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Permit (275) v" CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PLUMBING PERMIT PERMIT # ° PLM95 -0311 639 -4171 DATE ISSUED: 10/18/95 • PARCEL: 2S102AB- •01900 SITE ADDRESS...: 09438 SW TIGARD ST SUBDIVISION ° NO.TIGARDVILLE ADDITION AMEND. ZONING: I -P • BLOCK LOT .==- CLASS OF WORK.. :ADD GARBAGE DISPOSALS..: MOBILE HOME SPACES.: TYPE OF USE •COM WASHING MACH • BACKFLOW PREVNTRS.. :1 OCCUPANCY GRP ° °:B2 FLOOR DRAINS • TRAPS ° STORIES WATER HEATERS • CATCH BASINS • FIXTURES -• - -- LAUNDRY TRAYS • SF RAIN DRAINS • SINKS URINALS • GREASE TRAPS • LAVATORIES OTHER FIXTURES • TUB /SHOWERS • SEWER LINE (ft) • WATER CLOSETS ° °: WATER LINE (ft) ° DISHWASHERS RAIN DRAIN (ft) • Remarks: Installing backflow prevention device ' Owner: FEES DOUG ALLRED type amount by date recpt 9380 SW TIGARD ST. PRMT $ 25.00 B 10/18/95 95- 271783 5PCT $ 1.25 B 10/18/95 95- 271783 TIGARD OR 97223 Phone #: Contractor: - CEDAR LANDSCAPE, INC 14375 SW PATRICIA AVE HILLSBORO OR 97123 -. Phone #: 628 -3411 $ 26 °25 TOTAL Reg #. °: 5843 - REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the RP /Backflow Prey Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ___ Permittee Si _nature: nature: Issued By: . r" A444.t`�li ("' - - -- Call for inspection - 639 -4175 City b, Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # *3125 SW Hall Blvd. Permit # PLM q5 0'x)1 Tigard, OR 97223 (503) 639 -4171 MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE . Name of Development New Single Family Residences Only PULT/ - %mil "QC Job 3 , Sub 77 G /f� ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00 / ` ❑ 3 BATH HOUSE $225.00 Address no Fee includes all plumbing fixtures in the dwelling and the first 100 feet if if,J-/t/ 1 .. 57Z2-3 of water service. sanitary sewer and storm sewer. See fees below. Name ON name of Ek,ane..) FIXTURES QTY PRICE AMT 176o6 A-U. Sink 9.00 Mating A Iran phone Lavatory 9.00 Owner 93/5o sc) 77 aillt40 Tub or Tub /Shower Comb. 9.00 r ' ^ Sta1e DP Shower Only 9.00 7764jy7 , (p 9 fZ3 Water Closet 9.00 Name (n name of beanie.) Dishwasher 9.00 Garbage Disposal 9.00 Occupant Ma ` , g „dw„a Pitons Washing Machine 9.00 Floor Drain 9.00 Gay /State m Water Heater 9.00 Laundry Room Tray 9.00 Name Urinal 9.00 CZ)1)Ki 64r( os J� � / G. Other Fixtures (Specify) 9.00 Mailing Address fYY_ - e 9.00 Contractor L " ) - _ 1 � SuPA-rx/ L /4 9.00 City/State Zip 9 /(Ls f) if.C.) &L 9 7Ze' Sewer 1st 100' 30.00 State Registration No. ■ City sue. Tax No. Sewer - ea. Addit. 100' 25.00 S8 t Water Service 1st 100' 30.00 I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00 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' 25.00 number given is correct. (If exempt from State registration, please give reason below.) Mobile Home Space 25.00 ' y e a g, , Back Flow Prevention Device or Anti - Pollution Device Z 9.00 `aj7 Signature (owner or agent) Date Any Trap or Waste Not C' /(1 AVit- /O -/7-5'.S Connected to a Fixture 9.00 Describe work new( addition alteration 0 repair 0 Catch Basin 9.00 to be done residential 0 non-residential >1 Insp. of Exist. Plumbing 40.00 /hr Specially Requested Inspections 40.00 /hr Existing use of building or property Rain Drain, single family dwelling 30.00 Residential backflow prevention devices 15.00 Proposed use of building or property '(Except residential backflow prevention devices) NOTICE *Minimum Fee $25.00 SUBTOTAL 25:00 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 C�(Q.2� Special Conditions Date issued by Page No. 1 CASE HISTORY FOR CASE NO.: P12495 -0311 DOUG ALLRED • 09438 SW TIGARD ST 12/14/98 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By - - -- - -- -- - - - - -- - -- PLMC007 Application received / / / / 10/18/95 PEND B 10/18/95 B PLMCO10 Plan check by / / / / / / 10/18/95 B PLMC060 (F) Issue permit / / / / 10/18/95 PASS BON 10/18/95 B PLMC750 RP /Backflow Preventer 10/18/95 / / 06/25/96 APP GS 06/25/96 GES PLMC799 Final Inspection / / / / 06/25/96 see e1r96 -0177 •DIS GS 06/25/96 GES PLMC799 Final Inspection 11/10/98 / / 11/09/98 PASS GS 11/10/98 J *H PLMC800 Case Finaled / / / / 11/09/98 PASS GS 11/10/98 J *H • • .*:.;:e . . * ti tH' A ' './M." ,- „ ' "):'f " l' -. N k,, w .! + !G...±. 4. n.-,c{ i-K ,.r .- 1 : ,, , A {' ,• .. A o xlIN I TUALATIN VALLEY FIRE & RESCUE .P Fri < - -- AND i` e , BEA V ERTON FIRE DEPARTMENT Q Q V > FIRE MARSHALS OFFICE 4, d G e, (503) 526 - 2469 POSTED: & RE %, OCCUPANT i , 1 9 . " , ' t ' f `) , , 1 e-11 1 K C y CONTRACTOR BLDG. PERMIT 0 PROJECT NAME LL A,� '' QQ PLAN REVIEW 0 LOCATION 9 ki 3 ' 'k) �1 4 Lot^ JURISDICTION: 1= Be. 2= Du. 3= K.C. S Tu. 6= Sh. 7= Wi. 8= CC 9= WC 0= MC COVER FINAL SPECIAL FOLLOW -UP /REINSPECTION ATTEMPTED FINAL Ig Framing Walls Sprinkler System Shaft Fire 'Dampers (Overhead /Underground) 0 Alarm System ❑ Hood•Extng Systems ❑ Conference El Spray Booth El Ceiling Cover El Other luD 6 (4,vd — - ., A 1 - t - o -- P? y 5 ! G X11 6 i f y -I- c, - i, ,, , e — it/ o /Ai A I l J - e -Pt c 4, kui • C./livid-de to .(1 s c ev A A A - ) ( /ae- -F D A � a - 7 /40 5 C o / w 1 )1, t it rte✓ k) a-4'1/W 4,..A V A 2 , (t-42---rti A.10 a U 1 e -e / Yv 5 Y c 1.- s 71/0---4/ - � W 1 � � Date: 1 � V \ - 6 1\ Inspector: =� CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested --� c AM PM BLD 9 y Location 38 .5a) / /9�t 5 rd, e� Suite MEC Contact Person Ph PLM 9 . ' .J.// Contractor Le.flizte , Lz i Ph 6..2f 3V // SWR BUILDING Tenant/Owner ./J(i7.( / ,4 ��P L ELC Retaining Wall ELR Footing Foundation Acs V) FPS Ftg Drain NOT REQUESTED L SGN Crawl Drain Ins FOUND DURING RESEARCH Slab NO INSPECTION(s) IN FILE f SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer arm. Rain Drains - ART FAIL NICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA q 9 �,/ OPheoach /Sidewalk Date JA / / Inspector ��'�!i E Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.