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10450 SW DEL MONTE DRIVE O .A� Cn 0 v m r O z m v i 1 1 ' I 10450 SW DEL MONTE DR. r CITY OF 1 IGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2000-00101 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 03/30/2000 SITE ADDRESS: 10450 SW DEL MONTE DR PARCEL: 2S111CR-01307 SUBDIVISION: DEL MONTI= SUBDIVISION NO.2 ZONING: R-3.5 _BLOCK: LOT: 014_ -_�-� JURISDICTION: TIG CLASS OF WORK: AI_T GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: '0F WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS. STORIES: WATER HEATERS: CATCH BASINS: FIXTURES_ _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: 105 ft WATER CLOSETS: WATER LIFE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: 105'of sanitary sewer line Own �--------- —_ FEES ----` CROMBIE, RICHARD D JR + MICHEL Type By Date Amount Receipt 10450 SW DEL MONTE PRMT BON 03/29/200': $70.00 0001047 TIGARD, OR 972.23 L� BON _ 03/29/2001 _ $2.80 0001047 Total $72.80 Phone 1: — `- ---- Contractor: OWNER REQUIRED INSPECTIONS Phone 1: Sewer Incpection -- Reg #: Final Inspection ORIGINAL This permit is issued Subject to the regulations contained in the Tigard Municipal Code, Stat of OR. Specialty Codes and all other applicable laws. All wr ., - 11 be done in accordance with aporoved plans. This permit will expire if work is not started within 18J .ccs of issuance, or if wo,k is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the O egon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001 -0080. You may obtain copies of these rales or direct questions to OUNC by calling (503) 246-1987. Issued By: � Permittee Si nature: --, � /i -�- — gc L Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next usiness day ITY OF TIGARD Plumbing Permit Application Plan Check 1 _ 3126 SW HALL BLVD. Commercial and Residential Recd By ex _ IGARD, OR 97223 Date Recd Zt1^n 503) 639-4.171 Date to P E. Print of- Type Date to DST Incornplete or illegible applications will not be accepted Permit# (" r?tom= Related SWR#._'Z� I Called_- .__ - Name of Devclopmentfl roject FIXTURES (individual) QTY PRICE AMT Job Sink, �- 11.W Address Street Address - Suite Lavatory Y 11.50 5 k.' Ck 10 feL_- _ Tub or I jb/Shower Comb - 11.50- Bldg City/State Zip Shower Only -T !11.50 Name J Water Closet 11.50 j)l 1 C Ft f C q'- d r! ,KCr 14. F Urinal -- - -- 11.50 Owner Mailing Address Suite Dishwasher 11.50 - /C 1j(/ /1/0: f G Garbage Disposal 11.50 City/State Zip Phone - - _ 711 6s r� (0���•�i SSS Laundry Tray - 11.50 Nawe Washing Machine/Laundry Tray 11.50 Floor Drain/i-loor Sink 2" 11.50 Occupant Mailing Address Suite 3" �- 11.50 - City/State lip Phone 4" 11.50 Water Heater O conversion O like kind 11.50 Name Gas p,ping requires a separate mechanical permit. (A,;A fir i MFG Home New Water Service - 32.00 Contractor Mailing Address Site MFG Home New San/Storm Sewer 32.00 Hose Bibs 11.50 Prior to permit City/Slate Zip Phone Roof Drains 11.50 Issuance,a copy )j C - Drinking Fountain 11.50 of all licenses are Oregon Const.Cont.Board LIc.# Exp.Date _ _ _ required if Other Fixtures(Specify) 15.00 exp!red'i COT Plumbing Lic 0 Exp.Date database ---- - �` Pame Architect Sewer-1st 100' 38.00 ' or Mailing Address ulte Sewer-each additional 100' 32,-.n Cil (Stale Zip Phone Water Service-1 sl 100' 38.00- Engineer y p Ser -- Water vice-each additional 200' 3200, Describe work to be done: Storm&Rain Drain-1st 100' 38.00 New U Repair O Replace with like kind Yes O No O Storni&Rain Drain-each additional 100' 32.00 Res!dential O Commercial O -- Additional description of worker - Commercial Back Flow Prevention Device - 32.00 Residential Backfiow Prevention Device' 19.00 ( itch Basin 11.50 Are you capping,moving or replacing any fixtures? Insp of Existing Plumbing or Specialty Requested 50.00 Yes O No J Ins eraions prrtv If yes, see back of form to Indicate work performed by Rain Drain,single family dwelling 4500 ti:fs-re. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps - 11.50 WORK COULD RESULT IN INCREASED SEWER FEES. _ - _- QUANTITY TOTAL Thereby acknowledge that I have read this application,that the information given Is correct,that I am the owner or authorized agent of flip owner,and Isometric o.riser diagram is required n Quantity Total is >9 that l submitted are in compliancp with Or State Laws "SUBTOTAL. 3, Slghature of Owner/Agent Date -- -- - �'- ? 8% SURCHARGE r°1) Contact Person Name Phone ` "PLAN REVIEW 25% OF SUBTOTAL 1 TH HOUSE$178.00 r r t 1' nutred only X fixture qty total is>9 _-To ;SQA OUSE, 50 00 s ' s f TOT )2AL. PYA OVSSOs285 ti ncludeaF i u Mb{gig ureE In to III *Minimum Permit fee Is W+8%surcharge.except Residential Backflow prevenlon seWe1Rtorirl s rid YVatera Device vmKh Is$25.6%surcharge -All New Commercial Buildings require plans with ma rietric or nser diagram and ptan review 1 Ustsv,xmstpkxnapp doc t t 11 W PLEASE COMPLETE: Fixture Type Quantity by Work !�Ierformed -New Moved Replaced Removed/Capped Sink _.. ------ -----_ -- _-- Lavatory —— -- -- -- -- -- - ---- — — - - Tub or Tub/Shower Combination Shower Only _-- Water Closet. Urinal Dishwasher Garbage Disposal Laundry Room Tray __-- Washing Machine Floor Drain/Floor Sink_ 2" 4" Water Heater Other Fixtures (Specify) COMMENTS REGARDING ABOVE: dl,wtlfmf(1A,'-i9(KdX,InfNM CITYSOF TIGARD► ^SEWER CONNECTION PERMIT UEVELCPMENT SERVICESPERMIT#: SWR2000-00059 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 03/30/2000 SITE ADDRESS; 10450 SW DLL MONTF DR PARCEL: 2S111C13-01307 SUBDiVISION: DE! NlONTE "'UBDIVISION NO2 ZONING: R-3.5 BLOCK: — LOT: 014 JURISD,CTION: TIG TENANT NAME: CROMBIE, MICHELE & DOUGLAS USA NO: FIXTURE UNITS: CLASS OF WORK: ALT DWELLING UNITS: 1 TYPE OF USE: SF NO. OF 9UILDINGS: 1 INSTALL TYPE: I_TPSWR IMPERV SURFACE: Remarks: Connecting to sanitary sewer. Reimbursement District#16 fee paid. Septic tank must be pumped, filled, and inspected. Owner: T � FEES _ CROMBIE, RICHARD D JR + MICHEL Type By Date Amount Receipt 10450 SW DEL MONTE — — TIGARD, OR 97223 FRMT BON 03/29/200C $2,300.00 0001047 INSP BON 03/29/200C $35.00 0001047 Phone: ! Total $2,335.00 i -- Contractor: Phone: Reg #: Required Inspections Sewer Inspection Septic Tank Filled ORIGINAL This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all A;ractions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer' Permit and t,, Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: Permittee Signature:� d — Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next bUlsiness day