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13350 SW HILLSHIRE DRIVE N W W N O cn F. x H r r x H �7 CEJ tJ Z H C*) f n r 133-0 SCJ dif,Gc;HIRG DRIVE CITYOF T I G A R.D PLUMBING PERMIT DEVELOPMENT SERVICE; PERMIT#: PLM2000-00002 13125 SVv Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: PARCEL: 2S104CA-06600 SITE ADDRESS: 13350 SW HILLSHIRE DR SUBDIVISION HILLSHIRE ZONING: R-7 BLOCK: ^- LOT: 066 - JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PRE%/NTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: RAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWEr'S: SEWER LINE: 100 ft WATER CLO:,ETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Repair sewer line - 1st 100 it _ FEES Owner: — — Type By Date Amount Receipt GOCHBERG, .IOEL S + APRIL L PRMT KJP 01/04/200C $50.00 00-320866 TIGARD, OR 97223 13350 DHILLSHIRE DR 5PCT KJP 01/04/200C $4.00 00-320866 --- -- -- Total $54.00 Phone 1: Contractor: ROTO ROOTER SERVICE 4 PLUMBING HOFFMAN SOUTHWEST CORP 4248 NE 148TF: AVE REQUIRE INSPECTIONS PORT'AND, OR 97230 — Sewer Inspection Ph-.)ne 1: 682-9774 Final Inspection Reg #: LIC 00013989 PLM 37-"/6PB nn G ,11 � This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordanoe with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is susp nded for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-'1080. You mpk/ obtain copies of these rules or direct questions to OUNC by calling (503) 46-1987. Issued By: '�^ Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD Plumbing Permit Application Plan Check#_ 131.25 SW HALL BLVD. Commercial and Residential Rec'd By_ TIGARD, OR 97223 Date Recd (503) 639-417-4 / Dare r)P.E. — — Print or Type Date io DST IncompletF or illegible applications wiil not be accepted Permit# FLM Z-)Ct' Related SWR#_ Called__ _ _ Name of Develop,,ientrProject \ a FIXTURES (Individual) QT( PRICE AMT Job 12--,S C� �,�.) ,te Sink 11.50 --11 Ad dress Street Address Suite Lavatory _ 11.50 _ Tub or Tub/Shower Comb 11 50 Bldr = City State Zip `— — - !1 Shower Only 11.50 -- — -_T !Jame, -- Water Close! -- 11,50 — I (I nc 12 Urinal i SU Owner Mailing Address Wilte Dishwashar 11.50 S 0 rr, Q- 11.50 Disposal 11.50 City/State Zip Phone Laundry Tray 11.50 Name Washing Machine 11 50 Floor Drain/Floor Sink 2' _ 11.50 Occupant 11-iling Address SuitA 3" 11 50 — _ 4" 11.50 City/State Lip Phone Water Heater O conversion O like kind 11.50 ---- -- -- Gas piping requires a separate mechanical permit MFG Home New Water Servi;e 32.00 � N7)-O MFG Home New San/Storm`ewer 32.00 Contractor Mailing Address Suite — _ —75 5 S V,,/ `� S' S Hose Bibs --�- 11.50 Prior to permit City/$ to ZI Phone Roof Drains 11.50 issuance.a copy �/,�S ?(}�Q �2 00 Drinking Fountain 11.50 of all licenses are O egon Const Cont Board Uc# Ex — — - — p A ti Oth r Fixtures(Specify) 15 00 required if — ��—_— L G — expired in COT PI,imbing'.ic # I Exp.Pate n _ database -n_7 ?i.1 — 1 ild _cam CIC t I - Architect Sewer-1st 100'' � 3800 3 w, Or Mailing Address Suite Sewer-each addition,1100' 32.00 --- Water Service-1st 100' 38,00 Engineer City/State Zip Phone -- � Water Service-each additional 200' 3200 Describe work to bon Storrn 8 Rain Drain-list 100' 38.00 New O Re air Replace with like kind. Yes O No O Sw,r:!Rain Drain-each additional 100' 32.00 Residentia Commercial O — — Commercial Back Flow Prevention Devi,:e 32.00 Additional description of work r C Residential Backgow Prevention Device' '.^00 J F G' ) 1 F-�� _ Catch Basin - 11 50 Are you--appin , moving or replacing any fixtures? Insp of Existing Plumbing or Specially Requested 5000 Yes O Nci'��- Ins ections _ per/hr !; yes, see back of form to indicate work performed by Rain Drain,single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Trap 11 50 —J WORK COULD RESULT IN INCREASED SEWER FEES. TY TOTAL Isometric or riser diagr�n Is required r QUANTITY totals >9 I hereby acknowledge that I have read this application,that the information given i5 correct.that I am the ner or authorized agent of the owner,and --- —--- 0 that plans submitted are In ocaliance with on State Laws "SUBTOTAL Sh e of Owner/Ageli�nt Date /� _M -----T goo SURCHARGE pt 1[P1lract Person Name Phone lU ur\� �� 0 ; S-0 "PLAN REVIEW 25%OF SUBTOTAL 1 BATH HOUSE'5119.00 Required only it fixture qty total Is>9__ TOTAL 2 BATH HOUSE$250.00 tJ 0 3 HATH HOUSE$785.00 (This fee includes all plumbing fixtures In the dwelling and the first *Minimum permit fee is$50+8%surcharge,except Residential Backflow prevention t 100 feet of sanitary sewer storm sewer and water service) Device which is$25+81,F surcharge All New Commercial Buildings require plans with isometric or riser diagram and plan review dsls'i, ,.sq,�:nap{ dnc t'11'/,19 PLEASE COMPLETE:_ Fixture Type — Quantity by Work Performed_ 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 – ----3" — e - Water Heater ___ Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I ldit9VNms\r1umeryi do 11/17/9l) m m m m m > ) > \ ) \ $ § \ / C.) \ » / ± [ / f CO k s E OD 0 ) \ } \ � S \ \ K \ ` D n = o < m @ k \ \ ) t � \ t 0 m y m El \ CC} \ [ / 0 z m a m � Ln > � > m m ° $ \ $ / / § o � � w E$ �CL G) _ c M � �k k § k § $ f E 1 M p m m m n. ... 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