Permit CITY OF TIGARD PLUMBING PERMIT
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DEVELOPMENT SERVI PERMIT
ISSUED: O6/Oc'/9 -0196
PARCEL: 2S1O3DB -09900
SITE ADDRESS...: 11480 SW SONNE PL
SUBDIVISION • GENESIS NO. 3 ZONING: R -4.5
BLOCK • LOT •76 JURISDICTION: TIG
CLASS OF WORK..:REP GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •SF WASHING MACH • 0 BACKFLOW F'REVNTRS..: 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: Replace gas water heater
Owner: FEES
LARRY FRANK type amount by date recpt
11480 SW SONNE PL PRMT $ 25.00 DRA 06/02/97 97- 295331
TIGARD OR 97223 5PCT $ 1.25 DRA 06/02/97 97 -295331
Phone #: 620 -9068
Contractor
GEORGE MORLAN PLUMBING
5529 SE FOSTER RD
*SEE ALSO MORLAN PLUMBING*
PORTLAND OR 97206
Phone #: 771 -1145 $ 26.25 TOTAL
Reg #..: 002007
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 peruit will expire if work is not started
within 180 days of issuance, or if work is suspended for lore
than 180 days.
Permittee 'i• -tore: /.�.�
Issued B : • AA. I
Call for inspection — 639 -4175
Recd By ;ITY O1= TIGARD Plumbing Application C-¢-�'
3125 SW HALL BLVD. Commercial and Residential Date Recd (i - a -c l 7
i IGARP, OR 97223 Date to P.E
Date to DST
(503) 639 -4171 Permit# pi, H41 -01q
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project FIXTURES (Individual) QTY PRICE AMT
Job Sink 9.00
S treet Address Suite Lavatory 9.00
Address Tub or Tub /Shower Comb. 9.00
1 ii-1-80 SK) SoN n�C PL
Bldg # City /State Zip Shower Only 9.00
- 1"1(. , A - -,D q 7 Water Closet 9.00
Name Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
I 14430 r PL Washing Machine 9.00
City /State Zip Phone Floor Drain , 2" 9.00
'nW -TJ q 2,2-3 - (P20-' 7o6, 8" 3• 9.00
Name _
`- 4 9.00
Occupant Mailing Address Suite Water Heater / 9.00
Laundry Room Tray 9.00
City /State Zip Phone Urinal 9.00
Name
Other Fixtures (Specify) 9.00
C't_bt2. /')")o2c,5N PL-8 L-- 9.00
Contractor Mailing Address Suite 9.00
17�'8S Pu: TAG - 1 • 9.00
(Prior to issuance City /State Zip Phone
applicant must ' eA�t� OQi 17 Z23 (.a2x{- -73g / 9.00
fl
provide all Oregon Const. Cont. Board Licit Exp. Date - 9.00
contractors .A 9.00
license Plumbing Lic. # Exp. Date Sewer- 1st 100" 30.00
information 22c49(.90e1
Sewer - each additional 100' 25.00
for COT COT Business Tax or Metro # Exp. Date Water Service - 1st 100' 30.00
database).
I
Name Water Service - each additional 200' 25.00
Architect Storm & Rain Drain - 1st 100' 30.00
Of Mailing Address Suite Storm & Rain Drain - each additional 100' 25.00
Mobile Home Space 25.00
i Engineer City /State Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00
I Pollution Device
Describe work New 0 Addition 0 Alteration 0 Repair 0 Residential Backflow 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
/2 C PLAC.A -c 6A iii-TA1' r -72 Insp. of Existing Plumbing 40.00
I per/hr
Speciaily Requested Inspections 40.00
Existing use n,� -10��C� per /hr
' building or property perty --` Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL
Are you capping , moving or replacing any fixtures? Yes V No ❑ Isometric or riser diagram is required if Quanity Total is > 9
(If yes see back of form) 'SUBTOTAL
I hereby acknowledge that I have read this application, that the information .
i given is correct, that I am the owner or authorized agent of the owner. and 5% SURCHARGE
I that plans submitted are in compliance with Oregon State Laws. PLAN REVIEW 25% OF SUBTOTAL
Signature f Owner /Agent Date
/� aibi --e_,K (p 1 q Required only if fixture qty. total is > 9 TOTAL
.u../ Z) -----
Contact Person Name Phone
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*Minimum permit fee is 525 + 5% surcharge, except Residential Backflow
"
Vw ' t/1 ki - � (P2- (QK`j Prevention Device. which is 515 + 5% surcharge
1:\plmapp.doc 12/96 (dst)
PLEASE COMPLETE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced Qty
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet -
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I :\plmapp.doc 12/96 (dst)
5/9/99 Activities for Case #: PLM97 -00196
8:46:18 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA007 Application received 6/2/97 DRA RECD DRA 6/2/97
PLMA011 Create Permit 6/2/97 DRA PASS DRA 6/2/97
PLMA799 Final Inspection 7/31/97 MS FAIL J'H 8/19/97 SEE MISC ACTION 073197
PLMA740 Misc. Inspection 6/2/97 7/31/97 MS PASS J'H 8/19/97 Approved subject to
corrections: 1. Need to firestop
at ceiling. 2. 1" to combustible
required. CALL FOR
REINSPECTION
PLMA060 (F) Issue permit 6/2/97 • DRA PASS DRA 6/2/97
PLMA799 Final Inspection 2/3/99 MS PASS MRS 2/3/99
PLMA800 Case Finaled 2/3/99 MS PASS MRS 2/3/99
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