Permit --
CITY OF TIGARD ,//
4' DEVELOPMENT DEPARTMENT
1o1oumw Hall Blvd. Tigard, Oregon w72o"u1oe (6n3)e39-41n PLUMBING PERMIT
PERMIT #.......: PLM95-0185
• 639-4171 DATE ISSUED: 08/02/95
.
PARCEL: 29111CB-04300
SITE ADDRESS...: 10490 SW LADY MARION DR
SUBDIVISION....: MARION ESTATES ZONING: R-3.5
BLOCK..........: LOT.............:016
___________ ____ _
CLASS OF WORK.. :NEW GARBAGE DISPOSALS..: MOBILE HOME SPACES.:
TYPE OF U8E. . . . :SF WASHING MACH. . . . .. . : BACKFLOW PREVNTRS. . :1
OCCUPANCY GRP..:R3 FLOOR DRAINS.......: TRAPS...........~..:
STORIES........:1 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: Installation of a residential backflow device
Owner: -------- -- ---- -------- FEES --------------
DAVID HOFFMAN type amount by date recpt
10490 SW LADY MARION DR PRMT $ 25.00 JDA 08/02/95 -
5PCT $ 1.25 JDA 08/02/95 -
TIGARI> OR 97223 •
Phone #:
Contractor: - ----- •
GREEN SEASONS TURF AND TREES
P.O. BOX 583
WEST LINN OR 97068 ---- - - ----
Phone #: 503-631-7346 $ 26.25 TOTAL
Reg #. 5662
REQUIRED INSPECTIQNS
This percit is issued subject to the regulations contained in the RP/Backflow Prev _
Tigard Nun icipal Code State of Ore. Specialty Co-des and all other Final Inspection ___ _
applicable laws. All work will be done in accordance with .
approved plans. This percit will expire if work is not started ___
xithin 180 days of issuance, or if work is suspended for core
than i@N days. _ ______' -
� _ _ •
__
Mil --- - ------- Perm it t ay. 1 �� . __ � ___ __
__ ___ __
Issued B . __ __ __
//
�/ Call for inspection - 639
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City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #95 a 6 96
13125 SW Hall Blvd. Permit # ?LI19s -Dt 8
Tigard, OR 97223
(503) 639 -4171 •
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Nana a o...kw..n New Single Family Residences Only
« • ❑ 1 BATH HOUSE $140.00 • ❑ 2 BATH HOUSE $195.00
Job 1 Bw Lug may ion Or. ❑ 3 BATH HOUSE $225.00
Address «vsl. be
Fee includes all plumbing fixtures in the dwelling and the first 100 feet -
Tf�Ald , 0 Q. cq X1 9 3 of water service, sanitary sewer and storm sewer. See fees below.
N•^' ( mono of Wawa) FIXTURES QTY PRICE AMT
Sink 9.00
amino Maas awns Lavatory 9.00
Owner Tub or Tub/Shower Comb. 9.00
oi re Shower Only 9.00
Water Closet 9.00
N... (> maw «b,..»..) Dishwasher 9.00
Garbage Disposal 9.00
Occupant „ wing ,,,„„. - wino Washing Machine 9.00
Floor Drain 9.00
ce . an • Water Heater 9.00
Laundry Room Tray 9.00
Wm. Urinal 9.00
C OY een Se n con. ((1 1 - ---IL-110 Other Fixtures (Specify) 9.00
• 9.00
Contractor (� 1 ' 1 (� �/
Po IJUX 3 Vv l Linn ct c)( 9.00
cagsbc. zc 9.00
Sewer 1st 100' 30.00
Sa• R••+ No. «+' W ' - T° No. Sewer - ea. Addit. 100' 25.00
Slo fp 2 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 Mobile Home Space 25.00
give reason below.)
Back Flow Prevention
�� I 11 1 G q a - _q Device or Anti Pollution Device l 9.00
svm• i� = ` w�+r D . Any Trap or Waste Not
Connected to a Fixture 9.00
I. Describe work new 0 addition 0 alteration 0 repair Q 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 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 S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE I 2 S
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 2 2 5
_ Special Conditions
•
Date issued by
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 • Business Line: 639 -4171
y BUP
•
Date Requested 2 , 7 49 AMg�" PM BLD
Location / d I q Llilol n ► A, Suite MEC
Contact Person Ph PLM -CO S /ES
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall _ ELR
Footing FPS
Foundation NOT REQUESTED
Ftg Drain FOUND DURING RESEARCH • , — SGN
Slab
Crawl Drain NO INSPECTION(S) FOUND IN FILE j t
Post & Beam � — SIT
Ext Sheath /Shear 1 , .!��.- G_tA.3 �� 2A1 /AA 1.2
Int Sheath /Shear
Framing
Insulation
Drywall Nailing AA . AA r _
Firewall
Fire Sprinkler - Fire Alarm 0 1
R Ceiling
Roof
Misc:
Final
PAS§ PART FAIL
R(UMBIN
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Ve)
MECHANICAL
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
Approach /Sidewalk Date G D Inspector `� w Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.