9260 SW 70TH AVENUE ADDRESS :
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639.4171
PLUMBING PERMIT
PERMIT #. . . . . . . . PLM04--026r",
639-4171 DATE ISSUED: 12/07/94
PARCEL: 1S125DA--06700
"TE ADDRESS. . . : 091260 SW 70TH AVE].
JBDIVISION. . . . : KINGS VIEW ZONING: R-4. 5
'_CCK. . . . .. . . . . . : LOT. . . . . . . . . . . . . .G5
1-1-ASS OF WORK. . :ALT GARBAGE DISPO45ALS. MOLAILE HOME SPACES.
ryp,E OF USE. . . . :3F WASHING MACH. . ,. . . . . : BACKFLOW PREVNTRS. .
0CCUP(,NCY GRP. . :R3 FLOOR GRAINS. . . . . . . . TRAP 33. . . . . . . . . . . . . .
I UR I LS. . . . . . . . .2 WATER HE . . . . . . : CATCH HAS INS. . . . . . .
,,.X I-0 RES-------- Li�UNDRY TRAYS. . . . . . : SF RAIN DRAINS. . . . .
,INKS. . . . . . . . . . : URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . .
1-AV A 1*0 R IES. . . . . : OTHER FIXTURES. . . . . :
iJB/SHOWERS. . . . : SEWER LINE (ft ) . . . . . 100
-
AA1 �-t:.' WA (ft ) . . . . :
JR CLOSETS. . : rR L
DISHWASHERS. . . . . RAIN DRAIN (ft ) . . . . :
REPLACE LESS THAN 100 FEET OF GEWER LINE
FLEA
PHIL JARVIS type amul.int by date r,eQpt
9260 SW 70TH P R M7 f 30. 00 JF 12/07/94
5PCT $ 1. 50 JF IL/07/94
iGART) OR
:-iclyie #:
onti-actov—
ROUCHLEY PLUMBING
..' /17 N LOMBARD
PURILPND OR 97L17
; 'hone #c ,3 1. 5 0 TOTAL.
-q #. . : V1184
REQUIRED INSPECTIONS
This ;emit is issued subject to the regulations contained in the Sewer, ItisLiectiori
igard Municipal Code, State of Ore. Specialty Codes and all other F- iTlt-Al Inspecticm
olicable laws. All work will be done in accordance with
proved plans. This pe,-mit will expire if wore, is not started
CL thin 180 days of issuance, or if work is suspended for more
an 180 day;.
_J
,I-mittee
U tr d B
t all for inspect icm 639--4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
1312" 6W Hall Blvd. Permit #
Tigard, OR 3723
(503) 633-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
N.^,.of pevbpman, New Single Famity Residences Only
A0a•••'
Job ❑ 1 BATH HOUSE$140.00 El BATH HOUSE$195.00
/ r .��
❑ 3 BATH HOUSE$225.00
Address Fee includes all plumbing fixtures in the dwelling and the first 100 feet
of water service, sanitary sewer and storm sewer. See fees below.
H.m.r em,NBu•neul FIXTURES Qr( PRICE AMT
Sink 9.00
M,r,u Baa,,, p^•^• Lavatory goo
Owner v)�-U .1i(J Tub or Tub/Shower Comb. 9.00
cnvimn. Shower Only -- 9.00
L,l re Water Closet 9.00 —
"•^• «^• °^ �••°+• Dishwasher 9.00
Garbage Disposal 9.00
Occupant Ming , ,—, �. Washing Machine 9.00 —
Floor Drain 9.00
cftylltm. an Water Heater 9.00
Laundry Room Tray 9,00
Urinal 9.00
�-�,�� Other Fixtures tSpecify) 9.00
M.Ang Ana... ,e. 9.00
Contractor 8 7 -) a 9.00
zip 9.00
61 Sewer 1st 100 _ X 30.00
5h,,R#ptrv.»,No G"On.Tax No. Sewer-ea. Addit. 100' 25.00
V/ Water Service 1St 100' 30.00
I hereby sckno%oleage that I have read this application, that the Water Service ea. Addit. 200' 2500
information given is correct, that I am the owner or authorized agent of --the owner, that plans submitted are in compliance with State laws, that Sto,m & Rain Drain 1st 100' 30.00
1 am registered with the Construction Contractor's Board, that the Storm 8, Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please - --
give reason below.) Mobile Home Spa,e 25.00 y
Back Flow Prevention
Device or Anti-Pollution Device 9.00
•«° ^�^««•°•^ 5— Any Trap or Waste. Not
Connected to a Fixture 9.00
Describe work new Q addition Q alteration 0 repair Catch Basin 9.00
to be done residential O non-residential v Insp. of Exist Plumbing 40 001hr
Specially Requested Inspections 40 00/hr
Existing use of
building or property _ Rain Drain, single family dwelling 30.00 _
Residential backflow prevention
devices 1500
ra Proposed use of —
N building or property __— _ — --
'(Except oesidentfal backflow
'- prevention devices)
ti
NOTICE 'Minimum Fee $25.00 SUBTOTAL
G^.
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 — J
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL ,
Special Conditions
Date issued _— by