Permit __ CITY OF TIGARD
^ 1 TA :l �� DEVELOPMENT SERVI F�ERM # BING v � -0215
�, DATE ISSUED. 07/07/98
S PARCEL: 2S104BD -03500
SITE ADDRESS...: 12660 SW 135TH AVE
SUBDIVISION....: HANDY ACRES ZONING: R -7
BLOCK LOT :032 JURISDICTION: URB
CLASS OF WORK..:ADD GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -SF WASHING MACH 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP.. :R3 FLOOR DRAI 0 TRAPS ° 0
STORIES ° 0 WATER HEATERS 0 CATCH BASINS ° 0
FIXTURES LAUNDRY TRAYS 0 SF RAIN DRAINS :. 0
SINKS 1 URINALS • 0 GREASE TRAPS ^ 0
LAVATORIES 1 OTHER FIXTURES 0
TUB /SHOWERS...: 1 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS . 0 RAIN DRAIN (ft)...: 0
Remarks: Sinclair
Owner: FEES
BILL SINCLAIR type amount by date recpt
12660 SW 135TH AVE PRMT $ 27.00 JSD 07/07/98 98- 307112
TIGARD OR 97223 SPCT $ 1.35 JSD 07/07/98 98— :307112
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Phone #: 524 -3753
Contractor
OWNER
Phone #: $ 28.35 TOTAL
Reg 1$.. .
REO.UIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Rough —in Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM /Underfloor
applicable laws. All work will be done in accordance with . Top —out Insp
approved plans. This permit will expire if work is not started Final Inspection
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 'm1 -0010 through OAR 952- 0001 -0080. You may - '
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
410111 "4"
__-.4
Issued By: , Permittee Signature:Alkg�‘ � �„ G fir%•
VI
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Permit Application
Plan C c
13125 SW HALL BLVD. Commercial and Residential Rec By
d
TIGARD, OR 97223 Date Rec'd 0 / i
(503) 639 -4171 Date to P.E.
Print or Type Date to DS
Incomplete or illegible applications will not be accepted Permit# - j�I
Related SWR -
Called i .
Name of Development/Project On back indicate Work Performed by fixture.
Job /3/ LL S /mc 42' • �FIXTUBES„ (�ntlly(ifual) ^: �
�i
� Suite Sink s ue. a ' N PRICE ANlT
Address Street Address
/ . G (, o St-<-1 ( 35 rce 9.00 .
Lavatory ( 9.00
Bldg # City/State Zip
��� Tub or Tub /Shower Comb. 9.00
) GrZ 9
Name Shower Only i 9.00
/3 /4-4- S //VC,L.-.Tf /i2 Water Closet 9.00
Owner Mailin Address Suite Dishwasher 9.00
/ i ' p 5 C-J /a S` .(1e Garbage Disposal 9.00
City/State Zip Phone
74--AS 2 J Washing Machine 9.00
97 2� � 5 ,2�r 3 's?
Na a Floor Drain 2" . 9.00
• /3 /GL S //Vc X /2' 3" 9.00
Occupant Mailing Address Suite 4" 9.00
/� /�' G S T s /-g S Water Heater 0 conversion 0 like kind 9.00
City/State Zip Phone
t" ,1 / , C, OZ. 7
923 L--.2.14----3-7 Laundry Room Tray 9.00
Nene Urinal
9.00
13/ S /,tc'. /-e• Other Fixtures (Specify) 9.00
Contractor Mailing Address Suite
0-‘Cc) SZ-rJ r3S /1 � s.00
Prior to permit City/State Zip Phone 9.00
issuance, a copy 7 - /G4 ,2 ,Q De?, S Sewer - 1st 100' 30.00
of all licenses are Or gon Const. Cont. Board Licit Exp. Date Sewer - each additional 100' 25.00
required if Water Service - 1st 100'
30.00
expired in COT Plumbing Lic. # Exp. Date
database Water Service - each additional 200' 25.00
Name Storm & Rain Drain - 1st 100' 30.00
Architect Storm & Rain Drain - each additional 100' 25.00
Or Mailing Address Suite Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Engineer City/State Zip - Phone Pollution Device
Residential Backflow Prevention Device* 15.00
Describe work New 0 Addition Alteration O Repair O Any Trap or Waste Not Connected to a Fixture 9.00
to be done: Residential 0 Non - residential 0 Catch Basin 9.00
Additional description of work: Insp. of Existing Plumbing 40.00
per /hr
Specially Requested Inspections 40.00
per /hr
Existing use of
Rain Drain, single family dwelling 30.00
building or property Grease Traps 9.00
Proposed use of QUANTITY TOTAL
building or property Isometric or riser diagram is required if Quanity Total is > 9 s- ,.0
*SUBTOTAL "` �. a " f,, ° „ 7
x,4„0
I hereby acknowledge that I have read this application, that the information • : ;.
given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE '' ` �` . ": 4 //
that plans submitted are in compliance with Oregon State Laws.
Signature of Owner /Agent Date '"PLAN REVIEW 25% OF SUBTOTAL /
Required only if fixture qty. total is > 9
--7-- 77 /96 TOTAL W ,
ontact Person Name Phone -> ��•A; -r
/ 'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
/lilt 7 /,7/ � - 4/ ,rt .j?-L,/ =3 Prevention Device, which is $15 + 5% surcharge
"All New Commercial Buildings require plans with isometric or riser diagram
and plan review
i:ldststplumbapp.doc 5/5/98
1f4
- „
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed/Capped
Sink
Lavatory
Tub or Tub/Shower Combination
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Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3 „
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I: \dsts \ plumbapp.doc 5/5/98
6/19/00 Activities for Case #: PLM98 -00215
2:34:46 PM
Assigned Hold Updated ��
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA003 Application received 7/7/98 JSD PASS JSD 7/7/98
PLMA005 Create Permit 7/7/98 JSD PASS JSD 7/7/98
PLMA799 Final Inspection JSD 7/7/98
PLMA715 Rough -in Insp 7/7/98 JSD 7/7/98
PLMA720 PLM /Underfloor 7/7/98 JSD 7/7/98
PLMA725 Top -out Insp 7/7/98 JSD 7/7/98
PLMA050 (F) Issue permit 7/7/98 JSD PASS JSD 7/7/98
PLMA845 Request inspection research 6/1/00 JMT DONE No Hold JMT 6/1/00
PLMA850 Expired by limitation 6/7/00 HAP DONE No Hold AKJ 6/7/00
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