SUBDIVISION: AMART SUMMERLAKE NO. 2 ZONING: R -7 BLOCK: - LOT: 145 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential backflow prevention device. FEES Owner: Type By Date Amount Receipt PAUL DRAKE 12625 SW SNOW BUSH CT PRMT DEB 6/23/99 $25.00 99- 316345 TIGARD, OR 97223 MISC DEB 6/23/99 $1.25 99- 316345 Total $26.25 Phone 1: Contractor: NATURES PATH LANDSCAPING INC. 10623 NE FOX FARM ROAD DUNDEE, OR 97115 -0000 REQUIRED INSPECTIONS Phone 1: 680 -6040 RP /Backflow Preventer Reg #: LIC 6174 Final Inspection PLM 12041 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other 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. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 - 008 You ay obtain • •pies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issu :. By: 1 _ 2 4,4 . _4 , , A ik _ �� -' Permittee Signature: - _ f _ r r Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next usiness day CITY OF TIGARD Plumbing Permit Application Plan Check - 13125 SW HALL BLVD. Commercial and Residential R ec'd By.l �� . TIGARD, OR 97223 Date Rec'd G/ 'A ` " ° q V (503) 639 -4171 ` ‘ Date to P.E. - Print or Type (4-1,,R.35,,,i, Date to DST Permit #It.F - i(ERt1 ?'00/9 Incomplete or illegible applications will not be accepted Related SWR # -° Called Name of Development/Project FIXTURES (individual) QTY PRICE AMT • Job PA, J L - ORA g- Sink 11.50 Address 1 Street Address s � 1 ,43 R vS Suite Lavatory 11.50 r..7 Tub or Tub /Shower Comb. 11.50 Bldg # City /State Zip Shower Only - 11.50 7764 O Name Water Closet 11.50 Dishwasher 11.50 Owner Mailing Address Suite Garbage Disposal 11.50 Washing Machine 11.50 City /State Zip Phone Floor Drain/Floor Sink 2" 11.50 Name 3" 11.50 4" 11.50 Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 11.50 Gas piping requires a separate mechanical permit. City/State Zip Phone Laundry Room Tray 11.50 Urinal 11.50 Name IAA g _ l � T r I GN Other Fixtures (Specify) 15.00 1.24 Kg 5 ),4- -T /.A, - scAP /,-)r-, Contractor Mailing Address Suite (obZ3 s Nf I�'X )21 fit - Prior to permit City/State Zip Phone Sewer - 1st 100' 38.00 issuance, a copy -- 0‘.7,�g f el q7 1 / s 1,81 ( to of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date Sewer - each additional 100' 32.00 required if / -74 / l/5/)45 Water Service - 1st 100' 38.00 expired in COT Plumbing Lic. # / 24,4/ Exp. Da Water Service - each additional 200' 32.00 database / 03 / / 95 Storm & Rain Drain - 1st 100' 38.00 Name Storm & Rain Drain - each additional 100' 32.00 Architect Mobile Home Space 32.00 Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 32.00 Pollution Device Engineer City/State Zip Phone Residential Backflow Prevention Device' 19.00 (Irrigation timing devices require a separate J /g Describe work to be done: restricted energy permit.) / New Repair 0 Replace with like kind: Yes O No 0 Any Trap or Waste Not Connected a Fixture 11.50 Residential p- Commercial O Catch Basin 11.50 Additional description of work: L. A (,,.. A.7 Insp. of Existing Plumbing 50.00 / jJ S'V4 /i . gr4Cf( f2-0 a) PR', - S per/hr Are you capping, moving or replaci g any fixtures? Specially Requested Inspections 50.00 Yes 0 No per/hr R ain Drain, single family dwelling 45.00 If yes, see back of form to indi ate work performed by Grease Traps 11.50 fixture. FAILURE TO ACCURATELY REPORT FIXTURE WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quantity Total is > 9 given is correct, that I am the owner or authorized agent of the owner, and "SUBTOTAL o' ..... that plans submitte are 'n compliance with Oregon State Laws. Signature of NA ent �/G Date , 9 5% SURCHARGE A , 2 y Contact Perso Na e Phone "PLAN REVIEW 25% OF SUBTOTAL Required only if fixture qty. total Is > 9 1 BATH HOUSE $178.00 . TOTAL Ai , _2 BATH HOUSE $250.00 . - . _ 3 BATH HOUSE $285.00 'Minimum permit fee is $50 + 5% surcharge, except Residential Backflow (This fee includes all plumbing fixtures In the dwelling and the first Prevention Device, which is $25 + 5% surcharge 100 feet of sanitary sewer storm sewer and water service) "'All New Commercial Buildings require plans with isometric or riser diagram and plan review I: ldstsVornslplumapp.doc 6/2/99 • r" PLEASE COMPLETE: Fixture Type Quantity by Work Performed N ;. ew' . Moved . Replaced . ;:Removed /Capped Sink Lavatory Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain /Floor Sink 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I:tdstsformslplumapp.doc 6/2/99 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 QQ BUP "'ZS' l Date Requested G "'� I AM PM BLD Location �1n(���")�b,,��_. Suite MEC n/ Contact Person I ° e( vl 1 Y\ Ph U gO°{Q (S PLM ) q qq - 0D / C Contractor Ph SWR BUILDING Tenant/p ecuv Dw,ae.e., ELC Retaining Wall ELR Footing Access: Foundation I /� �/� ! /� FPS Ftg Drain ,/ Crawl Drain Inspection Notes: // ,^, ^ 11 �, SGN Slab 1.� S[ �1.�, SIT Post & Beam �� Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm �j� Susp'd Ceiling 11��`- 111 Roof Misc: Final PASS PART FAIL -- Post & Beam 19ack l Under Slab - Top Out Water Service Sanitary Sewer Rain Drains F' =. ) PART FAIL 171ELHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In 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 Approach /Sidewalk Other Date 6 �°dF Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.