Permit CITY OF TIGARD
ii ,,ryi � y ��; DEVELOPMENT SERVICES PLUMBING PERMIT
ry l� PERMIT #.......: PLM98 -0106
'� 13125 SW Hall Blvd., Tigard, OR_97223 (503)_639 -4171 DATE ISSUED
PARCEL: 25112DC -00200
SITE ADDRESS...: 07342 SW KABLE LN
SUBDIVISION....: SOUTHERN PACIFIC TIGARD INDUST ZONING: I —L
BLOCK..........: LOT -003 JURISDICTION: TIG
CLASS OF WORK ... :ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE.... :COM WASHING MACH......: 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP.. :B FLOOR DRAINS......: 0 TRAPS • 0
STORIES - 0 WATER HEATERS • 0 CATCH BASINS ° 0
FIXTURES - - -- LAUNDRY TRAYS.....: 0 SF RAIN DRAINS.....: 0
SINKS..... .....: 0 URINALS 1 GREASE TRAPS - 0
LAVATORIES OTHER FIXTURES....: 0
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS -: 2 WATER LINE (ft)...: 0
DISHWASHERS....: 0 RAIN DRAIN (ft)...: 0
Remarks: Install 2 lavatories, 2 water closets and relocate 1 urinal.
Owner: FEES
PACIFIC REALTY type amount by date recpt
111 SW 5TH PRMT $ 45.00 DLH 06/03/98 98- 306224
# 2950 5PCT $ 2.25 DLH 06/03/98 98- 306224
PORTLAND OR 97204 -0000
Phone #:
Contractor
MCKINSTRY CO
5400 NE COLUMBIA BLVD
•
PORTLAND OR 97218
Phone #: 331-0234 $ 47. 25 TOTAL
Reg #..: 000409
REQUIRED 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 Misc. Inspection -
within 180 days of issuance, or if work is suspended for more Insp existing / ca --
than 180 days. ATTENTION: Oregon law requires you to follow rules Final Inspection
adopted by the Oregon Utility Notification Center. Those rules are
set forth in DAR 952-111 -0010 through OAR 952 s.rr -0080. You may
obtain copies of these - rules or direct questions to DUNG by calling
(503)246 -1987.
Issued By Permittee Signature: ! _—.
+ ++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + ++ + + + + + + + + + + ++
Call 639 -4175 by 7 :00 p.m. for an inspection needed the next business day
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CITY OP TIGARD Plumbing Application Recd By p
13125 SW HALL BLVD. Commercial and Residential I� � Date Recd -
TIGARD, OR 97223 p Date to P.E. `��
(503) 6394171 r Date to DST 1-�-
�y� Permit# i...I c� 1040
Print or Type l Related SWR #5t t8 -eagle
Incomplete or illegible applications will not be accepted Called li; /
Name of Development/Project On back Indicate Work Performed by fixture.
Job -."L r Co. SFIXTURES Aindividaal)' " '' °° 'MTh PRICE ■C■NIT4.
Address Street Address Suite Sink 9.00
7 .140.,Sw Kolale. 1- a . • Lavatory a 9.00 a ea0
Bldg it City /State Zip /, Tub or Tub /Shower Comb. 9.00
r'a✓ d OIL C O d aY
Name v Shower Only 9.00
m......e.li CrptT' Water Closet a 9.00 /e ,o G
Owner Mailing A ess Suite Dishwasher 9.00
S9g0 S r.) ,Nt Garbage Disposal 9.00
City /St 1 t Phone Washing Machine 9.00
Verro" 9 Sly - 9 4 f 0 o
Name Floor Drain 2" 9.00
�hcy V Go. 3" 9.00
Occupant Mailing Address Suite 4' 9.00
Water Heater 0 conversion 0 like kind 9.00
City /State Zip Phone
Laundry Room Tray 9.00
Name Urinal J2C ' oGO. L -� ' 9.00 9.ev
AA Ck in,r7Lry Co • Other Fixtures (Specify) 9.00
Contractor Mailing Address • Suite 9.00
S Ntr co /idn,L)q,
9.00
Prior to permit City /State Zip Phone `,
issuance, a copy 1Q>, o2 c al�f . 3 j 1- aa'
J 4 9.00
of all licenses are Oregon Const. Cont. Board Licit Exp. Date i 9.00
required if yp 9e' f v` // yeah v Sewer- 1st 100" 30.00
expired in COT Plumbing Lic. # p. D e Sewer - each additional 100' 25.00
I database .31 - c).Q PG i f / ✓
Name Water Service - 1st 100' 30.00
Architect Water Service - each additional 200' 25.00
Or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00
Storm & Rain Drain - each additional 100' 25.00
Engineer City/State Zip Phone Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New 0 Addition, Alteration ( Repair 0 Pollution Device
to be done: Residential 0 Non - residential 0 Residential Backflow Prevention Device* 15:00
Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00
Catch Basin 9.00
Insp. of Existing Plumbing 40.00
per/hr
Existing use of Specially Requested Inspections 40.00
building or property per /hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
- QUANTITY TOTAL
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 Isometric or riser diagram is required if Quanity Total is > 9
that plans submitted are in compliance with Oregon State Laws. *SUBTOTAL ,_.,_ , . ,v. • ,1
1 Signature of Owner /Agent Date
5% r
5/o SURCHAR
J/ /�r PLAN REVIEW 25% OF SUBTOTAL ,
Contact Person Name
t /I Phone ' Required only if fixture qty. total is > 9
L Ow' cO or r't 7
Q7j1- 0A3 TOTAL . J�.a`)
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
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PLEASE COMPLETE:
x: � ' e � > a
` i Kb -W k�Perfor.
BFI • -
y a
c e av d
ed` /. R m e Moved . Replaced
`R
Sink
Lavatory
Tub or Tub /Shower Combination
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:
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