Permit �=_ � _ .
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/i..,,,,„,„0,,,, DEVELOPMENT SERVICES PLUMBING PERMIT
~�°~ ~ u�m~~�" "n"=~"m " ~�~~n xm "~~»�=' PERMIT # ^ PLM97-0027
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~ -' Tigard, ` DATE ISSUED: 01/30/97'�
PARCEL: 2S110BB-01800 '
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SITE,ADQRESS,..� 12395^SW CORYLUS OT . , ,, . ' ' .
SUBDIVISION. L.:' AMES 8R8HARD-` ' ' . .' ZONING: R-1
BLOCK..........: LOT.............:7
_ I
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. . .. " . ,, . . ...: Q/ /'.,�,', ,-,- URINALS�I4.,,�0:, I .-v. , . .4 :-,.f. 0��+ , GREASE TRAPS. ^�. . . . :. 0
LAVATORIES.....: 0 OTHER FIXTURES....: 0
,.,, TUB/SHOWERS. . .; �':` 0.-.,„,, ' ` .' - SEWER �LINE < )�, �,:„ �- 0.:^ . ,
WATER CLOSETS..: 0 WATER LINE ( ft)..": 0
DISHWASHERS,, � . :- 0 „;'. ' ' ! -.RAIN" DRAIN' . ( f t ) . . . : �,0,�./�
Remarks: INSTL 1 WATER HEATER
Owner: FEES
ROGER HAYS type amount by date recpt
12395 SW CORYLUS CT . .' ' '^ ,. ~ . . PRMT $ . 25� 00 TAT 01/30/97 97-289726
5PCT $ 1.25 TAT 01/30/97 97-289726
TIGARD OR 97224 •
Phone #:-
Contractor: -
POWER PLUMBING CO
P 0 BOX 23144
TIGARD OR 97281 -- -
Phone #: 244-1900 $ 26.25 TOTAL
Reg #..: 000523
' . . REQUIRED INSPECTIONS
This permit is issued subject to tharegulatima containedLip the,,,_ `i '.WateT ^ LiRe. Insp� ,
Tigard • State .of Ore i- ��es*���l.�4o,r,L, ., � Water.SRrvice Jn . '
applicable,. latis:,,,., ill I mark. intill.:,be :,,,done _ in,.. .".‘,~ :r / ��'Ro\!oh_'in ^ I,nsp. ,` ';.�. , ~ ' ' . �� ��'
appnmed7dans. 'Thit. Omit? will :expiweAf~woCAris oot 'i),:. ,:_PLM/Unde�f..loor . . - ` '^� .' ` J`^
within 'U5deys of,issxancpi}nr^��work^is`sospendedforroco■ . . •.' , Misc .:: ~ � ` '. ~''� � .•.-!;:,),.'�.
than-182 days:r° ^++ `�" • ^°k .,`'...--„,-. ^^ /' .' `•/ ' ,` Inspection.: ` . ' - . ,' ' ` ' '
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Permittee Si _
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Issued By: � ` • � '
��_�v^ ' ' __
NV
~ . ' .' ^ _ � 'i, Cal: l_ fo� insp ac, t,ion, �7° 633 _4175 . ^
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City of li,ctard PLUMBING PERMIT APPLICATION Planck/Rec. #
131.25 SW Hall Blvd. Permit #9'7 - 67:52:1
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name of oavebDment New Single Family Residences Only
"fires. ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job 12395 SW Corylus Ct. ❑ 3 BATH HOUSE $225.00
Address City/State z Fee includes all plumbing fixtures in the dwelling and the first 100 feet
Tigard Or 97224 of water service, sanitary sewer and storm sewer. See fees below.
Name (or name of Buaneas) FIXTURES QTY PRICE AMT
Roger and Marlene Hays
Sink 9.00
Mailing Address Phone Lavatory 9.00
Owner 12395 SW Corylus Ct. Tub or Tub /Shower Comb. 9.00
City/State MO Shower Only 9.00
Tigard Or 97224
Water Closet 9.00
Name (or name of Mm ,e.) Dishwasher 9.00
Same Garbage Disposal 9.00
Occupant Meting Add,... .none Washing Machine 9.00
Floor Drain 9.00
Cdy /Stet. LP Water Heater
/ 9.00
Laundry Room Tray 9.00
Nom. Urinal 9.00
POWER PLUMBING CO. Other Fixtures (Specify) 9.00
Maifng Address Phone 9.00
Contractor P 0 BOX 23144
9.00
City/State
T igard Or 97281 -3144 9.00
Sewer 1st 100' 30.00
Scat. Registration No. City Boo. Too No. Sewer - ea. Addit. 100' 25.00
52378 P l b g. 34-150
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
i'ethe 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 exemet from State registration, please
give reason bel� 41,7 1 Mobile Home Space 25.00
Back Flow Prevention
Device or Anti - Pollution Device 9.00
Signature (owner or agent) Date Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new 0 addition 0 alteration 0 repair 0 Catch Basin 9.00
to be done residential 0 non - residential 0 Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr
Existing use of
building or property Residential 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 z
.S,oC
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE /r Zs-
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 L,.6
Special Conditions .
Date issued by
•
4 aL- 7 ec
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing C 7
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: i i [� '- � `� ,,,� • Date:
1 1 A.M. P.M. E try. / J� ( �
Address: / 3 9 ��
Tenant: Ste: MST:
BUP: _
Con /Own: MEC: '% •
PLM: `� �' ! /
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspector Date: �/y
b DISAPPROVED /CALL FOR REINSP. CF CO