Permit .._,.CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PLUMBING PERMIT
PERMIT #- PLM95 -0328
639 -4171 DATE ISSUED: 10/30/95
PARCEL: 19125DC -02200
SITE ADDRESS...: 07005 SW VENTURA DR
SUBDIVISION ° WASHINGTON SQUARE ESTATES �O ZONING: R -4.5
LOT ° OT ° 1 2 ,14's� _ - - - --
CLASS OF WORK..:
ALT GARBAGE DISPOSALS..: .. E HOME SPACES.:
TYPE OF USE -SF WASHING MACH BA O OW PREVNTRS.. :
OCCUPANCY GRP.. :R3 FLOOR DRAINS . TRAPS
STORIES WATER HEATERS :1 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: One alteration of a water heater.
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Owner: - - -- FEES
JAMES MONROE - type amount by date recpt
7005 SW VENTURA PRMT $ 25.00 CJS 10/30/95 95- 272271
SPCT $ 1.25•CJS 10/30/95 95- 272271
TIGARD OR 244 -2:03
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Phone #:
Contractor:
POWER PLUMBING CO
PO BOX 23144
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- TIGARD OR 97281
Phone #: 244 -1900 $ 26.25 TOTAL
Reg #.. : 52378
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 Misc. Inspection
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started
within 18® days of issuance, or if work is suspended for more _
than 18® days. —.
Permittee Signature: AM _ —^ -- - —
Issued By: __.LLJ_ _C s 127'r v — ___________ _
Call for inspection — 639 -4175
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City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # 95-0) 7a .17/
13125`'SW Hall Blvd. Permit # PI/V9'S`o3
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name e' Devetopmem New Single Family Residences Only
Address ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job 7005 S. W. Ventura ❑ 3 BATH HOUSE $225.00
Address catst.t. zip Fee includes all plumbing fixtures in the dwelling and the first 100 feet
Tigard 97223 of water service, sanitary sewer and storm sewer. See fees below.
Name (or nerve of Buenee.) FIXTURES QTY PRICE AMT
JAMES MONROE 244 -2303 Sink 9.00
Meiling Address Phone Lavatory 9.00
Owner 7005 S W V F.NTi1R A nR . Tub or Tub /Shower Comb. 9.00 -
CartState nO Shower Only 9.00
Tigard 9 7 2 2 3 Water Closet 9.00
NOTe (or name 01 boomen) Dishwasher 9.00
Same Garbage Disposal 9.00
Occupant Mang ,,,
Phone Washing Machine 9.00
Floor Drain 9.00
City/State ZIP Water Heater 9.00 9.00
Laundry Room Tray 9.00
Name Urinal 9.00
POWER PLUMBING CO. Other Fixtures (Specify) 9.00
Malang Address Phone 9.00
Contractor P 0 BOX 23144 244 -1900 9.00
City/State DP 9.00
Tigard 97281 -3144 Sewer 1st 100' 30.00 -• -
Sate Registration No. Cdr Bu.. Tax No. Sewer - ea. Addit. 100' 25.00
)f 52 378 /Metro 146 -,` _ � ' ,:,_-; 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 Contracto oard, that the Storm & Rain Drain Addit 100' 25.00
number given is correct. (If ex pt from St r stration, please
give reason below.) Mobile Home Space 25.00
• Back Flow Prevention
-27-95 Device or Anti - Pollution Device 9.00
&finesse (moss or agent) Di Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new 0 addition 0 alteration - 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
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 25.00
PERMITS BECOME VOID IF WORK OR CONSTRUCTION - _... -
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE -- 1 -. 2 5
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
Special Conditions � �-
Date issued /O - 3 - 9S- by CC