Permit •
�I N ®
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 •
• PLUMBING PERMIT
PERMIT #° ° . ° . ° °' o PLM94 - -02S0
639 -4171 DATE ISSUED: 11/17/94
PARCEL: 15125DC -1Z1 1500
•
SITE ADDRESS— .° 07145 SW VENTURA DR
SUBDIVISION a WASHINGTON SQUARE ESTATES ZONING: R-4.5
BLOCK LOT °5
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CLASS OF WORK. °a ALT GARBAGE DISPOSALS°°: MOBILE HOME SPACES °:
TYPE OF USE °SF WASHING MACH ° BACKFLOW PREVNTRS.
OCCUPANCY GRP ° ° :R3 FLOOR DRAI NS. ° TRAPS
STORIES WATER HEATERS °1 CATCH BASINS •
FIXTURES LAUNDRY TRAYS ° -SF RAIN DRAINS °
SINKS ° ° ° ..... URINALS GREASE TRAPS
LAVATORIES °°°° °o OTHER FIXTURES
TUB /SHOWERS SEWER LINE (ft)
WATER CLOSETS. WATER LINE_ (ft) ° °.
DISHWASHERS RAIN DRAIN (ft) ° ° °,.e
Remarks: REPLACING GAS WATER HEATER
Owners — - -- - - - -- FEES - --
CAROL BENSON type amount by date recpt
7145 SW VENTURA PRMT $ 25.00 KS 11 /17/94 —
. SPCT $ 1.25 KS 11 /17/94 —
TIGARD OR
Phone 4
Contract or: --
GEORGE MORLAN PLUMBING & APL IANCES
12585 SW PACIFIC HWY
•
TIGARD OR 97223 —
Ph on e :kk : 624 =6895 3 26.25 TOTAL
Reg #° ° ° 02734
REQUIRED INSPECTIONS
This per ®it is issued subject to the regulations contained in the Final Inspect ion _
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with
approved plans. This pereit will expire if work is not started
within 180 days of issuance, or if work is suspended for oore
•
than 180 days. •
_
Permittee Signature: "..
Issued
Call for' inspect i on — 639 -4175
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n
I' .
C ity of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit # !Y -O 2-S73
Tigard, OR 97223
(503) 639 -4171
Lt1-9).' MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name of D00lo New Single Family Residences Only
IWtrma ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job tif 5 svg � re s ❑ 3 BATH HOUSE $225.00
Address ap Fee includes all plumbing fixtures in the dwelling and the first 100 feet
T r 6a rd or 972,2.3 of water service, sanitary sewer and storm sewer. See fees below.
Name (or name Doane nam° Doane FIXTURES QTY PRICE AMT
1 Y0 ( Taerrb00 Sink 9.00
NdNew R11e Lavatory 9.00
Owner _ ai _ Tub or Tub/Shower Comb. 9.00
• VP Shower Only 9.00
Water Closet 9.00 •
Nab (or naMe of bushomel Dishwasher 9.00
Garbage Disposal 9.00
Occupant ma.na Am. rte.
Washing Machine 9.00
Floor Drain 9.00
City/State DP Water Heater 1_ 9.00
Laundry Room Tray 9.00
Naas (D�'.6 Urinal 9.00
.J, mov an h' INS 1 Other Fixtures (Specify) 9.00
nwng �masa
Pitons 9.00
Contractor 12g85 514 i L y 131Z.22) 9.00
CByI61.te VP 9.00
11:1 i or' 91-223 Sewer 1st 100' 30.00
Sate RepheatIon N0. �' x� Tea No. Sewer - ea. Addit 100' 25.00
02_ 1 3 2.(a. 0 ( ) b 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
/ , _ I ` Back Flow Prevention
�Gj/ Device or Anti - Pollution Device 9.00
it prone' or aped Dd1e 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 j� 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
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
Special Conditions
Date issued by