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12476 SW 114TH TERRACE i ADDRESS: f - ?� Cr � 000I oc N J 1:lracotdslmicroflmltarg©lslbuilding.doc W J P CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : I-'LM94-0187 13125 SW Hall Blvd Tigard,Oregon 971223olE1199 (503 -4,171 0 J_V.?!� DATE ISSUED: 08/29/94 PARCEL: 2S103AC-03400 SITE ADDPESS. . . : 1x_476 SW 1. 1.47 H T E R R , SUBDIVISION. . . . : WALNUT GROVE SLIBD ZONING: R-4. 5 BLOCK. . . . . . . . . , , LPT. . . . . . . . . . . . . :3 CLASS OF WORK. . :Nl�W GA13BAGE DISPOSALS. . : MOBILE HOME SPACES T*Y[-',E OF USE. . . . :SF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS_ : 1 OCCUPANCY GRP. . :R3 1--'LOOR DRAINS. . . . . . . TRAPS. . . . . . . . . . I . . . : STORIE=S. . . . . . . . :2! WATER HEATERS. . . . . . CATCH Df-IS INS. . . . . . . FIXTURES--- LAUNDRY TRAYS. . . . . . SF RAIN DRAINS. . . . . SINKS. . . . . . . . . . : URINALS. . . . . . . . . . . . . GREASE TRAPS. LAVATORIES. . . . . : OTHER FIXTURES. . . . . TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . WATER CLOSETS— : WATT.R LINE (ft ) . . . . DISHWASHERS. . . . RAIN DRAIN (ft ) . . . . : Remay-lt-, , INSTALLING BACKFLOW 1"-1 REVENIION DEVICE Owner,: FEES J17-'FF BLACK type a m o 1-tn t by date t-eept 12'476 SW 144T1-I TERR PRMT $ 15. 00 BLT 08/29/94 5PCT $ 0. 75 BLT 08/29/54 TIGARD OR 9722'3 Phone #: Contr,actct-: ----------------------- --------- CONTRACTOR NOT ON FILE PTI on e It. $ 15. 75 TOTAL Req REUUIRED INSPECTIONS This permit is issued subject t- the regulations contained in the Final Inspection Tigard Municipal Code, State of Ore. Specialty C-.,dpc; and all other applicable laws. All work will he done in accordance with appruved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for sore thar. 180 days, cc it Lee S'33. k 1�- J m Call fat- inspection 639-4175 _J —OTW I-I y OF I D 44141.1 RLU I I P I fil. t (-I IMYI I r 1 11 t F I I..'I N(.1 c'--156of-i1 IHAA �-MCAJNI 115 NAME a IA(-ACK, .JC F44.14Y oMflUNI D D H L.,s i a 12,4 16 SW 1141'14 I I RP PHtW-1\11 DWE r 0 8 4 !-i IA 14 1)1 v I S 10 N 117 POWIFNI 1-'A J 1) PURPOW.-- (W PH'y ML 1',l I all) PI.AIMBINO 14 RM 111-mg/l 0107 1 V,0 81 . NII IIA) 14.14 lur(Il . AMOUNT 'r,'ii(J) 75 City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # m ��/• 13125 SW Hall Blvd. PerlriL i` , &I Tigard, OR 97223 oZS W4( - (593) 639-4171 MINIMUM $25.00 PERMIT FEE +ST. SURCHARGE Ninwo1Diy"°^"•^' New Single Family Residences Only AWL3 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00 Job l)il[6 ❑ 3 BATH HOUSE$225.00 Address ewer. m Fee includes all plumbing rixtures in Me dwelling and the first 100 feet ec,b,) `7'7 2,9 3 of water service, sanitary sewer and storm sewer. See fees below. N-�a""'•°'"'^"•••' FIXTURES OTY PRICE AMT Sink 9.00 M."A°'••• °An^' Lavatory S.00 Owner Tub or Tub/Shower Comb. 9.00 c'W"'•'• A' Shower Only 9.00 Water Closet 9.00 "•^�is^•^^w°,-) Dishwasher 9.00 Garbage Disposal 9.�0 Occupant ,,,,,,,o,,,,,., Washing Machine 9.00 Floor Drain 9.00 �•'• a• Water Heater 9.00 Laundry Room Tray 9.00 "•^• Urinal 9.00 i Other Fixtures (Specify) 9.00 "•"a A4,t- F%w 9.00 Contractor 9.00 m 9.00 Sewer 1st 100' 30.00 31•'•"•a•"~N0. dv&..T.ND Sewer-ea. Audit. 106' 25.00 Water Service 1st 100' 30.00 I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00 informatlen gnren is correct, that I am the owner or authorized age t 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 Construm on Contractor's Board, that the Storm&Rain Drain Addit. 100' 25.00 number given is correct. tlf exempt from State registration, please give real n low.) Mobile Home Space 25.00 Back Flow Prevention Device or Anal-F.)Ilution Device 9.00 y.'•N• a"• Any Trap or Waste Not I \i Connected to a Fixture 900 Describe work new addition O alteration Q repair Catch Basin 9.00 to be done residential Q non-residential Q Insp. of Exist. Plumbing 40.00/hr Specialty Requested Inspections 40.00/hr Existing use of Rain Drain, single family dwelling 30.00 building or ly i a Residential bacxflow pre%entlon e, devices 15.00 v~i Proposed use of r building or property F- •(Excopt resldenflal backflow preventlon devices) NOTICE 'Minimum -''ee 325.00 SUBTOTAL , G W -� 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 REVIEW 25% OF SUBTOTAL TOTAL Special Conditions - ___ Date issued by _�.-. L INSFECTIGN N_P ICE City of Tigard Building Denarteent 1.3125 SW Ha11 Blvd. 7'.gard, Oregon 91323 Inspection Line (Rec-0-Phone): 63°,-4175 Business Phone: 639-4171 Inspection:__-- plbg. Undereleb Mb^h. Rough-in Appr/Sdwlk Footing _ Found. Plbg. Top Out Gas Line INAL Poet/Beam Struck. San. Sewer Framing -Bldg. Post/Beata Mech. Rain Drain Insulation � Plbq. Underfloor Water Line Gyp. Bd. -Mach.I� -�-L//-� `Y Tlme, AM PM Date Requested: C�___ ---ll/----------- _ 1 a __AL � 7� Permit Address: �,�'�� 7 , C 7 1�451 Bulkier:� THE FOLLOWING CORRECTIONS ARE REQUIRED: N ------ J wCD - - - LLI J _ Inspecttort nate:—_---- V__APPROV2D bI9APPRnVRD -___ APPROVED SUR.TE('P TOABOVE Call For Relnnp. INSPECTION NOTICE City of Tigard Building Department 1.3125 SM Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rsc-O-phone): 639-4175 Bueinesa Phone: 639-4171 Footing Plbg. Undurslah Mach. Rough-in i App_/Sdwlk Found. Pltg. Top out ( Gas Line FINAL: PostlBeam Struct. San. Sewer Fr.uning -Bldg. Poet/Seam Wech. Rain Drain Insula`ion -plumb. Plbg. Underfloor Water GLine Gyp. Bd. -Mach. Date Requested: 7/ 1 — TLrrA x —AM / p� Ad.9reess�L�� 1: Builder: / 71 ld 20 Tl.'8 FOLLOWING CORRECTIONS ARE REQUIRED: Abgrlolv - cc Inspector: __i— —_ Dates r� ' APPROVED D15r%PPROVED APPROVED SUBJECT To ABOVE W -1 Call For Reinsp. S)�I I INSPECTION NOTICE City of Tigard Build+.ng Department 1.3125 SW Ball Blvd. Tigard, Oregon 97223 Inr:pection Line (Rea-O-Phone): 639-4175 Bunineoe Phone: 639-4171 Inspection:'___ APO,tIng Plbg. Underslab Mech_ Rough-in Appr/Sdwlk. Found. Plbg. Top Chit Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing \ Bldq, Poet/Beam Mech. Rain Drain Insulation Plbg. Underfloor Nater Line Gyp. Bd. _Meeh, �f I Date Requested: !2j G�y Pines _ AAM _ PM iI Addresn:-- '[ y�� /��`1`rCI- ����-- Permit f: -!l -02,(06 Builder: 1�'L ( - 0q:3 � THE '�FOLI.ONINGy�C-ORRNC:�TION£ ARE REQUIRED: f�.�' GL c.c •�--� �(�c-c a cY Y Inspector:_ I _ ---_--_-- Date-- 9 Y m ~ APPROVED l DISAPPROVED APPROVED SUBJECT TO ABOVE C7 _ W J call For Reinap. ',a