Permit CITY OF TIGARD
Y .4 % i �� DEVELOPMENT SERVICES F�ERMI-LrUMMBING PERMIT
PLM98 -047
DPATE ARCEL: ISSUED: 12/30/98
SITE ADDRESS...: 11950 SW 95TH AVE
: 4 1S135DC -04301
SUBDIVISION ZONING: R -4.5
BLOCK • LOT • C./ JURISDICTION: TIG
CLASS OF WORK.. :ALT GARBAGE DISPOSALS.: 0 MOBILE 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 • 1 CATCH BASINS • 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 (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...« 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Replacing gas water heater
Owner: FEES
ALYCE THOMSON type amount by date recpt
11950 SW 95TH AVE PRMT $ 25.00 B 12/30/98 98- 3118830
TIGARD OR 97223 SPCT $ 1.25 B 12/30/98 98- 3118830
Phone #:
Contractor
J & R PLUMBING
3430E SW 209TH AVE
ALOHA OR 97007
Phone #: 642 -7776 $ 26.25 TOTAL
Reg #..: 000726
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Misc. Inspection
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. 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 -8001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By« �- Permittee Signature. 111,
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
FROM : J&R PLUMBING PHONE NO. : 649 3599 Dec. 29 1998 133: IJ6PM P1
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
'' SW Hall Blvd. Permit # q - 6 1 47Z
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHAR
wm. aa.v°woma,l New Sindie Family Residences Only
'a4'e1 � 0 1 BATH HOUSE $ 140.00 0 2 BATH HOUSE $195,C
Job _i l 9 �j(7 c 5'a) 95 `) 0 3 BATH HOUSE $225,00
Address clt„rsal. tb Fee includes all plumbing fixtures in the dwelling and the first 100 fe
G 0 Og . - of water service, sanitary sewer and storm sewer, See fees below.
.m.tan.nw°r
rs ')') 5 ,� FIXTURES QTY PRICE AMT
• f /lam Sink 9.00
"" / r � P " 010 Lavatory 9.00 _
Owner 50 ,54/U � � Tub or Tub /Shower Comb. 9.00
"""ii`" Ai Shower Only 9.00
U PIO 0 •' , Water Closet 9.00
•
"' °f "..... of "a ` ..4 Dishwasher 9.00
L 0� Garbage Disposal 9.00
Occupant ",, ,,r. w : Washing Machine 9.00
Floor Drain 9.00
crr
:� Water Heater ' �
It 9.00 C' _.:_
Laundry Room Tra 9.00
Name
Urinal 9.00
J & R PLUMBING INC 642 -7776 Other Fixtures (Specify) 9.00
Melq Adam - .
Contractor Phone 9.00
18886 SW SHAW 9.00
Glyr3teu 4 – -
9.00
ALOHA OR 97007 Sewer 1st 100' 30.00 .
&.t neaNtaneW "°' cur B t. T. a Sewer - ea. Addit, 100' 25,00
1 72680 ' 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 Constntcticn 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
Sack Flow Prevention
• 5 5 4 (. 3, 4 04 E • -,<., Device or Anti - Pollution Device 9.00
e K ., 0 1 0 Any Trap or Waste Not
/ Connected to a Fixture 9.00
Describe work w 0 — addition 0 alteration 0 repair a Catch Basin
9.00
to be done residential
non-residential 0 Insp. of Exist Plumbing 9 40.00/hr
Specially Requested Inspections 40,00/hr
Existing use of _
building or property Rain Drain, single family dwelling 30.00
I Residential backflow prevention
Proposed use of
Mil
devices 15.00
building or property
'(Except residential backflow
---- prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL ■ 5 ,--
PERMITS BECOME VOID IF WORK OR CONSTRUCTION — C
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE l
CONSTRUCTION OR WORK 15 SUSPENDED OR ABANDONED -- I r
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED, PLAN REVIEW 26% OF SUBTOTAL
Spatial Conditions TOTAL G( ) S---
r
_ Date issued — - . , by
6/16/00 Activities for Case #: PLM98 -00472
2:00:33 PM 410
/ Assigned Hold Updated 1;1
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA003 Application received 12/30/98 B RECD DST 12/30/98
PLMA005 Create Permit 12/30/98 B DONE DST 12/30/98
PLMA799 Final Inspection DST 12/30/98
PLMA740 Misc. Inspection 12/30/98 DST 12/30/98
PLMA050 (F) Issue permit 12/30/98 B PASS DST 12/30/98
PLMA740 Misc. Inspection 2/18/00 2/18/00 2/18/00 JMT DONE No Hold JMT 2/18/00 research inspection request
PLMA850 Expired by limitation 6/7/00 HAP DONE No Hold AKJ 6/7/00
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