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Permit OF TI GARD COMMUNITY DEVELOPMENT DEPARTMENT 131oaSw*woa^m. Tigard, Oregon 9722 3.8199 (503) 639-4171 PLUMBING PERMIT PERMIT #.......: PLM95-0310 • 639-4171 DATE ISSUED: 10/16/95 PARCEL: 25104CA-03500 SITE ADDRESS... 13672 SW LAUREN LN SUBDIVISION.... HILLSHIRE ZONING: R-7 PD BLOCK..........: LOT.............:035 • _ CLASS OF WORK.. NEW GARBAGE DISPOSALS.. : MOBILE HOME SPACES. : TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS.. :1 OCCUPANCY GRP.. :R3 FLOOR DRAINS...... . : TRAPS............ .. STORIES.... . . . . :2 WATER HEATERS ^ CATCH BASINS. . . . FIXTURES - LAUNDRY TRAYS......: SF RAIN DRAINS..... SINKS ^ URINALS............: GREASE TRAPS....... LAVATORIES. . .. . : OTHER FIXTURES.. .. TUB/SHOWEAS....: SEWER LINE (ft).... WATER CLOSETS..: WATER LINE (ft >.... DISHWASHERS....: RAIN DRAIN (ft) Remarks: Irrigation backflow prevention device Owner: - - FEES ----- AUSTIN HOMES type amount by date recpt 15629 SW 149TH PL PRMT $ 15.00 CTR 10/16/95 95-271699 5PCT $ 0.75 CTR 10/16/95 95-271699 Phone #: Contractor: - AUSTIN HOMES 15629 SW 149TH PL TIGARD OR 590-0658 - - Phone #: 590-0658 $ 15.75 TOTAL Reg #..: 77489 ------- REQUIRED INSPECTIONS ------- This permit is issued subject to the regulations contained in the RP/Bac4flow Prey 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. ___-______ __ - _ - • - __ Permittee Signature: _____ ___ Issued By: _ _ _-_-' -- • ______ • Call for inspection - 639-4175 • '__ • • • ^ - City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # 13125 SW Hall Blvd. Permit # PQy29S =o3i© Tigard, OR 97223 (503) 639 -4171 MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE NaTe o(,°e1e`ep11ent • New Single Family Residences Only Address ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00 Job I a t. R-- 2- ) LAA, v Lid . ❑ 3 BATH HOUSE $225.00 Address ctt zo Fee includes all plumbing fixtures in the dwelling and the first 100 feet l C%INt2 V`' nom- 9 1-723 of water service, sanitary sewer and storm sewer. See fees below. Name (or name of Business) I FIXTURES QTY PRICE AMT -1 r ' Sink 9.00 Mating Address l P1p1e Lavatory 9.00 Owner - & ' f. i Le 4 St. Tub or Tub /Shower Comb. 9.00 Cit /St81e Lp Shower Only 9.00 l "\ V n-112-- q -ZZL\ Water Closet 9.00 Name (m name of business) 1 Dishwasher 9.00 Garbage Disposal 9.00 Occupant M /„de„ phone Washing Machine 9.00 Floor Drain 9.00 City /Fate EP Water Heater 9.00 Laundry Room Tray 9.00 Name Urinal 9.00 f-)h Vi -/t----- Other Fixtures (Specify) 9.00 Mating Address Phone 9 Contractor �,�1 c `� - 11. 1 ft (\ 9.00 City /State rid 9 . Sewer 1st 100' 30.00 State Regfababon No. City Bus. Tax No. Sewer - ea. Addit. 100' 25.00 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 pla submitted - • - - •••liance with State laws, that Storm & Rain Drain 1st 100' 30.00 I am registered • t = - .nstruction Contract. s Board, that the Storm & Rain Drain Addit. 100' 25.00 numb: glen i . re t. (If exempt , •m State !registration, please giv: reaso b:- ow.) / Mobile Home Space 25.00 f1 grAll-- Back Flow Prevention Device or Anti - Pollution Device 9.00 Signature (o er • 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 Rain Drain, single family dwelling 30.00 Residential backflow prevention / /�W devices 15.00 W Proposed use of building or property '(Except residential backflow prevention devices) NOTICE *Minimum Fee $25.00 SUBTOTAL PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIM E AFTER WORK IS COMMENCED. --- PLAN REVIEW 25% OF SUBTOTAL - -- - TOTAL l.1,? Special Conditions Date issued / by 91/(.. st-, CITY OF TIGARD BUILDING INSPECTION NOTICE 639 417 Inspection Line (Rec- O -Phon l +F>39- 4175 t Inspection: _O/IAA N . 4:,...16..;._.:____A . Underslab Mech. Rou gppr /Sdwlk Susp. Ceiling Sprink. RougJ� —. Footing gn / Fireplace Plbg. i Foundation Post /Beam Struct. Plbg. FINAL: Top Out Elec. Rough -in p Line Post /Beam Mech. San. Sewer Gas lumb. Rain Drain Framing Plbg. Underfloor s ,, Water Line Insulation Alarm - Elect. Underflr. Insul. Shear Wall Gyp. Bd. 0 Time: AM _PM Date Requested: Ar - 0 Address: 3 � Pe'rhii� Builder: !s � 0 3 I O THE FOLLOWING CORRECTIONS ARE REQUIRED: PC. j / / / .TJ ' Date: ,. AO" r A; In pector:.: i _APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp.