Permit CITY OF TIGARD
DEVELOPMENT LOPMEN A SERVICES P PERMI 1 T UMMBING PERMILM96 -0313 Hall Blvd., Tigard, (503)639-4171( ( r `h DATE ISSUED: 10/21/96
PARCEL: 1S136CB -08200
SITE ADDRESS...: 08240 SW STEVE ST
SUBDIVISION • HERB & PEGGY'S PLACE ZONING: R -4.5
BLOCK • LOT • 1
CLASS OF WORK..:REP GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -SF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:A1 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: WATER HEATER REPAIR( ?)
Owner: FEES
MICHAEL RANSHOT type amount by date recpt
8240 SW STEVE PRMT $ 25.00 TAT 10/21/96 96- 285444
SPCT $ 1.25 TAT 10/21/96 96- 285444
TIGARD OR 97223
Phone #: 620 -6530
Contractor: --
CONTRACTOR NOT ON FILE
Phone #: $ 26.25 TOTAL
Reg #...
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Service I n
applicable laws. All work will be done in accordance with Rough —in Insp
approved plans. This permit will expire if work is not started PLM /Underf 1 oor
within 180 days of issuance, or if work is suspended for more Misc. Inspection
than 180 days. Final Inspection
Permittee Si at! re:
Issued By: , ` 4
Call for inspection — 639 -4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 5;W Hall Blvd. Permit # PL?-3)3
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name of D )! 1 New Single Family Residences Only
Address /u,( l 'I �"' ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job �2(.�6 5W , S l.� vZ 0 3 BATH HOUSE $225.00
Address a n9 Fee includes all plumbing fixtures in the dwelling and the first 100 feet
T/ /( (fir �C 0 7 2 ' 3 of water service, sanitary sewer and storm sewer. See fees below.
Neme name of Busmen) FIXTURES QTY PRICE AMT
,ffi,1ddl Pal l7 Sink 9.00
Meting Ad &e.. ,, �/� Phone Lavatory 9.00
Owner / ' 3,q 6 /0 S,(JJ,S f-,,uL 10Z -6536 Tub or Tub /Shower Comb. 9.00
ate Shower Only 9.00
��j OK g 7 2 ' Water Closet 9.00
Na,,,t1,�, n of busmen) Dishwasher 9.00
Garbage Disposal . 9.00
Occupant M ating Aden shone Washing Machine 9.00
Floor Drain 9.00
City /State ZIP Water Heater / 9.00 `7•
Laundry Room Tray 9.00
( Name //� v� L hAtio Urinal 9.00
L /J /77) /, , Other Fixtures (Specify) 9.00
Mating Amen j Phone 9.00
Contractor `-0 • I* ,o80397 (0� , /27
�/ ry�� � Q y 9.00
ts ar !it Ole 9 7i l 9.00
Sewer 1st 100' 30.00
St°f ' Q80on No. Cit Baa. Tao No. Sewer - ea. Addit. 100' 25.00
7C, 35C q5- 361 / Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
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 Storm & Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit. 100' 25.00
number given is correct. (If exempt fro,. -te registration, please
give reason below.) Mobile Home Space 25.00
f /4-/-7- Back Flow Prevention
• - Io Device or Anti - Pollution Device 9.00
Suture (owner or aged Date Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new 0 addition 0 alteration 0 repair 0 Catch Basin 9.00
to be done residential 0 non - residential 0 Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00 /hr
Existing use of
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of
building or property
'(Except residential backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL r aJF co
PERMITS BECOME VOID IF WORK OR CONSTRUCTION w
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE /,25
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
- - FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL 0 2625
Special Conditions
Date issued by
Page No. 1 CASE HISTORY FOR CASE NO.: PLM96 -0313
MICHAEL RANSHOT
08240 SW STEVE ST
02/24/99
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
PLMA007 Application received / / / / 10/18/96 RECD TAT 10/18/96 TAT
PLMA050 (F) Issue permit / / / / 10/21/96 PASS TAT 10/21/96 TAT
PLMA130 Plumbing Undersl 10/21/96 / / 10/21/96 10/21/96 TAT
PLMA710 Water Line Insp 10/21/96 / / / / existing water lines. NOTE 02/19/99 RB
PLMA711 Water Service Insp 10/21/96 / / / / same NOTE 02/19/99 RB
PLMA715 Rough -in Insp 10/21/96 / / / / existing water lines NOTE 02/19/99 RB
PLMA720 PLM /Underfloor 10/21/96 / / / / N/A 02/19/99 RB
PLMA740 Misc. Inspection 10/21/96 / / / / 10/21/96 TAT
PLMA799 Final Inspection 10/21/96 / / 02/19/99 Case Final PASS RB 02/19/99 RB
PLMA800 Case Finaled / / / / 02/24/99 02/24/99 JT
•