Permit CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
PLUMBING PERMIT
PERMIT ; . ° ^ . ° ^ . ° PLM9S- '•0047
639 -4171 DATE ISSUEDo 04 /13/95
PARCE L o 151260C-01107
3I7E RDDRECS... o 09659 SW WASHINGTON SQUARE RD
SUBDIVISION °...o ZONING°C-G
BLOCK° ...... ° __ ____ LOT° ^ ... ° ° ° ° ° ° .. - vo . `- i - 5
CLASS OF WORK.. g ALT GARBAGE DISPOSALS. . o MOBILE HOME SPACES.
TYPE OF USE... ° e COM WASHING MACH....... z BACKFLOW PRE VNTRS— L
OCCUPANCY GRP.. B2 FLOOR DRA INS. .....°o1 TRAPS. ..° ..... ....
STORIES ..... ...g 1 WATER HEATERS. .....o CATCH BASINS.....
FIXTURES LAUNDRY TRAYS SF fRAIN ER IhS.....
SINKS..........° URINALS. ...... — GREASE TRAPS..
LAVATORIES. ....01 OTHER FIXTURES
TUB /SHOWERS....° SEWER LINE (ft)....
WATER CLOSETS.. 1 WATER LINE (ft) ...
DISHWASHERS....g RAIN DRAIN (ft)....o
Remarks TI
Owner -• -• -• FEES
SAS GOO DY C/O STATE PERMIT ype amo' -;nt by date re pt
PRMT $ 27.00 JDA 04/13/95 --
PO BOX 0224 PLC: 6. 75 JDA 04/13/93 ---
KENOSHA WI 53141 SPCT $ 1.35 JDA 04/13/95 --
Ph on e 44: e 80[D-432-2597
Contractor
MS I MEC:-1AN I CAL
9653 SW SUNSHINE CT 4700
BEAVERTON OR 97007 ------- •-. --
Phor;is to 642 -123: a 35.10 TOTAL
Reg 4... 70032
- -- - -- REQUIRED INSPECTIONS
This peroit is issued subject to the regulations contained in the Final Inspection -
Tigard "unicipai Code, State of Gre. Specialty Cedes and all other
—
applicable laws. All : ;srk will be done in accordance e:ith
approved plans. This perait will expire if work is not started
within 1C days of isseance, or if work is suspended for pore
than 182 days.
���
r
r�ei''ml'G'�ee JiL]nc�ti_Sr' _.._
Issued By -_ alb— — _ --
Call for inspection - 639 -4175
•
02/21/95 10:29 $503 684 7297 CITY OF TIGARD II002 /003
City-of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # -
13125 SW Hall Blvd. Permit # API 9S -- 0043
Tigard, OR 97223
(503) 639-4171 - -
- MINIMUM $25.00 PERMIT FEE + ST. SURCHARG
..- ....... - - New S1n4Ia Family Residences Only -
M
. i 6� 0 ' 0 1 BATH HOUSE 1140100 0 2 BATH HOUSE =195..00
Job :, - 4 .� • r`+c(l A 5 62. O 3 BATH HOUSE 5225.00
Address - m Fee Includes al phmibig returns in the dandling and the first 100 feet
1[&41Zt7 NA 0 )1 2-2-'27 water service. w service. sweaty sewer and storm sewer. See tees below.
m.... . t -... a sm FIXTURES CITY -PRICE AIR
W Ie4frWriie- *IAfo%P'23 - 45(1 Sat 9.00
MOO M... Ran LAvamry I • 9.00 9 Ci`
owner - 100 y- P-1 4 1 , ole . '9 bo : Tub or TuD/Snower Comb_ 900
.n_
atria. a Shower Only ... 9.00
o'j`jt.E_ ,v4^ °) X10 4- Water Closet 1 ' 9.00 of ad
ww pm oar r ... . • Si d: Ooh�her 9.00
dkw+ / a. PitrtH e': Garbage Disposal 9.00
mume
O aim, L 8ovl.¢3Z Wei Machine 9.00
P. o. 1‘ 40224- 2y y 1 Roar Drain 1 9.00 cl 0 0
aer�. a Water Heater - 9.00
t o yJ e - �i3 £4 I launder Roan Tray 9.00
.
Urired 9.00
fa" M5I MairiLlitkied Other Foasurea (Spedy) 9.00
9.00
Cone r -
6 /11 ss 6V1/4) ,1X
5114A,{ I n, [ CIE- _ E 766_ x
. b 900
144-". Lr • , , q S --- it 12 - 23 if Sewer 1st 100 - 30.00
a. wt+•.r..r
ay a. m. *. Seaver - ee. Addit 100' . 25.00
Wbter Service 112 100' - 30.00
I hereby acknowledge that I have read this applicsdon, that the Water Service ea. Ada 200' 25.00
infbrmadon given is correct. that I am the owner or a ltwrited agent of Shun & Rain Drain 1st 100' . 30.00
the owner. at plans submitted am in compfranoe with State taws, that
I am registered with the Construcdon Contractor's Board. that the Sion & Rain Drain Add_ 100' 25.00
number given 16 correct (U en i than State registration. Please
give reason below.) affiAl 0o Go6odg Mlle Harm Space 25.00
/ 1 3 Z -2-V1 Z 141Z/do Badc Flea Amnion
Device or And-Pollution Device 9.00
m ,.... . P _ �e+ _ My Trap or Waste Na!
Connected m a Feature 9.00
Describe work V 0 . - O alteration ® repair O Catch Basin 9.00
to be done residential Q • _.. - I. Imp. at Exist. Plumbing 40.00lhr
Specially Requested Inspections 40.001hr
Existing or of ��[i / tiaih Drain. sln9lu hill* dhrreling 30.00
burbling or property i� i''sD
Rasfdertsl baddbw prevention -
devices 15.00
Proposed use of -
buildng or property t0 lExcept rusideedal baclrflow
- prevention devices)
NOTICE 'ABnamwn Fee 526.00 SUBTOTAL 2 7 cc-
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS. OR IF 5% SURCHARGE 1 -3D
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS ki17 COMMENCED. PLAN REVIEW 25% OF SUBTOTAL - TOTAL
' Special Conditions c
Date issued by -