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Permit 'tire •� :� i PERMIT i��a:a , DEVELOPMENT SERVICES PLUMBING. f�;G ! LR. Ill ,��- .-...� 13125 - SW "Hall Blvd:, Tigard, OR'97223 (503) 639 - 4171 DATE ' i GG�UED a I i. I !% + i 7 . PARCEL; _'8 1 .- o4-y(r,^3 . SITE' ADDRESS:, r . ' 1 SW ROCK IHui °1 M• '1Ji3 GLID a' •ANI SEOR / HEJOH°r i - Z ONIW( R -4- is " , ',JUR'I 3D . TI , ' , i_ I. -A:SS - OF - WORK.'„. e ADD ' GARBAGE i) I SPOS Lc3 ; ' '0 r •'NOB:r LE HOME SPACES.' o 0 ' .. 'TYPE OF . USE. o -'- ; SF ' ' WA5FiINE. MAC:.••(, ..... - . , • 0 BACKFLO J' PREVNTRSe e _ 1 ' • OCCU;='ANC1'''GRP. a • -R.?,. . -, ' FL.00R. DRAII? - , 1;�' TRAPS..... e ,00nnunennu <s STQF,IES- .. e 4 Is - 0.; W HEATER So � ' • CATCH R SINSfl ,_ , „ ,_'i_s, • ''F I'k s JPES_ ;.,___..._— _.... --- - L f4L:INDI� ?'' TR�;YS�'„+ SF' RAlP,il' DRf.[I`li3., , - SINKS.. , • 0 . . LJ'RTNAL.8 .. ,.'...q..;,:, 0 . GREASE.' TRAPS ' n , L�AVATORIfES -,> ._ . 0 .. OTHER F'I I .1. ' !� 'TUB /SHOWERS.. o T. 0 SEWER LINE 't ft i fl R , - _0 . Wf4Ts- R + °SETS: o '0 r WATER LINE NE (ft ) - > - , 0 • .. . DISH ASHERSe - o .0 RAIN DRAIN s,i. (f.t) - .,- k7 , Re 1—.s' ' In'sbal.L' r ces'.i�� i ;i:aI_ backfl'otr., .p e v' e'n'� . ©n - •d �v� ,ce, to"' an ex`';, st, i' n`rl, riLiie , , a i,:1, 1 v ' dw;e'1 1 i : - • • _ , - e _, � - — '`', pr, _ - - - € • .Ir t —rl is —_ .mil = �.G_ ___- 5 ^'(r'i'•1,..— 7,7 z -___ _ —.= : 1.,3130,'SW ROC INGHAM „• ' . r'RMT' $ 15.00 GEQ 11J07/97 97 - -?0 800 r I GARD OR - '° ' - 5PC I, $ 0 7� GL -.O L 1":'0.x7 f 997 , 97.-300300 Phon,£ # • ' _ y ' t , - ..... -._- -- ... _•. -.._.. _- I - _ .- • __ - - - -- , r , WI ` ' i� � •' 1 t�iCf- lELI_, 'KGRE.Y. D' - � ' 1 C i.83; -Fi Ea `wrILRER ROAD: .• BEAV =R;"ON Ors, 9i006 _... -= _- _.:._�_�._ -_ :__.. _ - - -- - -- . • 'F:ti�Ynr 4 # ' 64' 5-74EG , „ • ' . ::$ , 15 Th.' TOT AL'.:.• 'RRe'rj 'W., , , 111001.26 - _ , , ' ' , - -• -- _•_ . RLRJI RED '�I4V�,:;PECT1'[: NS ; -, - „- 7 ?hi F,, oortit is issued ° subject to the reiulati Contained in the iil1 sc, - 1 i',CI'1.: - '. �' ... Tigard ,AUniCipal Code; State o., ee. ;,,r;ecialyv, Codes ar•d' -- other R. /Back Flo t F °r '' _ _ - �_�___ appblcatile laws.: All work will be done in accordance'with • Fi.na.t Inspect ion __ - , 'aporoved puns. This ;knit will expire , ,,if work is ni.it 'starter - - _• �— within :67):days of issuance, or if v;ark is suspended for ,core _- - - _.____ _ • �._ . than• -16?s days. ATTENTION:,.. Oregon. - law requires you to ,yellow rules —__ _._ _ aa�i;te w the 4regan lIti P,otificatioir Ce'n'ter Thus r�.11es are ' __.. _ ___. ___.__ --- " - .. , ', sit forth,. in' CO 952-00M-P thrdosgh GAR 952 : --001 i-U86. ' Yaiu• eay ' __ - -- - - Obtain', cope:,oi these rules 'or -dileCt•,questions ' to G: by cailiny (503)246 -i997. ' ' - ____ _- - - - 7 + f - r - -+ +.I- --h • �_ h r , 1 -i -I- r i- hti- +•, -r-i:.4--h+-I - +-I° h..!-,4.;.j - • .1... -I -� .- -:- .. - h- I-. a. ' _i•._4..v- I-- I-- r-•{- +�h.,}... r..a. - i ....: . �� ,_ s. -i== i••i'�.+"••r °, +-•i•"F � j�. ;..: ; -,. ,- i- } -h ! - Ca •41.75' q.') v -7. 3 I r) ci f,. a.n ,ins,rert -ion. needei I, e 2 n - e > L, •ia.•_rs1 TIE' s da�, .•� • •;i-+-r- .- _ -1- + ++ --i +-h ++= -h=!•s 11. 1::- 4..i..a- ++-1 --- _ 1 ++,- -i- 1-'i -i i-.: , i - -.h ' h-1-- 6- -4- I- ••i•i-- 4• +=F:t• r-r-- F�1 ^�s•'-•ri-'•F-•i- 'fig-}- =E•.�i.._1- -1 -�f-i� ! i-•f•- h;J-- F•-�- � - •i- i- -i -�• f CITY OF TIGARD Plumbing Application Rec'd By 13125 SW HALL BLVD. Commercial and Residential Date Recd Date to P.E. TIGARD, OR 97223 Date to DST (503) 639 -4171 Permit # ,A> f 9 -05 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 Ok-t, 6 ‘..1 n.4 i , /� ei , r FIXTURES (Individual) QTY PRICE. AMT Address Street Address ! Stmt ' �` Sink 9.00 13130 S t,1 � nrn 4 1 9 ' Lavato 9.00 Bldg # City /Stat Zip ry Tub or Tub /Shower Comb. 9.00 T,5/"« 0 rc_ Shower Only Y 9.00 t k.>7 r 6$2._0( U9 M e „-}- Water Closet 9.00 Owner Mailing Address Suite Dishwasher 9.00 1 3 t S �J Q .nf tG et5 44 . Q2_ Garbage Disposal 9.00 City/ t te Zip Phone Washing Machine 9.00 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 Name � Urinal 9.00 ` -0 IN 11 tkr. a .I,e-k . Other Fixtures (Specify) 9.00 Contractor Mailing Addrss Suite 70 s' r..) rnI A Co c_l._C.IL --'2,..-2,-I 9.00 Prior to permit City /State Zip Phone 9.00 issuance, a copy I` +� ' .1∎5� nn. A C j! 67 7/ zz 44s- %L/A' 3 9.00 of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date 9.00 required if Sewer - 1st 100" 30.00 expired in COT Plumbing Lic. It Exp. Date Sewer - each additional 100' 25.00 database Name Water Service - 1st 100' 30.00 Architect Water Service - each additional 200' 25.00 Or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00 Storm & Rain Drain - each additional 100' 25.00 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' pc__ 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 that plans submitted are in compliance with Oregon State Laws. /5 Sign ure of Owner /Agent Date 5% SURCHARGE t � • 1 ( - (O - PLAN REVIEW 25% OF SUBTOTAL Contact arson N "e Phone Required only if fixture qty. total is > 9 62e. - r;,,9e ;09S7e/g3 TOTA /5; *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow Prevention Device, which is $15 + 5% surcharge I ldststpimapp.doc 5/97 PLEASE COMPLETE: Fixture Type Quantity by Work 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: I:ltlstsl 5197