11545 SW DURHAM ROAD-3 ADDRESS :
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ilrecords\microflm\targets\building.doc
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CITY GF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd,Tigard,Oregon 07223.8199 (543)830-4171
PLUMBING PERMIT
PERMIT t#. . . . . . . : PLM94-0E'13
639-•4171 DATE TSSUE:D: 09/19/94
PARCEL: S110DC-00400
SITE ADDRESS. . . : 11545 SW DURHAM RD
SUBDIVISION. . . . : WILLOW BROOK PARK ZONING: C-G
BLOCK. . . . . . . . . . . LO T. . . . . . . . . . . . . : 16
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CLASS 13F WORK. . :A1._T GARBAGE DISPOSALS. . : MOBILE HOME SPACES. :
TYPE OF USE. . . . :COM WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . :
OCCUPANCY GRP. . .-B2 FLOOR DRAINS. . . . . . , : TRAPS. . . . . . . . . . . . . . ..
STORIES. . . . . . . . : 1 WATER HEATERS. . . . . . . CATCH BASINS. . . . . . . :
FIXTURES-------_ -_ -- LAUNDRY TRAYS. . . . . . : 5F RAIN DRAINS. . . . . 9
SINKS. . . . . . . . . . : 1 URINALS. GREASE. TRAPS. . . . . . . .
LAVATORIES. . . . . : OTHER
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :
WATER CLOSETS- 1 WATER LINE (ft ) . . . . .
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . . :
Remarks : ADDING SINK TO SPEC OFFICE
Owneir: _---•---_---___.__.._. .___.._ .. _._.-- .---..____._..__.__._ ___.___...__.______-- FEES �
JOHN SRAMEK type amount by elate recpt
11545 SW DURHAM RD PRMT '# 2-'5. 00 JG 09/19/94 -
5PCT $ 1. 23 JG 09/19/94 -
TIGARD OR 97224
Phone #:
Contract or:
LARSEN & SONS PLUMBING CO INC
7A00 SW 36TH AVENUE
F 1.113 fL11hID OR 9722219 -------•-----------.•--------------------
Pf-1 on e #: $ 26. 25 TOTAL
Rey #. . .- 37650
------- REDtJ I RED INSPECTIONS
---- ----
This permit is issurd subject to the regulations contained in the Top—out Insp
Tigard Municipal CoJ,, State of Dre. Specialty Codes and all other Final I n�:pect i on
applicable laws. fll worts will be done in accordance wit!,
approved plans. This permit will expire if work is not started
within. 181? days of issuance, or if work is suspended for more
than 180 days.
Permittee S i c)n a t f-1 r e:
Call for inspection - 639--4175
City Of Tigard PLUMBING PERMIT Planck/Rec. #
13125 SV',' Hal! Blvd. APPLICATION Permit #
'rigard, OR 97223
(503) 639-4171
�� •1111 e M ���----�—�
r , escnp Ion
ORS 81421-810 _ —LTY PRICE
Job y�4�' S W tLJV�_(,t?v.. ��� FIXTURES
Address Sink 7..50 o
Lavatory — 7
o .--
`�4a w��C C, ` YT 7 ower ny _ — — — --
Water Closet
`-
Owner 2�7 3Y 5 LJ,_,se4 Dishwasher 7.50
L r lar age Disposar
'2>`_ �J � �a� • � —was Ing ac InA —.--
•^ '� Floor Drain
atmeater
• a «• � *" Zauno'y Room rayOccupant Urinal
" - zip Other Fixtures pec
Contractor �-6 r z� MISCELLANEOUS r --
�� Sewer sit i0—
• • __,sewer -ea. Addit. ..
406 Water ervicesr1 6
ereriy ac now ge that T-Fia—veread-F—si—pplic—ation, that the Water Service ea. Addit. 200' 15.00
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 Storm & Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 15.00
number given is correct. (If exempt from State registration, please --
give reason below.) Mobile Home Space 25.00
ow raven n — "-
41 Device Ioice or Anti-Pollution Device 7.50
Any Trap or Waste Not -
I Connected to a Fixture 7.50
Describe work _ addition aeon repair �- a cfi Basin -
to be done residential non-residential Q - — -
Insp. of Exist. Plumbing per hr
Tam-
Specially Requested Inspections per hr
Existing use of Rain Drain, single family --
building or property `. - _ dwelling 15.00
est ent a Tia'c TCrjw prevention
c+vices 15.00
Proposed use of --_ ---
h0iding or property —
_-(Fx_L*p?_r_e_9Td@-nVa1 backflow
provandon devices)
N0710E "MlnImum Fee $25.00 SUBTOTAL Z,J
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5%n SURCHARGE �v
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF —
CONSTRUCTION OR 111ORK IS SUSPENDED OR ABANDOr1ED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 2.5%OF SUBTOTAL.
COMMENCED. — �---
TOTAL .Z Z
Special r.Witions
---_-- Date issued - -- by -� -
t•IPLUMeP4T
1.•IdlrelnA•v
ci,ry ov, TIGARD Rf-.*.C[-,IP'l M PAYMF--.Ni RF-CkIPT NO. %94-4285689;
AMOUNT 06, 2' i
NAME LARSEN, EBON CASH AM0L1N 1 t 0. 011
ADDRESS a 9825 BW 56TIA AVE PAYMENT DAU.-. a 09/J9/9,
SURD f V I li I ON II
M0 LmND, 1.)RUJUN 972I9--
PURPUBf- OF PAYMFNI AMIRINT PAID PURPOSE 01- I-"AYMt-Nl AMLION-1 PHI 11
(,ilIMBJN(-, VIVkM PLM94-02131. Poll. 00 ST. BUILD pt-li i. P!4)
i t54ti 13W DURHAM RD
TOTAL AMO INE PAID 26. 25