Permit PLUM PING PERMIT ✓
CITY OF T DATE ISSUED: 06/10/96 -0138
COMMUNITY DEVELOPMENT DEPARTMENT
`^ 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 151 35BA -00102
SITE ADDRESS...: 10250 SW WASHINGTON SQUARE RD #C1,2
SUBDIVISION • OAKBURG ZONING: C —G
BLOCK • LOT • 4
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: NSWIBILE HOME SPACES.: 0
TYPE OF USE •COM WASHING MACH 0 t'40 FLOW PREVNTRS..: 0
OCCUPANCY GRP..:B2 FLOOR DRAINS • 0 1 • 0
STORIES • 0 WATER HEATERS • 1 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 existing water heater
Owner: FEES
ROYAL PANDA type amount by date recpt
10250 SW WASHINGTON SQ. RD. PRMT $ 25.00 B 06/10/96 96- 280415
5PCT $ 1.25 B 06/10/96 96- 280415
TIGARD OR 97223
Phone #:
Contractor:
GEORGE MORLAN PLUMBING
5529 SE FOSTER RD
PORTLAND OR 97206
Phone #: 771 -1145 $ 26.25 TOTAL
Reg #..: 02734
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Top—out Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. I n s p e c t i o n
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than l80 days.
1 j I 1
Permittee Si nature: , ,,l,44/
Issued By: i I , ; /, _ ,�
Call for inspection — 639 -4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # a 4'b -n( ;6
13125 SW Hall Blvd. Permit #
Tigard, 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
NaTe of Davelonmma New Single Family Residences Only
Address ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job
0 20 SW 1NCi A. L C Rcl ❑ 3 BATH HOUSE $225.00
Address cat.
,,1 (� '( 91 ^ m Fee includes all plumbing fixtures in the dwelling and the first 100 feet
T (c aye! (J, J ' 1.1 of water service, sanitary sewer and storm sewer. See fees below.
Nam. « am. of Bourses) FIXTURES QTY PRICE AMT
Sink 9.00 •
Mang Address Mons Lavatory 9.00
Owner Tub or Tub/Shower Comb. 9.00
CdyrStaf. r* Shower Only 9.00
• Water Closet 9.00
Name (or name of busa a) / Dishwasher 9.00
Occupant • (\ o�fA I � � k �` 620-71-7. o Garbage Disposal 9.00
wing Adtr °AVna Washing Machine 9.00
° �2 Floor Drain 9.00
G8 Water Heater ' 9.00
Laundry Room Tray 9.00
Name 1_ Urinal 9.00
•
(S eo NlorloNN PknYIIDIY1 Other Fixtures (Specify) 9.00
Wang Address , �, - - 9.00
Contractor n
i 2 ��5 S W_ ` C1 1 C. (' V\l l� 9.00
CdylState J 9.00
Tic plat O \( 912 :1 Sewer 1st 100' 30.00
State Na aeon No Cay B's Tar No. Sewer - ea. Addit. 100' 25.00
02134 Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
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 Storm & Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please
•ye reas below.) Mobile Home Space 25.00
�9 6 1 0 - 9 h I / Back Flow Prevention
J v Device or Anti - Pollution Device 9.00
° (owner agent)
• Oats Any Trap or Waste Not
•
Connected to a Fixture 9.00
•nbe work new Q addition 0 alteration Q repair 0 Catch Basin 9.00
• • done residential 0 non - residential (Df Insp. of Exist. Plumbing 40.00mr
Specially Requested Inspections 40.00 /hr
Existing use of
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of
building or property
'(Except residential backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL ZS
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE I ' ZS
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
re f 1 TOTAL 21€. LS
Special Conditions 1 J�/�
j eked( J Date issued by