Permit CITY OF TIGARD
�:, � PERMI DEVELOPMENT SERVICES PLUMBING PERMIT
�rf # • PLM98 -0082
" � � -. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 03/25/98
PARCEL: 2S102BD -01001
SITE ADDRESS...: 09961 SW WALNUT ST #015
SUBDIVISION • NO.TIGARDVILLE ADDITION AMEND. ZONING: R -12
BLOCK LOT •007 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •MF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 FLOOR DRAINS • 0 TRAPS • 0
STORIES • 0 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: Replacing electric water heater
Owner: FEES
RON BLINE type amount by date recpt
8170 SW MAPLE DR PRMT $ 25.00 B 03/25/98 98- 304397
PORTLAND OR 97225 5PCT $ 1.25 B 03/25/98 98- 304397
Phone #:
Contract or
KENNEDY PLUMBING
13985 SW FARMINGTON RD
BEAVERTON OR 97005
Phone #: 643 -5535 $ 26.25 TOTAL
Reg #..: 001009
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 permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-1 -0010 through OAR 952- 0001 -0880. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
I ssued By: �LI�I� 1+•.� I Per mittee Signature. ` ‘S I
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
.QTY OF T19ARD Plumbing Application Reed By e,zc--
3125'SW HALL BLVD. Commercial and Residential Date Reed
- GARD, OR 97223 Date to P.E.
X03) 639 -4171 Date to OST
Permit • -
Print or Type Related SWR s
Incomplete or illegible applications will not be accepted Called
Name of Development/Project - .FIX[URES;;QndWldual) eginit E4 it
Job Will hv. " C Owl- -4cA , sit,'` e.00
Address Street Address `suite 9.00
dd
' /y 5 50 I�Q l huh' i 5 Tub or TutdShower Comb. 9.00
'"/ # ( Bldg s State Zip Shower Only 9.00
■ctaild Water Closet
9.00
o n E l i ne. Dishwasher 9.00
Owner Address Suite Garbage Disposal rig su) maple Or 9.00
bp �� 9.00
Any State Floor Drain - r 9.00
4d of c� 5 a . 42 I6O'{ 3 -
Name 9.00
4- 9.00 •
Occupant Ong Address Suite Water Heater
I 9.00 9 ,Oo
Laundry Room Tray 9.00
Clty/State Zip Phone Urinal
9.00
Other Fodurss (Specify) 9.00
f, emwax i ce∎ U rwQ01 nq 9.00
Contractor Address `-J su,o e • i e9 . 5 5 O k c,✓m� ruF0 9.00 .
(Prior to issuance /State
appOcant mush l 0 p S 64 3 5 5 35 9.00
provide all Oregon Coset• Cont Board tic.* E. Data - 9.00
contractors 1 l 6 Exp.
Name PAanbuig Lit:. it Exp. Date - 9.. 0 •.
information Sewer -tat 100' 30.00
3 y - 4 Q Sewer - each additional 100' 25.00
for COT COT Business T ; �o s Exp. Date
database). J Water Service - tat 100' 30.00
Name Water Service - each additional 200' 25.00
Architect Storm & Rain Dram -1st 100' • 30.00
or Mang Address Suite Storm & Rain Dram - each additional 100' 25.00
Mobile Home Space 25.00
Engineer City /state Zip Phone Commercial Back Device or Anti- 25.00
Pollution Device 7,esaibe wort New 0 Addition 0 Alteration Repair o Residential Baddlow Prevention Device' 15.00
s be done: Residential Non - residential 0 My Trap or Waste Not Connected to a Fixture 9.00 ,r
:wibonai desaiption of work �,, Catch Basin
✓
1 QV (6,C 2, Q-A •e--6 (• w G--k1L h e6AIL- gyp_ of Existing Plumbing - 40.00
per/ hr
Existing use of , ^ E' Specially Requested Inspections 40.00
twlding or property VV 1 r_ perfhr
Rain Drain, single family dwelling 30.00
'r000sed use of filr Grease Traps 9.00
)uildi g or property
QUANTITY TOTAL
9F�vN a
moving or replacing any fbtturesT Yes Q rn
No ❑ Isoeax: or mar diagram is required ed aurhay Taal is > 9 5''.t :1;...+J. Are you capping , mov
(If yes see back of form) 'SUBTOTAL •-'-- : ••ss
hereby acknowledge that I have read this application. that the information `
' p,5 .OU
,rven,rs that I am the owner or authorized agent of the owner. and 5% SURCHARGE . : d:'
?hat p suornitted are in compliance with Oregon State Laws. r- D.,5 signs of OwneNAgent (*\-(.,•6O - Q PLAN REVIEW 25% OF SUBTOTAL • "
( I ^� ` l y ReauaW artly d fixture fixture cry. tow a _ 3. 9 - - I
r aL O TOTAL �'0
= ontact Pe Phone - `d�
I re (C - tA 'e SS 1 6'-43.5 535 Prevention Device. which is $15 + surcharge. Ras+dentia 8 adcflaw
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PP ( )
'LEASE 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)
:OMMENTS REGARDING ABOVE:
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