15455 SW ROYALTY PARKWAY ADDRESS:
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CITYIGAR®
PLUMNi'ERMII
PERMIT #. .BI . .G. .
OF
DA-1E ISSUED.- 06/:2/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd, 'Igard,Oregon 97223e8199 (503)639-4171 PARCEL: cR'S110CD--053I1I0
SITE ADDRESb. . . ' 1'-54'b:) ':�W ROYHLly I-'KWf
SUBDIVISION. . . . : ZONING:
BLOCK. . . . . . . . . . : . . . . . . . . . . . . .
CLASS OF WORK. . .- Rl I-' GARBAGL DISPOSPI—S. I'TIOBILE HOML SPI-')(:ES.
TYPE OF USE. . . . 'Sj-- WASH I NG NOCH. . . . . . 0 BACKFLOW PRE-.VNT RS. 0
OCCUPANCY URF'. . :P3 FLOOR DRAINS. . . . . . . 0 TRPIPS. . . . . . . . . . . . . . .
STORIES. . . . . . . . . IZI WATER HEArERS. . . . . . 0 CATCH BASINS. . . . . . . : 0
F I XTLJIRES--------- LAUNDRY IRAYS. . . . . * 0 SF RPIN DRAINS. . . . . : IZI
SINKS. , . . . . . . . : 0 URINALS. . . . . . . . . . . 0 GREASE "FROP S. . . . . . . „ 0
LAVATORIE=S. . . . . . 1171 OFHER FIXTURE=S. . . . : 0
TUB/SHOWERS. . . . : 0 SEWER LINE (ft) . . . : 0
WA)-LR GLC"'.JETIS. . : V, WATER LINL (ft ) . . . : 1111III
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . ' 0
RemaAlr-k's : Water service 1st 10OFt.
Owner: FEES
DONALD NELSON type amal.tylt L,'-
- date r,ecpt
lb455 SW ROYALTY Pr'W�' PRMT 30. 00 C.'�S 07/31/96 96-28307(..
5PCT 6 1. 50 CJS 07/31/96 96-2,8301t,
KING CITY OR
Contractor: --------
FULLOIAN COMPANY
5805 SW HOOD
PORTLAND OR 97201
Phone #:: 2L-'4--5,*.","1 s ;:31. 5111 TO1 AL
Req fl. . : 00445
RLuui RED I NSPEC-r 1 UNS
This permit it issued sl;b)ect to the regulations contained in the Watev, Line Irisp
Tigard Municipal Code, Statp of Ore. Specialty Codes and all other lylisc:. Inspect ion
applicable laws. All work will be done in accordance with InSpeCti-On
apprnyea plans. This permit will expire if work is not started ...........
mit*, 180 days of issuance, or if work is suspended for sore
that, 18e days.
1 e r,m-i t t P e i q n a t 1.1 r'e
Ca I I for inspect icon 6 1-69 417`;;
1
Cih -)f Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
131 SW Hall Blvd. Permit #
Tigaro, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
New SIE!.le Family Residences Only
" = -T� �� —
°"'•• � ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
,Job 1 1 5 }� P ❑ 3 BATH HOUSE$225.00
,Address cnrsn. / a, ae includes all plumbing fixtures in the dwelling and the first 100 fer't
7? I of water service, -.andary sewer and storm sewer. See fees below.
"'�"�'"�^"ff^•°'� ^•"' �JJQ _ FIXTURES QTY PRICE AMT
�C 3 Sink — 9.00
1A.g"°s"• c ^• Lavatory 900
OwnerI Cj J Lv Tub or Tub/Shower Comb. 9.00
" '• zl" j Shower Only 9.00
Cql"l Water Closet 9.00
"•"•'"" °'°"^""
Dishwasher 9,00
,?� Oar`,aDisposal _ 9.00
Occupant Nr a T'y`'- geWashing Machine 9.00
Floor Drain 9.00
' �'•'•
ZIP Water Heater 9.00
Laundry Room Tray 9.00
"•"•r Urinal
9.00
L1 1" S?S-✓r C e?— Other Fixtures (Specify) 9,00 _
".Og rm". "h— 9.00
Contractor �-
S�J b-,V r. .� VO 9.00
�.�.
_ 9.00
(7?Qc)( Sewer 1st 100' 30.00
•'• • 'Q•h "
j[:777C--' "^B" T"" Sewe' -ea. Addit. 100'-- 25.00
oca-) I (� Water Service 1st 100' 30.00 pLl
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
informat'zi given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm & Rain Drain 1st 100' 30.00 r —
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please _
give reason elow.) Mobile Home Space 2500
Back Flow Prevention
� _- % Device or Anti-Pollution Device 9.00
""•"""°"" �'"" 0.4 Any Trap or Waste Not
Connected to a Fixture 9,00
Describe work new C) addition rJ alteration (, reoair Catch Basin 9.00
to be done residential Q non-residential n Insp. of Exist. Plumbiry 40 00/hr
Soecialiy Requested Inspections 40.00/hr
Existing, use of Rain Drain, single family dwelling 30-00 _
building or property _ _ _ —
Residential backflow preventiun
devices 15,00
Proposed use of —
building or property _
- — (Except residential backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED ----FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVI"I 25% OF SUB rOTAI_
TCTAI_
Special Conditions _ L 0 r --
Date issued `) - by
i � i
ti trot ; � �,, t i „ , •t t� �
rCIri1l.. PJIAi 141
t_
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mach.
PIbg.Und/Fir/Slab Plbg.Top Out Insulation -E ect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other W A_-J-r P.M.
Da __
_ - 2--�7'" A.M. — Entry: -�-
A� - st ► _
Tenant: __ Ste:_ ST:
BUP: �—
Con/Own Wr1... �k�Yti� -__ MEC
F'LM -- n
ELC --THE FOLLOWING CORRECTIONS ARE REQUIRED ELR
Inspector -rd_. _ '-� Date:
_ APPROVED _—DISAPPROVFD/CALL FOR REINSP. (Ct') CO