Permit CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
1J1. 13125 SW Hall Blvd., Tigard, OR 97223 (503)6394171 PERMIT # • PLM98 -0145
DATE ISSUED: 05 /26/98
PARCEL: 2S1O3BC -04500
SITE ADDRESS...: 12360 SW WALNUT ST
SUBDIVISION • CURL ACRES ZONING: R -4.5
BLOCK LOT •004 JURISDICTION: TIG
CLASS OF WORK..:ADD GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •SFA WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 FLOOR DRAINS • 0 TRAPS • 0
STORIES • 1 WATER HEATERS • 0 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS : 1
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: install rain drains
Owner: FEES
LITTLE, C BRUCE type amount by date recpt
PRMT $ 30.00 GEO 05/26/98 98- 306040
5PCT $ 1.50 GEO 05/26/98 98- 306040
Phone #:
Contractor
OWNER
Phone #: $ 31.50 TOTAL
Reg #..: 000000
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Rain Drain Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final I n s p e ct i o n
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 -0001 -0010 through OAR 952-0001-0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
•
Issued By: �, . Permittee Signature: y ay C .._.f.a. ignat e.
+ ++ + + + + + + + + + + + + + + + + + + ++ +++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Permit Application Plan Check #
13126 SW HALL BLVD. Commercial and Residential Rec'd By
TIGARD, OR 97223 Date Rec'd
(6'03) 6394171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit # Pc/di qcc - o/c/5
/ c Related SWR #
C I (iieC ,� / /x s Called
._ Name of Development/Project On back indicate Work Performed by fixture.
Job iA-3 i -3 (00 - S j +44 :FIXrTURES
,�.�.,� ) !;l.;I"�i ��: - ° • GTY1- , PRICE • AMT =
Address Street Address Suite Sink A 9.00
Lavatory 9.00
Bldg # I City/State Zip Tub or Tub /Shower Comb.
9.00
Na Shower Only 9.00
(Ad Water Closet 9.00
Owner a lin Add _Suite / L .j ishwasher 9.00
/ (
a 5 .:e: /43.,9 4 ` ' to Garbage Disposal 9.00
Ci tate Zip /�}� � ` P ne _
A" Washing Machine 9.00
7 2 3
Name Floor Drain 2' 9.00
�
3 " 9.00
Occupant Mailing Address Suite 4" 9.00
City /State Zip Phone Water Heater 0 conversion 0 like kind 9.00
Laundry Room Tray 9.00
Name Urinal 9.00
Other Fixtures (Specify) 9.00
Contractor Mailing Address Suite 9.00
Prior to permit City/State Zip Phone 9.00
issuance, a copy Sewer- 1st 100' 30.00
of all licenses are Oregon Const. Cont. Board Licit Exp. Date Sewer - each additional 100' k 25.00
required if Water Service - 1st 100' 30.00
expired in COT Plumbing Uc. # Exp. Date Water Service - each additional 200' 25.00
database
Name Storm & Rain Drain - 1st 100' 30.00
Architect Storm & Rain Drain - each additional 100' 25.00
Or Mailing Address Suite Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Engineer City/State Zip Phone Pollution Device
Residential Backflow Prevention Device* 15.00
Describe work New 0 Addition 0 Alteration 0 Repair 0 Any Trap or Waste Not Connected to a Fixture 9.00
to be done: Residential 0 Non - residential O Catch Basin 9.00
Additional description of work: Insp. of Existing Plumbing 40.00
per/hr
Specially Requested Inspections 40.00
per/hr
Rain Drain, single family dwelling 30.00 fig)
Existing use of y � . T.
building or property Grease Traps 9.00
Proposed use of QUANTITY TOTA
building or property Isometric or riser diagram is required if Quanity Total is > 9 ' :„; : -
-
*SUBTOTAL 1.,g;,
I hereby acknowledge that I have read this application, that the information = " r R- �
given is corr ct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE . , ,,;, +; _ ,.'; �V V.p; ce/
// �
th- • ans 'ubmitted are in compliance with Oregon State Laws.
+' =_
S , n u l ot Owner /Agent Date "'PLAN REVIEW 25% OF SUBTOTAL ;'-' '"' Alp ign "o ,
Q c Required only if fixture qty. total is > 9 N + +y ry cs 44 :ac¢. ':
ICQ. - t�C Q S - TOTAL s1_•_ v
C • tact Person Name Phone
'Minimum permit fee is $25 + 5% surcharge, except Residential BackflOW
n
RO (i < E. LII- 5 - 5 , -/-) 7 Prevention Device, which is $15 + 5% surcharge
"All New Commercial Buildings require plans with isometric or riser diagram
and plan review
I 5/5/98
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed /Capped
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)
7OMMENTS REGARDING ABOVE:
'a�w ,bapp .d« 5/5/98