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Permit . . _ . , • CITY O FTIGARD � ' ��U��U�U��U��~� ��U��U�� PLUMBING PERMIT �� 13125 SW Hall Blvd., Tigard, OR 97223 (583) 638-4171 PERMIT #. . . . . . . : PLM97 DATE ISSUED: 03/31/97 1 � � ^ PARCEL» 2S110CD-051W0 . - SITE ADDRESS...; 1'5475 �475 SW � ROYALTY PKWY ' . SUBDIVISION.... : ZONlNG: BLOCK. . . . ' . . . . . : LOT. . . . . . , . . . . ' : ~��W JURI KIN � �� -___-_________ ' -___ _-____-___ CLASS OF WORK..:REP GARBAGE DISPOSALS.* 0 MOBILE HOME SPACES.: 0 - TYPE OF USE.,.. WASHlNGMACH......i VY BACKFLOW PREVNTRS..: 0 ` ^' OCCUPANCY G9P..:H2 FLOOR DRAINS......: 0 TRAPS.............,: 0 ^ STORIES... ..... : 0 WATER HEATERS.....: 0 CATCH BASTNS.... . .. : 0 , FIXTURES - -7--------- - LAUNDRY TRAYS..... : N SF RPIN DRAINS..... : 0 S7NKS. . . . . . . . . : 0 URDNAiS... . . . . . . . . . : 0 GREASE TRAPS.,„,....: . . . . .� : 0 � LAVATORIES � . . : W OTHER� FIXTURES. . . . � 0 ' ` TUB/SHOWERS . : 0 ' SEWER LINE (ft}.... : 0 ' ' ' WATER CLOSETS. : 1 WATER LINE <ft)...: 0 ' � , `' ` ^ r- DISHWASHERS... 0 RAIN DRAIN (ft)...: el ' . . . . . Remarks: instl 1 water closet . � . . ' O wner-!. -- ------------- ---- --- FEES ---- ---- ED BLOCH � type amount by date recpt ' i5475 SW ROYALTY PK�� . - 'oRMT'$ 25.00 TAT 03/31/97 KING CITY ,~ KING CITY OR 97224 5PCT $ 1.25 TAT 03/31/97 KING CITY ' ' . . � � . . Phone #� 699-9367 , � ' ` . . ., .. C ontractor--------��-----�-----�--------� '. CHRISTIAN PLUMBING ' . . . �. � ' ^ ` ' 2317? SW STAFFORD RD. TUALATIN OR 97062 ----- ---------------------�---- Ohone #:, 503-638-8231 $ 26.25 TOTAL . Reg #..i 42671 ' ' . ` ------- REQUIRED IMSPECTIONS ------- ' This beroif is. 'issued subject to the regulations contained in the Water Line, t Insp ' • �i��~�uicio � State' �e, Stotnf'�.' Sop ialt� Codes and all ,other i c We' Sorve'` In , ��' ' appl'cable lawt. All Work *bil be done i n ' accordance with Rough-ih Insp' ' __L_ '' • ' approved 'plans: This permit will expire if work i� not startp� PLM __ /UnderfI�n� ^' __ ' . ^ within 180 day 'of issuanoe or if is suspended fcr nmo To p-o ut Ins . _.___ than 180! days. . Miso Inapection � • . Fin�l Inspection _____�_____________. ' ^ � ' Pormittce St x � / ' �7 (� � ----- ------ _____ :' �ssued G c //_^ �_ 1 ' _ , _ _________�_� ' -�_-_____'___---_-__� _-____--- � � ` �� ` �nall for insp�ction - 639-41�5 �� ^ '' ' , ^ . / � ` � } /. ' � � ' � ' � �� . � .. .� � ` � � , ,, . ,' � . � • . .� . . ' � _ . ----- -JAN-04-'00 WED 02:56 ID: FAX NO: _ . #005 P02 CITY. OFJLGARD Plumbing Application Reed By 13t25 SW HALL BLVD. Commercial and Residential Date Recd Date to P.E. TIGARD, OR 97223 Date to DST (503) 639-4171 permit* 'Lin q7 I . Print or Type Related SWR It Incomplete or illegible applications will not be accepted called • Name of Development/Project ..INFU..E. ..0#4 IM •';..Al :':9 ANIT ' Sink 9.00 Job FL 3 j (rii Lay.tory 9.00 . Address treet AdIress Suite , L. 7 (2 'e / - Tub or Tub/Shawer Comb. 9.00 - Bldg * Ci /Sta e Zip Shower Only 9.00 • t . e- t)'s - 7 2 2- water Closet . f 9.00 Name Dishwater 9.00 - ------- Garbage Disposal 9.00 Owner Mailing Address Suite Washing Machine 9.00 _ City/State Zip Phone Floor Drain 9.00 I 3: . Nam 9.00 : , eit_ 61,,c-h ___ I 4 9.00 - .... Occupant Mailing Addreaa „,, Suite il j pi Water Heater 9.00 I 5 G ....7 I 75 L, go val ix fc-I Loc.-t aundry Rcom Tray 9.00 City/State Zip i Pn , j , Urinal - 9.0o sq_iz,t--e-/ 6 c4‘ lb, Other Fixtures (Specify) 9.00 1 Name/ , 9.00 CA c Pi (/ i J Contractor Mailing Address Suite 9.00 J( 7 1 5_1 i 'A-- ' 9.00 city/State Zip Ph an@ - - 9.00 f t/6 la.i if- ok C,744 ' 9. Oregsu3Colia>Co Board Licit Exp. Date 00 _ Attach Copy of (-- 0 9.00 Currant Plumbing Lic. 0 Exp. Date Sewer - 1St 100" 9 00 1.1conSes Sewer • each additional 30.00 onal 100' I . COT usi ness Tax or Metre C Exp. Date e 1- 4 7/ 1 t- 1--7 Water Service - let 100' . - . 25.00 I Water Service - each additional 200' 30.00 Name Storm & Rain Drain - let 100' 25.00 Architect Storm & Rain Drain - each additional 100' 30.00 or Mailing Address - Suite Mobile Home Space 25.00 . . Engineer eitY/State Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00 Pollution Device . - Describe work New 0 Addition 0 Alteration 0 Repair dl"- Residential Backflow Prevention Device 15,00 .. . to be done: Residential O'Non 0 Ally Trap or Waste Not Connected to a Fixture 9.00 I Additional description of work Catch Basin 9.00 Insp. of Existing Plumbing 40.00 ,, per hr Ai C, t"./ tA/6•+ C f IP 7 e ' r Specially Requested Inspections 40.00 Exiating USG vf per hr building 6? property Rain Drain, single family dwelling 30.00 Proposed use of Grease Traps 9.00 building or property . QUANTITY TOTAL Are you capping any urtures? Yes No Isometric or riser otagrem Is required I? Quanily Tetal 're f a ,M °SUBTOTAL *.;014:; I hereby acknowledge that I have read this application, that the information ;..4tfi 7 ... , .. - . ". given is correct, that I aM the owner or authorized agent of the owner. and , •i::, 1 that plans ubmitted are in co Hance with Oregon State Laws- 6% SURCHARGE SIgnatu of Owned ent Date PLAN REVIEW 26% OF SUBTOTAL 41.,■,::..f,:;.;lici ::, -- 3 -I Required only it fixture qty. total is > 8 7 1.'` , . ,:... TOTAL ontact Person Name Phone t..- L I Su 'I 4 - . 62-e-7711 *minimum permit fee is 525 • 5% surcharge, except Residential Sackilow Prevention Device, which is 515 + 5% surcharge hdsts1p1mapp.doc 8/96 RECEIVED MAR 3 1 1997 COMMUNITY DEVELUPMEN1 z CITY OF TIGARD Plumbing Application Rec'd By f----N. .1-3 SW HALL BLVD. Commercial and Residential Date Rec'd - i ---`i Date to P.E. TIGARD, OR 97223 Date to DST - 3 3i -ct1 (503) 639 -4171 Permit # anal "obi Print or Type Related SWR T Incomplete or illegible applications will not be accepted Called Name of Development/Project I FIXTURES (individual) - - , - QTY PRICE AMT Q J� Sink 9.00 Job f; `' " 3 l i /, r/ Lavatory 9.00 Address treet Address I Suite 1. S'/ 75 Cl �'t/ Pte / Pc w «/ Tub or Tub/Shower Comb. I 9.00 Bldg * City/State Zip 7 Shower Only I 9.00 K i of ✓ S - Lh, 17 2 2 -7 I Water Closet ( I 9.00 Name Dishwater I 9.00 Owner Mailing Address I Suite Garbage Disposal 9.00 Washing Machine 9.00 City/State Zip I Phone Floor Drain 2" I 9.0C . 3" 9.0C Na rT L 4" 9.00 Occupant Mailing Acoress Suite Water Heater 9.00 1 $ �( 75 5 t.(/ 4 ✓GPI t--.7 f G./ / Vvc / Laundry Room Tray 9.00 City/State Zip J Phorie Urinal 9.00 k i. w G. u q f -! 7 2 Z"`1 G�yt -� 3C ? Other Fixtures (Specify) 9.00 Name /� I 9.00 C/t / ! r „. 4, � j Contractor Mailing Address �, I Suite 9.00 23(77 5i ''/''� I 9.00 City /State Zip Phone 9.00 f lili t .i. ILI dl- 6 i'l y 9.00 Ore Const. Cont. Board Lic.# Exp. Date Attach Copy of -( 70 I ' 9.00 Current Plumbing Lc. x I Exp. Date Sewer - 1st 100" 9.00 Licenses . Sewer - each additional 100' 30.00 I . COT Business Tax or Metro ;* Exp. Date Water Service - 1st 100' 25.00 C t 1i 7 / 1 1- /- 7 Water Service - each additional 200' 30.00 Name Architect Storm & Rain Drain - 1st 100' I 1 2_5.0C Or Mailing Address Suite Storm & Rain Drain - eacn additional 100' 30.00 Mobile Home Space 25.00 Engineer City /State Zip I Phone Commercial Back Flow Prevention Device or Anti- 25.00 Pollution Device Describe work New 0 Addition 0 Alteration C Repair Residential Backflow Prevention Device' 15.00 to be done: Residential 'Non- residential 0 Any Trap or Waste Not Connected to a Fixture 9.00 Additional description of work Catch Basin 9.00 insp. of Existing Plumbing 40.00 pe hr ./1/ C./ t-•/ 1A/6..4- e/ G1 o 5c' r Specially Requested Inspections 40.00 Existing use of per hr building or property Rain Drain, single family dwelling 30.00 I I Proposed use of Grease Traps 9.00 building or property , QUANTITY TOTAL _ Are you caning any fixtures? Yes ❑ No I '4 - Isometric or riser diagram is recuired if Quanity Total is > 9 I hereby acknowledge that I have read this application, that the information *SUBTOTAL e- I given is correct. that I am the owner or authorized agent of the owner, and 5 SURCHARGE that plans submitted are in comjiance with Oregon State Laws. / „ Si of Owner! ent Date /�7 PLAN REVIEW 25% OF SUBTOTAL � . _ 3 1- Z / �eouired only f fixate c y. Total is > 9 ontact Person Name ' Phone TOTAL L O w- ` t ( SL) "1 �, c h 621-77 4 3'1 -Minimum permit fee is 525 + 5% surcharge. except Residential Baci tow i:ldstslplmapp.dec 8/96 Prevention Device. which is S15 + 5% surcharge RECEIVE APR 141997 COMMUNITY UC