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68403 SW ASHFORD STREET
CITYOF T I GA R D PLUMBING PERMIT
DEVELOPMENT SERVICES �� PERMIT#: PLM1999-002..52
13125 S 1 Hall Blvd.,Tigard, OR 97223 (503) 639-417�ti� DATE ISSUED:
SITE ADDRESS: 06 !03 SW ASHFORD ST j0 PARCEL: 2S112CB-04200
SUBDIVISION: ASHFORD OAKS NO. 2 � ZONING: R-7
BLOCK: LOT: 056 JURISDICTION: TIG
CLASS OF WC ':K: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF L)S'': SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIX i URES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of residential backflow prevention device.
Owner: FEES --�
MOLLY MURDOCK. � Type By_ Date Amount Receipt
8403 SW ASHFORD ST PRMT DEB 8/9/99 $2r..00 99-317517
5-'C T DEB 8/9/99 $1.75 99-317517
------------ Total $26.75
Phone 1: 684-6280 ----
Contractor:
OWNER
REQUIRED INSPECTIONS
Phone 1: RP/Backflow Preventer A--�
Reg #•
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans
This permit will expire if work is not started within 180 days of issu,nce, or if work is suspended for more
than 180 days. Ai TENTION: Oregon law requires you to follow rult,� adopted by the Oregon Utility
Notification Center. Tlicse rules are set forth in OAS )52-0001-0010 through OAR 952-0001 0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issu fey: Permittee Signature: ��
Call (503) 639-1175 by 7:00 P.M. for an inspection needed the next Tsiness day
CITY OF TIGARD Plumbing Permit Application Plan 0eck# _
13125 SW HALL BLVD. Commercial and Residential Rec'dBy
TIGARD, OR 97223 Date Recd
(503) 639-4171 Date to P.E.
Print Or Type Date to DST
- --- ,
Incomplete or illegible -nnlications will not he accepted Permit# �M /'r
Related SWR#_
Called
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Jobsink '-
Aclareb Street Address 5T, Suite Lavatory - 11.50
11.50
t 65hFoR.0 Tub or Tuo/Shower Comb. 11.50
Bldg# Ulty/State Zip Shower Only 11 50
Name Water Closet/Urinal (Specify) 11.50
MO I I`( ti k 00C.I< Dishwasher _ 11.50
Own(,r Mailing Address I ST Suite Garbage Dispa,al 11.50
D 3 3 S I���� Washing Machine/Laundry Tray (Specify)
City/State Zip Phone 11.50
1 1(9 0 iO Cle �� �y �y _(a �U Fluor Drain/Floor Sink 2" 11.50
Name 3" 11.50
4" 11.50
Occupant Mailing Address Suite Water Heater O conversion O like kind 11,50
__ Gas piping requires a separate mechanical permit.
City/State Zip Phone MFG Home New Water Service 28.00
- MFG Home New San/Storm Sewer 28.00
Name _
LA/A/ C!(_ Hose Bibs 11.50
Contractor Mailing Address Suite Rain Drairs 11.50
Drinking Fountain 11.50
Prior to permit City/State Zlp Phone Other Fixtures(Specify) y 15.00
issuance,a copy
of all licenses are Oregon Const.Cont.Board Lic.# Exp.Date
required it -
expir din COT Plumbing Lic.# Exp.Date
da.ribase
Name
Sewer-1 at 100' 38.00
Architect Sewer-each additional 100' 32.00
Of Mailing Address Sull' Water Service-;zt 100'
38.00
Engineer City/State Zip Phone Water Service-each additional 200' 32.00
_ _ Storm&Rain Drain-1 st 100' 38.00
Describe work to be done: Storm&Rain Drain-each additional 100' 32.00
New O Repair O Replace with like kind: Yes O No O Commercial Back flow Prevention Device
Residential O Commercial O 32.00
Additional description of work: Residential Backflow Prevention Device* 19.00
t c v Catch Basin
11.50
Insp.of Existing Plumbing 50.00
Are you capping, moving or replacing any fixtures? per/hr
Yes O No bt Specially Requested Inspections 50.00
If yes,see back of form to indicate work performed by error
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain,single family dwelling 45.00
WORK COULD RESULT IN INCREASED SEWER FEES. Grease rraps 11.50
I hereby acknowledge that I have read this application,that the information QUANTITY TOTAL
given is correct,that I am the owner or authorized agent of the owner,and Isometric or riser diagram Is required it Quantity Total is >9
that plans submitted are in compliance with Oregon State Laws.
Slgnetro of wrier/Ag Date - 'SUBTOTAL
Contact Pertoln Name Phond 7% SURCHARGE
i
ct 9�"1 ;t` -'"PLAN REVIEW 26%OF SUBTOTAL-
1 BATH H,;.I1S 178.00 Re cared only H fixture qty,total is>9 _
2 BATH I I0UF,, $250.00 TOTAL
3 BATH IIOU .$285.00
(This fee hicl 1-es all plumbing fixtures in the dwelling and the first --
100 feet of ar:i ary sewer storm sewer and w,ter service) 'Minimum permit fee is$50+7%surcharge,except Residential Backflow Prevention
Device,which is$25+7%surcharge
All New Commerclal Buildings require plans with Isometric or riser diagram and
plan review
PLEASE COMPLETE:
Fixture Type _ _ Quantity by Work Performed
New Moved Re Laced Removed/Capped
ink
Lavatory --- _ _ -- --- ----
Tub or T_ub/Shower Combination _ — ------ -
Shower Only --
Water_Closet_ —
Dishwasher_ _ — -
Garbage_Disposal__„ _ — —
Washing Machine _ -.-
Floor Drain/Floor Sink 2" — ----
3„ —
Water Heater -
LaundryRoom Tray _--.-
Urinal --
Other Fix`.ures (Specify)
COMMENTS REGARDING ABOVE:
I,dslsVdmsk,luma{,p dac 9/5x99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST ine: X639-4171 BUP _—
24-Hour Inspection Line: 63'9-4175 Business L _
C q
--
Date Requested _.L_AM— —PM ___ BLD
7 Suite _ MEC
Location
, (Xt- PLM
Ph �u�� CLQ
Contact Person _
Ph SWR
Contractor
l
ELC
rBUiLDING Tenant/Owner ELR
��-R--etainin��_ FPS
Footing Access -- ---
Foundation SGN
Ftg r'rain
Crawl Drain Inspection Notes. SIT --
Slab
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing -
Insulation i
Drywall Nailing ----
Firewall
Fire Sprinkler =
Fire Alarm i
Susp'd Ceiling
R oof
Misc:
1-inal
PASS PART FAIL_
LUMBI
Post&Beam
Under Slab
Top Out
Water Service ---
Sanitary Sewer
Drains
Fi
ASSN PART FAIL ------------
ANICAL _ __-------
Post&Beam _
Rough In
Gas Line
Smoke Dampers _
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm — r
Final
PASS PART FAIL
SITE _ —
Backfill/Grading
Sanitary Sewer ( ] nspReiection fee of$ ____required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Storm Drain ( j Unable to Inspect-no access
Catch Basin ( ]Please call for reinspection RE: .___._ --
Fire Supply Line J�
ADA � ' Ext
_2z__
pate Inspector _ _
Other
LFinal DO NOT REMOVE this inspection record from the job site.
Sg PART FAIL
- — — —