Permit C I 1( OF T PERMI'TU #SING PERMIT
PLM96 -0106
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 05/07/96
13126 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
PARCEL: 2S104CD -10000
SITE ADDRESS...: 13652 SW TRACY PL
SUBDIVISION HILLSHIRE ESTATES NO. 2 ZONING: R -7 PD
BLOCK • LOT °099
CLASS OF WORK.° :NEW GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE °SF WASHING MACH 0 BACKFLOW PREVNTRS..: 1
OCCUPANCY GRP.. :R3 FLOOR DRAINS : 0 TRAPS ° 0
STORIES ° 2 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: PATH I
Owner: FEES
WINDWOOD CONSTRUCTION, INC type amount by date recpt
6933 SW TIERRA DEL MAR PRMT $ 15.00 JDA 05/07/96 96-
5PCT $ 0.75 JDA 05/07/96 96—
BEAVERTON OR 97007
Phone #:
Contractor:
CEDAR LANDSCAPE
14076 SW PATRICIA
HILLSBORO OR 97123
Phone #: 503- 628 -3411 $ 15.75 TOTAL
Reg #.. . 5843
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP /Backflow Prey
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:
I ssued By: O• 0/4/
Call for inspection — 639 -4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Prall Blvd. Permit # RiTl qf6- ci (hp
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Nam e ' °i"°0" / , New Single Family Residences Only
// / / /sh /f c
Job i `TRfFC�/ Pt. 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
3 soma S(,�
❑ 3 BATH HOUSE $225.00
Address apses. m Fee includes all plumbing fixtures in the dwelling and the first 100 feet
, i-/& , i-/&.40 / o . of water service, sanitary sewer and storm sewer. See fees below.
Norm (t' "°m of men FIXTURES QTY PRICE AMT
Vh/V b vy'OGL' #61/1.-S Sink 9.00
Maim AO"° Fi1d. Lavatory 9.00
Owner /38D- 2 #.76A;4. �,42ve Tub or Tub/Shower Comb. 9.00
caws. a• Shower Only 9.00
i G/1R OR. Water Closet 9.00
Nt"n. (or nom or aerws) Dishwasher 9.00
Win/) WOJd NO/#FS Garbage Disposal 9.00
Occupant ,,,r,o,,,,... Rime Washing Machine 9.00
Floor Drain 9.00
°wS. u• Water Heater 9.00
Laundry Room Tray 9.00
N'"" Urinal 9.00
Cebrl LRNd scf pe 642P- -34 / / Other Fixtures (Specify) 9.00
Moog Address vtwt. 9.00
Contractor
/43 7S S(A) P/4- rPICIN I V 9.00
apsn4 no 9.00
AI /Ws - iv/0 Oa 8712.3 Sewer 1st 100' 30.00
Saito Ron N.. Crf a- TO Na Sewer - ea. Addit. 100' 25.00
$ 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 from State registration, please
give reason below.) Mobile Home Space 25.00
Back Flow Prevention
Caw -e- ( Device or Anti - Pollution Device 9.00
s`v10.I (maw cm post) Q° ' Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new (' addition 0 alteration 0 repair 0 Catch Basin 9.00
to be done residential non- residential 0 Insp. of Exist Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr
Existing use of /
budding or property , e, Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00 /0
Proposed use of
building or property
'(Except residential backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL /0.--m
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE
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 /3" ,1-5
Special Conditions r
Date issued .517 96 by
Y?6.44(
IPP .- •
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line 639 -4175 Bus Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling C:►.
Post/Beam Mech. Shear /Sheath Framing
PIbg.Und /FIr /Slab Plbg. Top Out Insulation '1
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bid..
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: � /��i����
- i!
Date: A P.M. Entry:
Address: .- 5 Z / i�
Tenant: Ste: V MST: / 6 g--.11.5 —
BUP:
Con /Own: MEC:
PLM:
ELC.
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: 7
V iC
q 1 \ 12136
0' 1,-, * 7.-
Inspect. . `�r Date: —/ , /7 /
PPROVEI DISAPPROVED/CALL FOR REINSP. bCF CO
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