Permit CITY OF TIGARD
.. /„.,.:, A\ DEVELOPMENT SERVICES PLUMBING PERMIT
! - . 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 pE RM I T # PLM97 -0028
DATE ISSUED: 01/31/97
PARCEL: 2S109DD -90221
SITE ADDRESS...: 12665 SW PRINCE EDWARD CT #B
SUBDIVISION • ZONING:
BLOCK • LOT •
CLASS OF WORK..:REP GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •SF WASHING MACH 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:A1 FLOOR DRAINS • 0 TRAPS : 0
STORIES • 0 WATER HEATERS • 1 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0
SINKS • 0 URINALS 0 GREASE TRAPS • 0
LAVATORIES • 0 OTHER FIXTURES • 0
TUB /SHOWERS • 0 SEWER LINE (ft)...: 0
WATER CLOSETS..: 0 WATER LINE (ft)...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: REPLACE EXISTING WATER HEATER
Owner: FEES
MARGARET NIELSEN type amount by date recpt
12665 SW PRINCE EDWARD PRMT $ 25.00 TAT 01/31/97 97 -289772
# B 5PCT $ 1.25 TAT 01/31/97 97- 289772
KING CITY OR 97224
Phone #:
Contractor:
GEORGE MORLAN PLUMBING
5529 SE FOSTER RD
*SEE ALSO MORLAN PLUMBING*
PORTLAND OR 97206 --
Phone #: 771 -1145 $ 26.25 TOTAL
Reg #..: 200734
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Service I n
applicable laws. All work will be done in accordance with Rough—in Insp
approved plans. This permit will expire if work is not started PLM /Underfloor
within 180 days of issuance, or if work is suspended for wore Misc. Inspection
than 180 days. Final Inspection
Permittee Signature /`I,LI
Issued By: L/ - _
Ca for inspection — 639 -4175
12/16/96 09:11 $503 684 7297 CITY OF TIGARD Priiq1-6NW IQ 003/004
CITY OF TIGARD '1/� Plumbing Application
9 P P Recd By
1 3125 SW HALL BLVD. Op Commercial and Residential Cale Reed
TIGARD, OR 97223 ate to P.E
(503) 639 -4171 e 0 I �� Y CO bV Dale to OST
Pemml a
Print or Type Reared SWR s
Incomplete or illegible applications will not be accepted Called
i
Name or CeveroomenuProlect 1 ° FIXTURES (individual) 1 QTY PRICE r AMT
Job � �
Si nt
hind ("Alec (' 4 R e.Plac ¢lYn�f 9.00
Address Street Address Suite r Lavatory 9.00
Vi-(065 r i`Irke t.b 1AJ#l1S to o Tub or Tub/Shower Comb. 9.00
Bldg a C&tyiSlate ap /-1'y�1 ShowerOnty 9.00
k.n eo oft.. "1 z1.1 , Water Closet 9.00
Name � AZ /4 /, l ^ v i Q ' S e 1Y Dismantler 9.00 ■
Owner MallIr� Address y / Garbage oispoeal 9.00
n. Prfria G C t- WaenngMachine 9.00
ahIa IIp Phone Floor Drain r 9.00
k;yw, CII 4 K 472-24 63g-(? 761 - _ 9.00
Memel t, 13.00
Occupant • t*9 Addle= Suite Water Flamer i 9.00
Laundry Room Tray 9,00
-
GTYiState Zp Pnane Uncial .
'Name ■ r' �jJ Oute Fixtures S . - 9.00
//� /bN /f4 (Specify) - 9.00
Contractor Mating Aearess Suite 9.00
'z � s tw P46,1, Ow,
9.00
CayrSLate Zip Phone
T'A err z''
/ of r 2n G-( -7J( _ _ 9.00
O• Cant Cant Board Uma Exp. Ow 9.00 e
AGM* Copy of C2 Z7 3` , C / /R /47 - 9.00
'Memos Feinipdq Lie . a Esp. Date Sewer - 1st 100' 30.00
• 1.1ornese Z�� CJ."f G/7 Sewer - each aaditional 100' j 25.00 l
COT Business Tax or Mews Exp. Dare Water Semite _ 1st 100' 30.00
Marne Water Saralee - each additional 200' ' 25.00
Architect Storm 8 Rain Drain - 1st 107 30.00
Or mailing Addrnss su.t. Stour, & Rain Cram - each additional 100• 25.00
Mobile Noma Space 25.00
y
Engineer Chu Zip Phone Comrnerciai Back Flow Prevention Device or And- 25.00 -
Potbrton Demos
Coeatne wen Haw 0 Addition 0 Alteraeen 0 Repair O Residential Beddow Prevention (Device' 15.00
b be done_ Res+Eenoal 0 Non-residential 0 .arty Trap or Waste Not Connected to a Fixture I 9.00
Adattlonr dos=oon of week
Catch Basin 9.00
Insp. of Existing Plumping 40.00
permr
tam Requested Inspeoons 40.00 of
Cenral
making Droper�
ng
Rain Cram, single family dwelling 30.00
Proposed Win of Grease Traps 9.00
I building dr property
QUANTITY TOTAL
Ars you rapping . To or replacing any fixtures? Yes Q No p . laaneptc w rater sown la =Wed d Craney Tau is 1. a
lWyes see back of fermi 'SUBTOTAL 5 60
I hereb! aeund vfedge that I har.e read this applicadon. that the information 5 /o SURCHARGE I t / = �
glue++ s correct di
:hat I am e earner or autnorized agent of the owner. and S
that clans summated art: in compliance with Oregon Slate Laws.
Signature of OrneriAgene Data PLAN REVIEW 25% OF SUBTOTAL I
. a mitred caw a rtaure DTI. Reel is > 9
4 __. rh q TOTAL
Contact Person Name Phon S
_ r i 'Minimum roe is 525 • 5% suratalge. saapt Rascennal Baarpow
_ // "4 A/ //e.i7 G2 N -. 7 . f j Prevention Cevice, which is 515. 5% surcharge
: 5196
7/27/99 Activities for #: PLM97 -00028 •
1:54:03 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA007 Application received 1/31/97 1/31/97 TAT 1/31/97
PLMA130 Plumbing Undersl 1/31/97 1/31/97 TAT 1/31/97
PLMA711 Water Service Insp 1/31/97 TAT 1/31/97 - .
PLMA715 Rough -in Insp 1/31/97 TAT 1/31/97
PLMA720 PLM /Underfloor 1/31/97 TAT 1/31/97
PLMA740 Misc. Inspection 1/31/97 TAT 1/31/97
PLMA799 Final Inspection 1/31/97 3/13/97 MS FAIL DGW 4/23/98 no one home
PLMA050 (F) Issue permit 1/31/97 TAT PASS TAT 1/31/97
•
•
•
•
•
•
Page 1 of 1 •
•