Permit CITY OF TIGARD
L��rz>;� DEVELOPMENT SERVI PERMIT PLUMBING PERMIT
PLM98 -0164
DATE ISSUED: 06/05/98
PARCEL: 2S11OCC -09900
SITE ADDRESS...: 15695 SW QUEEN VICTORIA PL
SUBDIVISION • KING CITY NO. 3 ZONING:
BLOCK LOT :012 JURISDICTION: KIN
L
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -SF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 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: Installation of new gas water heater.
Owner: FEES
FRANKLIN CHAVE type amount by date recpt
15695 SW QUEEN VICTORIA PL PRMT $ 25.00 DEB 06/05/98 KING CITY
KING CITY OR 97224 5PCT $ 1.25 DEB 06/05/98 KING CITY
Phone #: 598 -6781
Contract or
ENERGY MASTERS INC
7470 SW 76TH
(SUB'S CCB EXPIRES IN 1/2001)
PORTLAND OR 97223
Phone #: PH 244 -8880 $ 26.25 TOTAL
Reg #..: 000585
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Misc. Inspection
• 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. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952 -m1 -0010 through OAR 952- 0001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued Permittee Signature: ' 4 ` F _ d'"
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
--- " --- "..TUN-05- ' 98 FR I 01:18 I D: FAX NO: 14074 P02 -- r-
CITY OF TIGARD Plumbing Application Redd B�f = 'f7'LiS ,,,-J
13125 SW HALL BLVD. Commercial and Residential Date Recd la
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171
Date to • r (�
Permit t a - � 1lp T
Print or Type Related SWR St
Incomplete or illegible applications will not be accepted pted Called
Name of DevelopmenuProjeot :.On bask Indicate Work Parfonned by fixture.
Job F- r •. I 1 n Ct/ItLQ s i.FD(TU :(IndMdual . mr y ,
Address StreetAddress . l Suite Sink 9.0
t - Vi 5 q 1Q�
uit tit VrGfrrnct. Lavatory 9.00
f31dp (State p
wt1 ,I. y 0 f Cl � 4 Tub or Tub/Shower Comb. g im
N alp_ Shower Only 9.00 `
I ✓'t 1pt- LJ Water Closet -
Owner Mailing Address
A Suite Dishwasher 0.00 •
15 bg5J Qji ' '' to .Vicl` 4
Garbage Disposal 9,00
C . .._,, Zip Phone
Nell Ct'4"x 0- 1.72 . 57 ( 3_ / c4 I Washing Machine 9.00
Name Floor Drain 2' 9.00 `
3 " 9.00
Occupant Mailing Address Suite 4" 9.00 • City /State ZIp 'Phone Water Healer eversion 0 like kind 9.00
Laundry Room rayr 9.00
e Urinal 9,00 -
Contractor Maliin9 y S Suite ' Other Fixtures (Speelfy) 9.00
'74� 7 1 v '1 -ai g.00
Prior to permit i pt /;Mate G� q 1p Phone 9.00
issuance, a copy F') (,L) 7223 -+ .- ""S•4 9.00
of all licenses are Oregon Const_ Cont, Board Ltc.#Y E rp Date 5 900
required if no r g 1 30.00
�lJG 1 Sewer • 1st 100"
expired in COT Plumping LIC, T 0 P e E pate Sewer- each additional 100' - 25.00
database / � e{� 3.7(
Na •
e y ',��LY 'W
aater Service -1st 100' 90.00
Architect - Water Service - each additional 200' 2500 ' r
blew Address Storm & Rain Drain -1St 100' 30.00
or - za
7 uite
Co p Storm & Rain Drain - each additional 100' 25_00
Engineer ci State Zip Phone Mobile Home Space 25.00
v �`Q �i / L Q 7 22.:3 4 -Sg'VO Commercial Back Flow Prevention Device or Anti- - 25.00
Describe work New 0 Addition 0 Alterationnl Repair 0 Pollution Device
to be done: Residential 0 Nonresidential 0 / _ Residential Backnow Prevention Device" 16.00
Additional description of work: ,
,� 1. , ,p Any Trap or Waste Not Connected to a Fixture 9.00
(- �t�..tr Vim. c.e '. " f ` , TTY- Cater Basin 9.00
Imp. of Existing Plumbing 40.00
per/he
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 0.00
building or property
I hereby acknowledge that I have read this application, that the information QUANTITY TOTAL
given is correct, that I am the owner or authorized agent of the owner, and Isom or doer diagram a regt'irad a Guquty Torsi is > 9
"
pn Oregon Stat Laws.
'SUBTOTAL •
ante with O ` • that plans submitted are in eom . •.
,'' ;' :`
61pna ure of OwneNAgent ( Gate 6% SURCHARGE
Contact Person Phone PLAN REVIEW 25% OP SUBTOTAL
Required More on7 ure qly. total is a 9 •
` y � TVO t S 1 b21( r 244 -qci ) TOTAL i , /
`Minimum permit fee is $25 r 5% sun (large, era"! Residential Backflow
Prevention Device, which IS 515 + 5% surcharge
•
I:\d$ s1p1mapp.doc 5)97
1 01'` p
((f 1 CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: -- 0 — - , /\ M. P.M MST:
Location: • • ' 1 4I / if
L =O BUP:
Tenant: // �� Suite:�� �Bl 4117 MEC: •
17
Contractor: J4 Q ,1 /"LcZ.�� Phone: 0---4 ' - O 0 6 (Y .) PLM: l. 4 — Q J. 4 .-/
Owner: n Phone: ELC:
X�(' .U— C I ! .d . fL M / ' I ELR:
`
• & --Srr:
BUILDING BLDG (con't) ( J ' • CHANICAL ELECTRICAL SITE
Site Post/Beam Pos ossubeam Cover /Service Sewer /Storm
Footing Roof UndFUSlab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm urnace 3 Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved • Tprov -a • pp ov=•' Approved Approved
Appr /Sdwlk Not Approved • o • pproved • o • • 'roved Not Approved Not Approved
FINAL ',, &On. FINAL FINAL
Al // / i. ,- ' %L�. /
7 i P
Cl Of
•
Call for reinspection O Reinspection fee of $ r uired before next inspection Cl Unable to inspect
Inspector: / r - r) ( 4' fi Date: o (6 P Page_ of
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