Permit CITY TIGAR® PLUMBING PERMIT
A, DEVELOPMENT SERVICES PERMIT #: PLM1999 -00219
^�s „� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/22/99
SITE ADDRESS: 09620 SW WASHINGTON SQUARE RD
PARCEL: 1 S126C0 -01107
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M 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: Installation of water heater.
FEES
Owner:
Type By Date Amount Receipt
WINMAR PACIFIC
700 FIFTH AVE MISC DLH 7/22/99 $3.50 99- 317059
SUITE 2600 PRMT DLH 7/22/99 $50.00 99- 317059
SEATTLE, WA 98104 Total $53.50
Phone 1:
Contractor:
GEORGE MORLAN PLUMBING
5529 SE FOSTER RD
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Phone 1: 771 - 1145 Final Inspection
Reg #: LIC 000027
PLM 26 -60PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of, OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Permittee Signature: d'Al /97 /6 7 ///9/2_ EL
II (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
JUL -19 -1999 14 :03 r'el
I T ur I l.2MmU II faMtt ■vn■a ■ %.3 lemma imNirnvNa ■.... PZ,A /99 ed
1125 SW HALL BLVD. . . Commercial and Residential 2E< o 7/22/75
GARD, OR 91223 RECEIVED 3 Y b,z-/7
03) 639 -4171 .
Print or Type JUL 2 2 1999
Incomplete or Illegible applications will not be accepted
1)..?/ '4-
COMMUNITY DEVELOPMENT
Name of Developmen'/ProJect /XTU E$ (lndiv14g0:70: :I: :QTY P J
Job friar Ks &Wm% k he o Sink 11.50
Address tAddress
Lavatory 11.60 •
Q U /, . Tub or Tub /Shower Comb. 11.60
Bldg* C ate IP Shower Only = 11.50
N ! Qr� j ()r. ! 7 Water Closet 11.50
Y rks a.i b w k Shop Dishwasher 11.50
Ovens Ma ing Address 7 ' p� Garbage Disposal 11.50
/.. „I► .1 D i i d. • t l - Washing Machine 11.50
WO:. tale �1� Floor Drain/Floor Sink 2' 11.60
I are t 3- 11.60
Name
Co /A//1 f}4. O e- ffr/ 4' 11.50
Occupant Mailing Address Suite Water Heater 0 conversion G-thc6 kind / 11.50
740 / *Gi/ i94 6 /77) Gas piping requires a separate mechanical permit. / 750
City /State Zip / Laundry Room Tray 11.50
;E -- �� /c Urinal 11.60
Nat �. „ o ' I Q P i n I . Other Fixtures (Specify) 15.00
Contractor 411 l3 d `1f •V j „„.r-i.. 1
Prior to permit fate Zi Pone Sewer - 1st 100' , 38.00
Issuance, a copy CLrd �'1 j � I • Sewer - each additional 100' 32.00
of all licenses are Oregongonst Cont. Board Uc.I Exp. Date 38.00
required If 7 �/ /0 _2_, water Service -1st 100'
expired In COT Plumbing �Lk:. * Exp. Date Water Service - each additional 200' 32.00
database � rP - Cp 0 Pi g 6 Storm & Rain Drain - 181 100' 3&00
Name `� ( Storm & Rain Drain - each additional 100' 32.00
Architect Mobile Home Space 32.00
Of Malang Address Suite Commercial Back Flow Prevention Device or Anti- 92.00
- Pollution Device
Engineer City /State Zip Phone Residential Backllow Prevention Device' 19.00
(Irrigation timing devices require a separate
Describe worst to be done: restricted energy permit.)
Sew 0 Repair 0 Replace with F e kind: Yea Q Any Trap or Waste Not Connected to a Fixture 11.50
Qesldential 0 Commercial Catch Basin 11.60
40ditlonal description of work: .
Insp. of Existing Plumbing 50.00
r Lc .c 2. el e C . Loci- kk�-Q '2-r- per/hr
you capping, movin or replacing any fixtures?
Specially Requested Inspections \re per/hr
moving Y parmr
Yes O No O Rain Drain. single family dwelling 45.00
f yes, see back of form to indicate work performed by Grease Traps ' 11.50
ixture. FAILURE TO ACCURATELY REPORT FIXTURE
NORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL -:-..;-- .-; :, ,
hereby adcnowiedge that I have read this application, that the information Isometric or riser diagram Is required If Quantity Total Is > 9 -..
Ivan Is correct, that I am the owner or authorized agent of the owner, and 'SUBTOTAL 0'D
hat plans submitted are In compliance with Oregon State Laws. > ' =, , 4 ` A Slam oT dAgent -' '- Data 0 SURCHARGE ° R's ; ;; •i; R c:' 3 s0
:o non ma 1 phone **PLAN REVIEW 249ro OF SUBTOTAL n - .
' r . _-.0. CD,2 - , Cl3G Required only If fbnure qty. total Is > 9 .. , ....V....',' ,,
•
Y W , .1 "4 ., r . J�a::: ai 2;::::y; ,;'. et$" N'.se5 w ci TOTAL So
\ fff ♦ [ r `i v `t x i.
" ;: ;, r'g'Y : x l. . 1 t �.� s r -minimum permit fee is $50 • 5% surcharge, except Residential Backflow
<
r : i ^1 ��4 ` il s �Y� , t iYt',x' S '',11,:r........... ` '"` � q ,, .�` ? ;:q.1 Prevention Device, which Is $25 4. 5% surcharge
' ` F3 t� -: i`` . rit "Vi t ,440 � 4 3 ' 'f'' a , +� : 'J` F � " "All New Commercial Buildings require plans with Isometric or riser diagram
.+L.:_,i..r.....,bIL...r r.r...1 ........... .... r.�... :k;; .... _..,.o....,., ,. and plan review
Wamsroamapp.dot 51=90
54/' /t/ TOTAL P.01