Permit v {
C}1YOFTIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.9199 (503) 639 -4171
PLUMBING PERMIT
PERMIT # PLM94-0134
639 -4171 DATE ISSUED: 07/11/94
PARCEL: 2S102BD -01001
SITE ADDRESS...: 09975 SW WALNUT ST
SUBDIVISION ° NO.TIGARDVILLE ADDITION AMEND. ZONING: R -12
BLOCK LOT °7
CLASS OF WORK..:ALT GARBAGE DISPOSALS..: MOBILE HOME SPACES.:
TYPE OF USE -COM WASHING MACH BACKFLOW PREVNTRS..:
OCCUPANCY GRP..:B2 FLOOR DRAINS TRAPS
STORIES WATER HEATERS ° 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) °200
DISHWASHERS RAIN DRAIN (ft)
Remarks: WATER LINE SERVICE
Owner: FEES
RON BLINE type amount by date recpt
8170 SW MAPLE PRMT $ 35.00 SW 07/11/94 —
5PCT $ 1.75 SW 07/11/94 —
PORTLAND OR 97225
Phone #: 297 -4023
Contractor:
KENNEDY PLUMBING
13985 SW FARMINGTON ROAD
BEAVERTON OR 97005 --
Phone #: 5036435535 $ 36.75 TOTAL
Reg #.. : 10967
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 Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within l80 days of issuance, or if work is suspended for more
than 180 days.
Permittee Signature: ) 9•12%#
461e•-eatd-ri
Issued By: /it-tk)
Call for inspection — 639 -4175
•
•
pi_A/19 y - 00 13'4-
Ci of i..gard PLUMBING PERMIT Planck/Rec. #
13125 SW Hall Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639 -4171
•
#4.m. a Ova.1aprnent Description
�i86/1u&T- CZ ,49?r3 ORS 814- 21-610 . I CITY PRICE AMT
ndr...
Job qq7S S& G(iL,,fllz,C---- FIXTURES
Address airs- Sink - 7.50
77 e ►t` - 973 Lavatory 7.50
#4a "' i e'' / Tub or Tub/Shower Comb. 7.50
'1 i"" 0 C.(/t/ te Shower Only 7.50
Wiry AO"" Phone Water Closet 7.50
Owner 9/70 SeJ / X92-4043 Disposal 75
� 7215- Garbage washing Machine 7.50
#4`A0 t= nano °' busnosai Floor Drain 7.50
Water Heater 7.50
MaiGno Ada*. Phan. Laundry Room Tray 7.50 -
Occupant urinal cersin• zv Other Fatures (Specify) 7.50
G 7.50
f it-
AWE fiu�efrej ‘ 7.50
Pt.,. .
Contractor s" ,G�. 4/ y3 .S MISCELLANEOUS
fC/;' U ek - �/ /} � ?(j(1,� Sewer 1st 100' 30.00
7)•
� P. w on N o 6 ��� +++ Co r4.1.. Sewer - ea. Addrt. 100' 15.00
S 7 ''/ 2 /a6 f 11-3 Water Service 1st 100' /� 20.00 7,09- I hereby acknowledge that I have read this application, t the Water Service ea Addrt. 200' 0.00 15.00 /S..
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 I Storm & Rain Drain 1st 100' 30.00
am registered with the Constriction Contractor's Board, that the number Storm & Rain Drain Addrt. 100' 15.00
given is correct (If exempt from State registration, please give reason
below.) Mobile Home Space 25.00
Back Flow Prevention
Device or Anti- Pollution Device 7.50
s."'°`0 (owner « Ile ooa Any Trap or Waste Not
Connected to a Fixture 7.50
Describe work new 6a addition 0 alteration 0 repair 0 Catch Basin 7.50
to be done residential non-residential 0 40.00
Insp. of Exist Plumbing per hr
40.00
Specially Requested Inspections per hr
Existing use of Rain Drain, single family
building or property /Yr `� �[ ' dwelling 15.00
Residential back low prevention
devices 15.00
Proposed use of
building or property
'(Except residential backflow
prevention devices)
NOTICE W - •Minimum Fee $25.00 SUBTOTAL 35
PERMITS BECOME VOID IF WORK OR CONSTRUCTION l � �
5% SURCHARGE i 75:
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25% OF SUBTOTAL
COMMENCED. 361--- TOTAL 36
Special Conditions
Date issued by
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