Permit CITY OF TIGARD
�,, E ; DEVELOPMENT SERVICES PLUMBING PERMIT
I�j PERMIT # • PLM97 -0525
...- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/09/97
PARCEL: 2S102BC -THP02
SITE ADDRESS...: 12725 SW WATKINS AVE #PREV
SUBDIVISION • THOMPSON PARTITION ZONING: R -4.5
BLOCK ° LOT •002 JURISDICTION: TIG
CLASS OF WORK..: ADD GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE °SF 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
1 SINKS • 0 URINALS ° 0 GREASE TRAPS • 0
LAVATORIES • 0 OTHER FIXTURES • 0
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 300
WATER CLOSETS.: 0 WATER LINE (ft)...: 200
DISHWASHERS : 0 RAIN DRAIN (ft)...: 300
Remarks: Install sewer line, water line & storm drain lines.
Owner: FEES
DAN THOMPSON type amount by date recpt
12765 SW WATKINS PRMT $ 215.00 DRA 12/09/97 97- 301577
TIGARD OR 97223 5PCT $ 10.75 DRA 12/09/97 97- 301577
Phone #: 639 -4747
Contractor
CURTIS HAYS
24305 SW BOONES FERRY RD
TUALATIN OR 97062
Phone #: 682 -9353 $ 225.75 TOTAL
Reg #..: 113286
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Sewer Inspect ion
Tigard Municipal Code, State of Ike. Specialty Codes and all other Water Line Insp
applicable laws. All work will be done in accordance with Water Service In
•
approved plans. This permit will expire if work is not started Storm Drain Insp
within 180 days of issuance, or if work is suspended for more Rain Drain Insp
than 180 days. ATTENTION: Oregon law requires you to follow rules Misc. Inspection
adopted by the Oregon Utility Notification Center. Those rules are Final Inspect ion
set forth in OAR 952 wi1-0010 through OAR 952 -0001 -0080: You may
obtain copies of these rules or direct questions to OUNC by calling
(593)246 -1987.
AK
1T
Issue By: � �
Permittee Signature i _
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + ++ + + + + + + + + ++ + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OFITIGARD Plumbing Application Rec'd B
13125 SW HALL BLVD. Commercial and Residential Date Rec'd 49 - 9 -
TIGARD, OR 97223 Date to P.E.
Date to DS
(503) 639 -4171 Permit # L -O O
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project On back Indicate Work Performed by fixture.
Job .FIXTURES'.(IndlvIdual)s . . ""Y.' - QTr , - ,PRICE,:, '
Address Street Address Nts n I - Suite Sink 9
/Z7 ZS` G/'I'tti 5 J Lavatory 9.00
Bldg # City/State Zip Tub or Tub /Shower Comb. 9.00
Name
/ / 6/teA Shower Only 9.00
%7A- TJi N -.� Se, m_ Water Closet 9.00
Owner Mailing Address Suite Dishwasher -
9.00
�
2 A-+i 5 J tvI Garbage Disposal 9.00
City/State Zip Phone Washing Machine 9.00
- / - / - 64e0 ( . 9 /7e/7
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
N,age / _ Urinal 9.00
6 E�° 7U /' S �.�K f a lid. Other Fixtures(Speafy) 9.00
Contractor ling Address Suite 9.00
Prior to permit ity/State Zip Phone 9.00
issuance, a copy �� 4 14-4<,,, 9 7o 6 Z ( 51-93.3 9.00
of all licenses are Oregon Const. Copt. Board Licit Exp. Date 9.00
required if / / ,3 L 9 So 4"-8
expired in COT Plumbing Lic. # Exp. Date Sewer - 1st 100" / 30.00 30
database Sewer - each additional 100' 25.00 3- --- -
Name Water Service - 1st 100' ( 30.00 3
Architect Water Service - each additional 200' 25.00 ag -
Or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00 3d
Storm & Rain Drain - each additional 100' ' h 25.00 V -- Engineer City/State Zip Phone Mobile Home Space / 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New 0 Addition 0 Alteration 0 Repair 0 Pollution Device
to be done: Residential 0 Non-residential 0 Residential Backflow Prevention Device' 15.00
Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00
Catch Basin 9.00
Insp. of Existing Plumbing 40.00
per/hr
Existing use of Specially Requested Inspections 40.00
building or property - per/hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quanity Total is > 9
given is correct, that I am the owner or authorized agent of the owner, and
*SUBTOTAL co that plans submitted are in co .liance with Oregon State Laws. = ,;, a / , , v
Sign. e o • ner/Age Date 5 %SURCHARGE
w•- X: ct Person . ! - Phone PLAN REVIEW 25% OF SUBTOTAL
Required only if fixture qty total is > 9 V .
i TOTAL
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge c - /S -
I ldsts\plmapp doc 5/97
PLEASE COMPLETE:
E4/6 97 -6 4'0 //i",7-
Fixture Type Quantity by W ork 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)
COMMENTS REGARDING ABOVE:
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