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10105 SW MCDONALD STREET-1 1S aIVNOa3W MS 50606 w w ly F- IL o � a CO) z o a m J Cl) LO O r A r 10105 SW MCDONALD ST CITY OF TIGARD DEVELOPMENT SERVICES SEWER CONNECTION PERMIT MAIM 13125 SW Hall Blvd.,Tigard,OR 97223(503)639-4171 PERMIT #. " . . " . . : SWR98-0335 DATE ISSUED: 1?/17/98 PARCEL: 2S102CC-03800 C I T.:. ADDRESS. . . : 10105 SW MCDONRI._D ST SUBDIVISION. . . . :FRELEON HEIGHTS ZONING: R-3. 5 Sl_OCK. . . . . . . . . . LOT. . . . . . . . . . . . . :006 JURISDICTION: TIG ----------------------------------------- ------------- TENANT NAME. . . . . :DEMAREE, ED USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0 CLASS OF WORK. . . .-NEW DWELLING UNITS. . : 1 TYPE OF USE.. . . . . :SF NO. OF BUILDINGS: 1 INSTALL TYPE. . . . :1-TPSWR IMPERV SURFACE: 0 sf REmarks : Sewer r_.onnectinn. Septic tank must be pumped, filled and capped or removed. Owner: ---------------------------------------------------- FEES -------------- ED -------_----_ED DEMAREE type amount by date recpt 101.05 SW MC DONALD SR PRMT $ c300. 00 DEA 12/17/98 98311608 TIGARD OR 97223 INSP t 35. 00 DES 12/17/98 98311608 Phone #: 620-7N40 Contractor.: -------------------._----------- OWNER Phone #: f 2335. 01A 00 TOTAL Reg #. . : ---- REQUIRED INSPECTIONS -------- This Applicant agrees to comply with all the rules and regulations _ of the Unified Sewage Agency. The permit expires 188 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agenry does not guarantee the accurary of the M i side sewer laterals. if the sewer is not located at the measurement _ given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral. _ ATTENTION: Oregon law requires you to follow rules adopted by the 9: Oregnn Utility Notification Center, Those rules are set forth in OAR fIx .. 952-881-8818 through OAR 952-8881-POP, You may obtain copies of W these rules or direct questions to OUNC by calling (583)246-1987. m Issued r C�!nZ Permittee Signature +++++++++++++++F+++++.+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Call 639--4175 by 7:00 p. m. for an inspection needed the next bt_rsiness day ++++++++++++++++.%-+++++++++++++++++++++++++++•+.++++++++++•++++++++++++++++-F+f•+++++ CITY CSF TIGARD PLUMBING PERMIT I DEVELOPMENT SERVICES PERMIT #. . . . . . . : Pl_M98--0460 13125 SW Hall Blvd.,Tigard,OR 97223(503)639-4171 DATE ISSUED: 12/17/98 PARCEL.: 2S 102CC--038Qc10 SITE ADDRESS. . . : 101.05 SW MCDONnLD ST SUBDIVISION. . . . : FREL.EON HEIGHTS ZONING: R-3. 5 BLOCK. . . . . . . . . . . L0T. . . . . . . . . . . . . :006 JURISDICTI0N: TIG CLASS OF WORK. . :ALT G1-iRBAGE DISPOSALS. : 0 MC S I LE HOME SPACES. : 0 TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0 OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0 STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH F 1NS. . . . . . . .. 0 FIXTURES--- ---- -- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0 TUB/SHOWERS. . . : 0 SEWER LINE (fu ) . . . : 40 WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 Remarks : Install sewer line for new connection. Septic tank must be pumped, filled and capped or removed. Owner: ------------------------------------- FEES ED DEMAREE typr amount by date recpt 1.0105 SW MC DONALD SR PRMT $ 30. 00 DEP 12/17/98 9:3-311608 TTGARD OR 97223 SPCT $ 1. 50 DEB 12/17/98 911-311608 Phone #: 62-10-7840 JOHN FRANK 16780 SW BULL MT RD TIGARD OR 97223 Phone #: 628-0155 $ 31. 50 TOTAL Reg #. . : 62819 ------— REQUIRED INSPECTIONS ------ - This persit is issued subject to the regulations contained in the Sewer Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection d applicable laws. All work will be done in arrnrdance with _ r, approved plans. This persit will expire if work is not started Nwithin IN days of issuance, or if work is suspended for acre than 180 days. ATTENTION: Oregon law requires you to follow rules _ adopted by the Oregon LRility Notification Center. Those rules are set forth in OAR 952 0881-8810 through OAR 952-0081-0888. You say CO obtain copies of these riles or direct questions to 01I11C by calling W (503)246-1987, T- IF.,sUerI u-4-1 Permittee Signature: +++++++i++++++f•+++++++-: ++4-++-F++++++++++++•+++++++++++++++++++++++++++++++++++++ Call 639-4173 by 7:70 p. m. for an inspection needed the next business day +++4+}++++++++++++++++++++++++++++.4-++++++++++++++4++++++++++++++++++++++++++++ CITY OF TIGARD Plumbing Permit Application Plan CheL* 13125 SW HALL BLVD. Commercial and Residential Recd By TIGAJRD, OR 97223 Date Recd (503) 639-4171 Dale to F.E. Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit• 'G--�-- Related SWR* -"O Called �j` cwt. 1,- Name of Development/Project FIXTURES {Individual) QTY,,4 !PRICE *WT Job Sink _9.00 Address Street Address Syne Lavatory 9 00 I ub or Tub/Shower Comb. 9.00 Bldg t City/State Zip — �, Shower Only 9.00 z oz Name Water Closet 9.00 16-114-4 UCi / Dishwasher 9.00 Owner Mailing Address Suite Garbage Disposal 9.00 -$r(."; V,""./c i, Washing Machine 9.00 City/State Zip Phone — M1 i -— ( .7 Cay�� Floor Drain/Floor Sink 2" 9.00 arne 4 3" 9.00 (_Wei 0-7 l e, 4" 9.00 Occupant Mailing Address Suite Water Heater O conversion O like kind 9.00 Gas piping requires a separate mechanical permit. City/State Zip Phone Laundry Room Tray 9,00 — Name Urinal 9.00 — ----- ` ]— % Other Fixtures(Specify) 900 Contractor Mailing Address Suite 9 r,) /S0 5:0 s. C,L, &ib.iG�ctr 9A0 Prior to permit City/State Zip Phone Sewer-1 at 100' 30.00 Issuance,a copy �tY< car�H! -345 7 % 5 7 3 `35 P/r s S Sewer-each additional 100' 25.00 of all licenses are Oregon Const.Cont.Board Lic.x Exp.Date _ required K f C, /o;j-,J 7_`!' - Water Service-1st 100' 30.00 expired In COT Plumbing Lic.* Exp.Date Water Service-each additional 200' 25.00 database Stolen rh Rain Drain-1st 100' 30.00 Name Storm d Rain Drain-each additional 100' 25.00 Architect _ Mobile Home Space 25.00 or Mailing Address Suite Commercial Bach Flow Prevention Device or Anti- 25.00 Pollution Device _ Engineer Clty/State Zip Phene Residential Backflow Prevention Device' 15.00 _ (Irrigation timing devices require a separate Dear-'be work to be done v restricted energy permit.) New • Repair O Replace with like k!nd Yes O No O Any Trap or Waste Not Connected to a Fixture 9.00 Residential • Commercial O _ ,v_ Catch Basin 9.00 Additional description of work — Insp.of Existing Plumbing 40.00 Specialty Requested Inspections 40.00 4 C� �c:.� r /4 c c.n�. per/hr cc Are you capping, movlr g or replacing any fixtures? GreRaiDrain,single family dwelling 30.00 U) I`_ Yes O No • Grease Traps 9.00 >_ If yes,see back of form to Indicate work performed by QUANTITY TOTAL t— fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is rec�Ired ffQusntfty Total is >9 1 . _J WORK COULD RESULT IN INCREASED SEWER FEES. "SUBTOTAL M I hereby acknowledge that I have read this application,that the information 0 given Is correct,that I am the owner or authorized agent of the owner,and 6%SURCHARGE W thatplans subml are in compliance with Oregon Stale Laws. _ •i Slgr)Jltafe t nar/A � Date '"PLAN REVIEW x6%OF SUBTOTAL 1 y�r / , R ulred on M 1!1 .rotal Is>9 4n 4�-/� y _ TOTAL ntact Person Name Phone •Mlnlmum permit fee Is$25+5%surcharge,except Residential Backflow 4 Prevention Device,which Is S15+5%surcharge "•AI!New Commercial Buildings require pians with Isometric or riser diagram and plan review 1 klststplumapp doc MM PLEASE COMPLETE: rixture Type Quantity by Work Performed New Moved Replaced Removed/Capped Sink _ � "' Lavatory Tub or Tub/Shower Combination Shower Only —' Water Closet _ Dishwasher Garbage Disposal Washing Machine , Floor Drain/Floor Sink 2" Water Heater - Laundry Room Tray -� Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: ' 1%diftVA maw dor 7771"