Permit r' ,r________ , . .-..............----. . ,, ---...--r------------
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- CITY O TIGARD, .,
...,„ .. , DEVELOPMENT SERVICES
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' PLUMB LNG ',PERM IT , , , . • ,
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.,- " ..ni . 13125 SW,Hall Blvd., TigarCOR:97223 . (503) 639-4171 '' , PERMIT '#,J......',:' PLM97 -0075 '
,.' DATE ISSUED 03/10/97
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PARCEL: 1S1260C -01109
i SITE ADDRESS.--- 09500-SW WASHINGTON SQUARE RD
SUBDNISION . . ZONING: C-G
BLOCK..........: LOT
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CLASS OF WORK..:ALT , GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
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- .TYPE OF USE:. ,-;- :COM ,,, ;.,..: ,H. WASHING .11ACH. ., ... : . 0 . . BACKFLOW P RE,V NIRS,„ ,,, : 0
'OCCUPANCY ' GRP.' „ :B ' ' 'FLOOR DRA INS.' . .-..-.' -. . .. "z,. •' TRAP'S— . .. . „ — . . ., . : 0 ,. . ' •
STORIES. '.'"..,.='.,,-...,. :.', 0y-'„ ,..-. WATER. 'HE ' ..., r.
ATERS. .:, . . ,. . ..1.,,' CATCH, BAS I NS. . ....,'. .. ' . ': 0 .• , ' "
F I XTURES--- - -,-- LAUNDRY TRAYS • 0. . SF RAIN DRAINS - 0
SINKS '. ..,.. ..,.. ;;. „ : , , .0 :: ,'' ,, URI NALS„, ,v . „,'„ .. .u.: - :.',... , :,-,1 , :_t, 0,,i, GREASE TRAPS •,0
LAVAT,ORIES'. — — : 0 OTHER FIXTURES ' - 0
TUB/SHOWERS. . . . : ,‘. s - .0 , .,-... - ,,,: SEWER'' LI NE ( ft, )1. ''... :-- f,,,, 0.,.:
WATER CLOSETS,. : 0 WATER LINE ( f t ) . : 0
DISHWASHERS. .'.;'..- :' , p,..L: , ,. •,, RAIN DRAIN, „( ft ) .., „. : ,„
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Remarks : Instal 1 ing a water heat er . . , . ' • ..
t` CO I . type , at : by dt e. recpt
J. C. PE
9500 SW WSHI .
'' A SR RD PR
MT, ,,'..; ,,,',..,„ .„!.,:'',,,' , • .'';' . ' , i, 4:.11 .:i moun a
,,,.,,-25,. 00 B . v. .03'11,0197,97-291480
SPCT $ 1.25 B 03/10/97 97-291480
'TIGARD OR 97223 - • , ,
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Contract or:
GEORGE MORL.AN PLUMBING '
5529 SE FOSTER. RD.. . , .
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PORTLAND OR 97206 . ,,., , , , , , . . - . - •. . • '
. Phone #: 771-1 , , 145 , '' ' . . , $ ' 26.; 25 TOTAL , '
Rag" #..„; ,:. - ' 02734
o273::, ,., ' ,, „ . , . . ,
'i, ., •.,., . ' , _,.„ • ,,.', , ,-, ,L,,, , ',, , , . 'REOU I RED ' „I NSPECT IONS
This permit is issued subject , to.-theegulations 'containerl'An„,the-;,,„. ,_• , T oip-,put -, ; I n s p ._ -., , .
Tigard Municipal Code,. State of, Gr e. Specialty Codesand all other . . - Final- I n s p e c t i o n ,,, .
applicable laws. ,, All, work will be done in accordance with. , _ ,:, • ,
approved plans. This permit will expire if merit , vi- I . _.' , , . ,
. . within 180 days' of- iSsicance, 'or if' work ,,is. suspended; for, more „'„.,,,...,: ,,,,,, ,,, ,:. . - ,,• ' . . .
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Permittee ..Si , atur e ,
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Issued By : AAAAkk " '''' . ' .
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Ca 11,. f o r,,, _I. n s P e_c•t i.ork,-. -7-639-A175_
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CITY OF TIGARD Plumbing Application Recd By 1 k 1.. j , .i. i
13125 , SW HALL BLVD. Commercial and Residential Date Recd - lb '
TIGARD, OR 97223 Date to P E.
Date to DST
(503) 639 -4171 Permit PLN\q -/- (b
Print or Type Related SWR s
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Incomplete or illegible applications will not be accepted_ _ _. Carted .
Name of Development/Proiect FIXTURES (individual) QTY PRICE AMT
Job Sink 9.00
Address Street Address Suite Lavatory 9.00
G1,C✓W Sw ( L. 4 , Tub or TubiShower Comb. 9.00
Bldg s CityiState Zip Shower Only 9.00
- A O� } � Water Closet 9.00
Name + T J�
V /Jea Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
' D( r(A) 6041451. (• Washing Machine
9.00
71 '4� GA, � p 4127-3_ G Phone L 0 - 0 co Floor Drain 3' 9.00
3 9.00
Name (('' _
J Li 4 •- 9.00
Occupant Madng Address Suite Water Heater L 9.00
Laundry Room Tray 9.00
City/State Zip Phone Unnal 900
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Name
Fixtures (Specify) 9.00
I r;a1 g l/`�Lf1 9.00
Contractor Mailing r Address Suite 9.00
/ (Lit.) ANA bo, 9.00
City/State Zip Phone 9.00
7g Oe ' 2Z) (t4 -73 1
Oregon Const. Cont. Board Lic.s Exp. Date 9.00
Mach Copy of 62 7,741 6 -/1-41 9.00
Current Plumbing Lic• s E Date Sewer - 1st 100'
30.00
UCeneee Z .0,, 25.00 I
3 0 �� Sewer - each additional 100'
COT Business Tax or Metros Exp. Date Water Service - 1st 100' 30.00 I '
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• Name Water Service - each additional 200' 25.00
Architect Storm 8 Rain Drain - 1st 100' 30.00
Or Mailing Address - S :e
Storm 8 Rain Drain - each additional 100' 25.00
Mobile Home Space 25.00 1
Engineer I C:ty/State Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00
Pollution Device
Describe work New 0 Addition 0 Alteration 0 Repair O Residential Backflow Prevention Device' 15.00
to be done: Residential 0 Non- resiaential 0 Any Trap or Waste Not Connected to a Fixture 9 00
Additional descnpuon of work Catch Basin
9.00
Insp. of Existing Plumbing 40 00
peahr
Eosang use of
Specalty Requested Inspections 40.00
oenhr
xiiicfing
or property Rain Drain. single family dwelling 1 30.00
Proposed use of Grease Traps ( 9.00
i ouilding or property
QUANTITY TOTAL
Are ycc capping , moving or replacing any fixtures? Yes ❑ No 0 Isometric dr riser diagram is reouired if Cuanrty Total is > 9
(If yes see back of form) 'SUBTOTAL
I hereby acknowledge that I have read this application, that the information
'given s :arrect. tnet I am the owner or authorized agent of the owner. and 5% SURCHARGE 1.2c
rat clans submitted are •n compliance with Oregon State Laws.
Signature of Owner /Agent � ' Data 1 PLAN REVIEW 25% OF SUBTOTAL
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� � � . � % r / � / 3 ( 7 / 4 7 Required only if r i ture my. totals > 9
- �� TOTAL
Contact Person Name Phone 16.1-S
i � (� 'Minimum permit fee is 525 • 5% surcharge. except Residential Backflow
Y141 �� v / /f/� 4 //e1.- 7 -7 3Q / Prevention Device. which is 815 * 5% surcharge
i:tdststplmapp.doc 5196
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PLEASE COMPLETE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced Qty
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:
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
.Foundation Water Line Ceiling �7
Post/Beam Mech. Shear /Sheath Framing -Mech.
Plbg.Und /Flr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: / 0.- ] ' I
Date: 5/D-- I -! / A.M. P.M. Ent
Address: cj SZ) W SO - Rc
Tenant: / i'}1.e f/ — Ste: MST:
BUP:
Con /Own: ita- ute G ZD -p 7SU MEC:
) PLM:
" ey ` ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Spector: r- ' Da O/g
PPROVED DISAPPROVED /CALL FOR REINSP. CF CO