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Permit • at ,„A CITY OF TIGARD PLUMBING PERMIT 0i4 DEVELOPMENT SERVICES PERMIT #: PLM1999 -00424 • - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/13/1999 SITE ADDRESS: 12376 SW QUAIL CREEK LN PARCEL: 2S103C6 -09400 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5 BLOCK: LOT: 052 JURISDICTION: URB CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: 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: Residential backflow prevention device FEES Owner: Type • By Date Amount Receipt DON MORISSETTE HOMES 5PC2 BON 12/13/199E $2.00 99- 320369 4230 GALEWOOD STREET PRM4 BON ' 12/13/199E $25.00 99- 320369 SUITE 100 LAKE OSWEGO, OR 97035 • Total $27.00 Phone 1: 274 -5223 Contractor: PROGRASS LANDSCAPE SERVICES 29895 SW KINSMAN RD WILSONVILLE, OR 97070 REQUIRED INSPECTIONS Phone 1: 682 -6076 RP /Backflow Preventer Reg #: LIC 00006136 Final Inspection • PLM 11558 • ORIGINAL • • This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other 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. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. ■ Issued By �---- • Permittee Signature: )i a 4 i' — �� 9'v' e xt Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the nbusiness day 06/08(99 TUE 10:57 FAX 503 598 1960 CITY OF TIGARD Q002 • CITY OF`TIGARD Plumbing Permit Application plan Cne • 13125 SW HALL BLVD. Commercial and Residential Redd By jC.J TIGARD, OR 97223 Date Reed ( - - (503) 639-4171 , Date to P.E. Print or Type Date to DST I or illegible applications will not be accepted Permit ° v1 -.lg oD Related MR 4 Called , Name of Deve:opmenUProjea - =F .URES (Indlvtdual) = - -- •'Q 7t: PRICE_ Job ©,Lt Lit- 4o11(Jlk3 Sink 11.50 Address Street ¥(L { ` ' C &L. Tub or 11.50 Tu or TubiShower Comb. 'I 11.50 Bldg f! City /State Zip 'TI q cLL� I O Shower Only 11.50 f I Name Water Closet i 11.50 Dan r rOv i S'S G -/C., Hvme S Ctsl:washer I 11.50 Owner Mailing Address Suite Garbage Disposal 11.50 1a3o ac, Ga / 1.4 oad ■ 1 � /ashing Machine 11.50 City /State Zip Phone Fl CraWFloor Sink 2° 11.50 LAKC vSwcgo 0IQ, 790- ie y S(O • i Name 3° 11.50 • 4° 11.50 Occupant Mailing , ss Suite Water Heater 0 conversion 0 Ike kind 11.50 Gas piping requires a separate mechanical permit City /State Zip Phone Laundry Room Tray 11.50 I Urinal 11.50 ame U- !riclscop - � &rasS lime SG other Fixtures (Specify) 15.00 Contractor Mailing Address Suite ay >< 9 S S•tv /Gnsmarl. Pricr to permit City/State Zip Phone L p - Sewer - 1st 100' 38.00 Issuance, a copy WO Dnik OR. 9707o 6,07e 21' Sewer - each additional 100' 32.00 of all licenses are • Orego Conat. Cont. Board Uc.# Exp. Date required if (13(p g f 3 J j0, Q Water Service -1st 100' 38.00 expired In COT Plumbing Lie. U Exp. Date" Water Service - each additional 200' 32.00 • database i Storm & Rain Drain -1st 100' 38.00 Name Storm & Rain Drain - each additional 100' 32.00 1 Architect Mobile Home Space - 32.00 i or - Mailing Address Suite Commercial Back Flow Prevention Device or Anti- _ 32.00 • Pollution Device Engineer I City/State Zlp Phone Residential BacKflow Prevention Device' 19.00 /9 eo (Irrigation. timing devices require a separate 1 Describe work to be done: restricted energy permit.) New 0 Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 11.50 Residential O Commercial 0 Catch Basin 11.50 Additional description of work: . ` Insp. of Existing , Plumbing 50.00 per/!v I you capping, movin or replacing any fixtures? Specially Requested Inspections • per /i j Are Y 8 p 9 Y pednr Yes 0 No 0 . Rain Drain, single family dwelling 45.00 if yes, see back of form to indicate work performed by Grease Traps I 11.50 fixture. FAILURE TO ACCURATELY REPORT FIXTURE WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL 1 f: j 'ati° I hereby acknowledge that i have read this appication, tha: the information Isame:rie a riser dagram is required lf Dean:uy Tctal is s• 9 J !' _ '. `,. given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL that plans submitted are in compliance with Cregon State Laws. Signet er /A Date V, S.% SURCHARGE _ _ ,: : C ontact Pe ,on N me Phone •'PLAN REVIEW 25 °k OF SUBTOTAL - Requite erdy ii fixture qty. total Is > 9 .. . ' :l ' it3 ti I t1s'I. 78:1:45 - a ; .- = '- e15:.��° z 7 -�•�`-s;. .::.., ...:. . •j TOTAL I r'.- (iSE. 2'O ic_c_ . r. ^7_'r3°pl- - .•1:L...:d._ +o?r. v _ .. +••,� . _ .. . _ M. u .__x - : ,. =•fIt :� 'Minimum permit fee is $50 + 5% surcharge, except Residential Backilow p "' •= °, � s "• j'"' gg; = rjtiti' °yy -7 Prevention Device, which is $25 + 5% surcharge `r§lyoe;7Ep4�"�'d�!ieM�(► d> v= ; wpbca4*6 �g (� er-gt _ i P _.};; _? All New Commercial Buildings require plans with isometric or riser diagram and plan review i:ldssL'srmslplumapp.dcc 5x2/89