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14625 SW 89TH AVENUE ADDRESS: 'Ti/ A V ,,,ti,�a s F-- r H J N 0 W J I:Vecords\microllmUargels\building.doc v 0 z v m a � Q N T w C`Y w CO _-�' z° z z ° z -z° z r r O G cii z z N z z m a 0 J o o o o CL d to a a U ` A N N N N ry O 4-� N b N N A d d •, Obi Obi V N N Q o d J �1 L N ISC, ,r a a d c w S d 3 vi d aN aq ami u(ii ca w ULL LL ri o o o (Cy r > Q Q ~ Q Q co to V u _j a a a a. a s CITYOF TIGARD PLUMBING PERMIT _^ DEVELOPMENT SERVICES PERMITM PLM1999-00116 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/2,1/99 PARCEL: 2 S 111 AD-04000 SITE ADDRESS: 14625 SW 89TH AVE SUBDIVISION: PINEBROOK TERRACE ZONING: R-4.5 BLOCK: LOT: 037 JURISDICTION: TIG CLASS OF WORK: REP GARBAGE DISPOSALS: MOBILE HOME SPADES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOF DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES_ LAUNDRY TRAYS: SF RAIN DRAINS: S!NKS: URINALS: GREASE TRAPS: _AVATrRIES: OTHER FIXTURES: TU'3/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Replacement of gas water heater with like kind. _ — FEES Owner: Type By Date Amount Receipt BALDWIN, CLARENCE W/MARY C TRS PRMT DRA 4/21/99 $25.00 99-314(33 14625 SW 89TH AVE MISC DRA 4/21/99 $1 25 99-314733 TIGARD, OR 97224 _ LTotal $26.25 Phone 1: Contractor: HIGH TECH PIPING INC PO BOX 230005 TIGARD, OR 97281-0005 REQUIRED INSPECTIONS Phone 1: 620-6082 Misc. Inspection Reg M LIC 48395 Final Inspection PLM 26-356PB n- N This permit is issued subject to the regulations con`ained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance wi,h approved plans. This permit will exp�,e if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENI ION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Viose rules are set forth in OAR 9520001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling 3 46 7. �C • �� ftL�-r1 Permittee Signature: x Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD Plumbing Permit Application Plan ---- 13125 %'M HALL ©LVD. Commercial and Residential Rer'd Tl[GARD, OR 97223 Date Recd (503) 639-4171 Date to P.E. Print or Type Date to U T Incomplete or illegible applications will not be accepted Permit#_ �l Related SWR# _ 1 _ Called_ Name of Development/Project - FIXTURES (Individual) QTY PRICE AMT Job Sink -- 9.00 Address Street Address ^ Suite Lavatory 9.00 Tub or Tub/Shower Comb. 9.00 Bldy#- City/State Zip^ Shower Only 9.00 1/6,17"1:.#) )rte : T1. e y --_ Water Closet 9.00 Name( L� L11V - --- - 1 �� • / �.-S)h � �>y Dishwasher g.p0 Owner Mailing Addretta Suite Garbage Disposal 9.00 It - _ �` L1 / Washing Machire 9.00 City/State Zip ehone'5 t -'- , I e '`,`) r, I ') ( Floor Drain/Floor Sink 2" - 9.00 Name I`- 3" 9.00 �-_ I ( -i '(S�� 4" 9.00 OCCU alit Mailing Address Suite Water Heater' O conversion p Q like kind 9.00 Gas piping requires a separate m6c"lucal permit. City/Slate Zip Phone Laundry Room Tray 9.00 11 1 `l C) ) r, I I I Urinal 9.00 Name Other Fixtures(Specify) 9.00 C t r!N �- -_-- Contractor llin�1Addrvss Suite 9.00 L3 >> 9.00 Prior to permit City/State Zip Phone ,r Sewer-1st 100' 30.-03 Issuance,a copy T 4 f( &� _ J Sewer-each additional 100' 25.00 Jll of all licenses are Oregon Const.Cont.8 ard�ic.# Exp.Dat required if Ci (1-�t--0 c Water Service-1 st 100' 30.00 expired In COT Plumbiv Yc.# /_ , Exp, ate Water Servlcs-each auJilional 200' 25.00 databore l-CG 5 C �.�� 6 �� �%r Storm R Rain Drain-1st 100' 30.00 Name Storm R Rain Drain-each additional 100' 25.00 Architect I Mobile Home Space 25.00 or Mailing Address Suite Commercial Back Flow Preven1on Device or Anti- 25.00 'ollutinn r,,,vice Engineer City/State Zip Phone Residtrrtial Backflow Prpvenfioo Device' 15.00 (Inigati m timing dev',;es regwi�^ ^parate Describe work to be done: restrlcle�energy p-srmit. New O gcpair O Replace with like kind: es l O No O - Any Trap or`haste Not Connected to a Fixture 9.00 Resident 4 Commercial O Catch Basin 9.00 Ad clitlonalliescription of work: Insp.of Existing Plumbing 40.00 Specially Requested Inspections 40.00 per/hr --- - Rain Drain,single family dwelling 1000 Are you c•rpping, moving or replacing any fixtures? _ Grease Traps 9.00 Yes O No O If yes, see back of form tc indicate work performed by -- - - fixture. FAILURE TO ACCUPATELY REPORT FIXTURE QLIAN1'ITY TOTAL. Isometric or riser diagram Is required M Quantity Total Is >9 WORK COULD RESULT IN INCREASED SEWER FEES. "SUBTOTAL I hereby acknowledge that I have read this application,that the information given Is coiect,that I am the owner or authorized agent of the owner,and 6%SURCHARGE that tans sub !ed w i o lance t re un Slat Laws. / signature of wn g t I Date --FLAN REVIEW 25%OF SUBTOTAL j' rRelred only R fixture qty total Is>9 Contact Parson Name Phone TOTAL w 5 *Minimum permit fee Is$25+5%surcharge,except Re,identlal BackflowY Prevention Device,which Is$15+5%surcharge "AL1 New Commercial Buildings require plans with Isometric or riser diagram and plan review I%dshlpk"W.doo MM PLEASE COMPLE'rE: Fixture Type -- Quantity by Work Performed_— _— Now More+--i Replaced Removed/Capped Sink ------ Lavatory _ -- -- -- — ----- Tub or Tub/Shower Combi;,ation _ Shower Only — -- Water Closet _ - -- DIchwasherv- Garbage Disposal ---- .nhashing Machine --- Floor Drain/Floor Sink 2" --- 3„ --E---- --___J 411 Water Heater --- Laundry Room Tray Urinal _-- __ - -- —� —-- Other Fi;,iures (Specify) — - -- COMMENTS REGARDING ABOVE: R - -- -- - -- —---- —- F-- r J C10NIpAMnpp.aoe mAe CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-1176 Business Line: 639-4171 _ n a BLIP Date R,agjested_ / / AM PM BLD Location L�' �_" % ; I41, __ Suite MEC C;cntact Pe,son _ Ph —, PLM Contractor Pil _ SWR _ BUILDING --—" i enant/Owner ELC Retaining Wail ELR Footino — Founciation FPS r-tg Drain S(aN Craw!Drain Inspection Notes: -- Slab _ _ _ SIT Pos!& Beam Ext Sheath/Shear _ Int SheathlShear Frami r9 Insulation Drywall Nailing -- ----- `� Firewall Fir,,�4orinkler Fire AIL•n', Susp'd Ceiling _ Roof Misc. Final 4 ✓ PASS PART FAIL Barri Under Slab Top Out — Water service _ Sr- lary Sewer R&D' s PART FAIL ICAL Post& Beam — --- Rough In Gds Line — —-- — Smoke Dampers IFioal — - — PASS PART FAIL cLECTRICAL — — Service v; Rough In UG/Slab _ Low Voltage Fire Alarm r.- Final PASS PART FAIL __- - SI'i E Backfill/Grading Sanitary Sewei )corm Drain ► )Reinspection feo of$ required before next inspect'-1. Pay at City Hail, 13125 SW Hall Blvd Catch Basin I )Please call for reinspection RE:---�_-_ _ f )Unable to inspect-no access Fire Supply Line _ ADA Approach/Sidewalk 3 A; Other nate t/A— Inspector^ Ext Final PASS PART FAIL DJ N07 REMOVE this insF ection record from the joh, site.