9970 SW GARRETT STREET-1 V
9970 SW Garrett Street
CITYOF TIGARD PLUMBINGF,_FtMI _
DEVELOPMENT SERVICES PERMIT#: P /9/00 00377
DATE ISSUED: 10/9/00
13125 SW Hall Blvd.,Tigard, OR 97223 (503) E39-4171
PARCEL: 2S 102CC-00319
SITE ADDRESS: 09970 SW GARREI-T ST
SUBDIVISION- FREWINGS ORCHARD TRACTS ZONING: R-4 5
BLOCK: LOT: 012 _ JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF MAIN DRAINS:
—_^—�--SINKS_ — -- URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUFT/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of residential backflow prevention do
S=EES
Owner: ^Fype By Date Amount Receipt
LIERMAN, CARL AND MAY PRMT CTR 10/9/00 $36.35 27200000000
9970 SW GARRET-F ST ",PCT CTR 10/9/00 $2.90 27200000000
TIGARD, OR 9722:3 ---
Total $39.25
Phone 1:
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED INSPECTIONS
RP/Backflow Preventer
Phone 1: 691.6166 Final Inspection
Reg #: LIC 87906
PLM 34-250PB
EXPIRED
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 issuance, or if work is suspended for more
than 180 days. ATTENTION Oregon law requires you to follow lutes adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 thro h OAR 952-0001-0080.
You rrmy obtain copies of these rules or direct questions to OUNC by Galli g (503) 2 -197
Permittee Signature:
Issue d By: r /_• i — _
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the neXtLsiness day
___m - __ I
Plumbing Permit Application
Uatereccived: /o"i'eW permitno.. al:k t� Z37
City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: E edate:
cil)'"f Tisa"/ Phone: (503) 639-4171 —
Fax: (503) 598-1960 Date issued: f)y Receipt no.:
ij
Case file no.: Psyment type:
Land use approval: -
1ppll I I= MM7
I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U Additio:r/alteration/replacement r_;;l 1 service U Other.
7XU New construction s
11liLLIP41,11fil11 t
�f Description Qty'. hee(ea.) 'Total
Job_address: 9 U i > o. — New 1-and 2-family duelling%only: --
Bldg.no.: Suite no.: (includes 100 ft.for each utility connection)
Tax map/tax lot/account no.: SFR(1)bath_
Lot: Block: Subdivision: SFR(21 bath
Project name: — SFR(3)bath
City/county: / ZIP: 7,� Each additional bath/kitchen
Site utilitles:
Description and location of work on premises: Catch basin/area drain —
Drywells/leach line,/trench drain
Est.date of completion/inspection: Footing drain(no.lin.ft.)
I 1 ' Manufactured home utilities
Business name: Manholes
Udress: ►� Rain drain connector —
State: ZIP: Soni sewer(no.lin.ft.)
City: Storm sewer(no.lin,ft.)
Phone: Fax: E-mail:
Water service(no.lin.ft.)
CCB no.: Plumb.bus.reg.no: Fixture or Item:
City/metro!ic.no.: Absorption valve
Contractor's representative signature: Back(low preventer _
Print name: Date: Dackwater valve
1 1 Basins/lavatory
Clothes washer
Name: _ Dishwasher
Address: prinking fountain(s)
City: State: ZIP: Ejectors/sump
Phone: Fax E-mail: Expansion tank
Fixture/sewer cap _
Ftoor drains/Iluor sinks/hub _ __ _
Name(print): t I .Y hlkb Garbage disposal`
Mailing address: ,w liosc hibh
City: (,� State: Zi : Ice maker _
Phone: Fax: Email: Interce tor/ rcase trap -i
Owner instal Iallow resider tits l maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the pmperty 1 own as per ORS Chapter 447. Sink(s),basin(s), ays(s)
Sum
Owner's signature: Date: Tubs/shower/shower pan _
Urinal —
Name: Water closet
Address: — Water eater
City: Slate: ZIP: Other
Phone: Fax: E-mail: Total
— Minimum fee................$
Not WI jurisdiction cept credit cards,please call judfdic roe more intorm,uion. Notice:This permit application Plan review(.at — %) $
U visa U terCard expires if a permit is not obtained State surcharge(8%) ....$
Credit can]caret numwithin 160 days after it has been
•ap rcs� TOTAL .......................$
accepted as complete.
o
_�- Amount EXPIRED
'X P I R ED 4"16(WDNt OM)
('ardholder�grtttwre
PI aeBE COMPLETE•
FIXTURES (Individual) Qty Price. Total,
_ _ Fixture Typo Quantity b f Work Performed
Sink 16'60 Now I Moved Replaced Removed/Capped
Lavatory
16.60 Sink
- 16.60 Lavatorr �_•,_.�
Tub or Tub/Shower Comb. _ Tub or TuIdShower Combination
Shower Only 16.60 Shower Only ^-
--- -
Water Closes Water Closet--
Urinal 16.00 Dishwasher
Dishwasher 16.60 (3arba a Disposaj
Laundry Room Troy _
Garbage Disposal 16.60 Washing Machine __�-- _
Laundry Tray 16.60 Floor Oraln/Floor Siink 2' _
---3.
Washing Machine 1G.60 t A'
Floor Lkain/Floor Sink 2' 16.60 Water Heater
Other Fixtures(Specify)
3• 16.60 _ _-
4• 16.60
Water Healer O conversion O like kind 16.60 -- -- ---
Gasiping requires a separate mechanical Permit. -- -
MFG Home New Water Service 46.40 - �-
MFG Home New San/Storm Sewer 40.40 COMMENTS REGAR0ING ABOVE:
Hose Bibs 18.60
Roof Drains 16.60 ---
Drinking Fountain 16.60 ---
Other Fixtures(Specify) 21.75
9ewer-1s1100' 55.00
Sewer-mach additional 100' - 46.40
Water Service-1st 100' 5.5.00
Water Service-each additional 200' 46.40
Stone Q Rain Drain-tsl 100' 55.00
Storm d Rain Drain-each additional 100' 46.40
Commercial Back Flow Prevention Device 40.40
Residentlai Backflow Prrvention Device' 27.55
Catch Basin 16.60
Insp.of Existing Plumbing or Specially Requested 72.50
Inspectionsperthr
Rain Thain,single family dwelling 65.25
urease Traps 16.60
QUANTITY TOTAL +�
Isome.1rk:or riser diagram is required_N Quantity Total rs >9
•SUET )TAL s
8%SURCHARGE R
"'PLAN REVIEW 25%OF SU6TOTAL ''
Required only N Iixlure 1L total Is>9 _ �'• �"` r -.
TOTAL
� U'Minimum permit fee is f12.50.6%surcharge,except Residential na.kfbw Prevention C 1
-AllDe%jW,which is s36.75gal til sura rarpe.
"All New Commercial Buildings nequNe plans with Isortrelrk:or riser diagram and plan review t