Permit CITY OF TIGARD `D
• COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard. Oregon 97223.8199 (503) 639 -4171
PLUMBING PERMIT
PERMIT # • PLM94 -0211
639 -4171 DATE ISSUED: 09/16/94
PARCEL: 2S112DA -00700
SITE ADDRESS...: 06650 SW REDWOOD LN
SUBDIVISION • ZONING:
BLOCK . LOT •
CLASS OF WORK.. :NEW GARBAGE DISPOSALS..: MOBILE HOME SPACES.:
TYPE OF USE •COM WASHING MACH BACKFLOW PREVNTRS..:
OCCUPANCY GRP..:B2 FLOOR DRAINS . TRAPS
STORIES •3 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) •100
DISHWASHERS • RAIN DRAIN (ft)
Remarks: Building 240— fire line only
Owner: FEES
PACTRUST type amount by date recpt
15115 SW SEQUOIA PKWY, SUITE 200 PRMT $ 30.00 KS 09/16/94 —
SPCT $ 1.50 KS 09/16/94 —
TIGARD OR 97224
Phone #:
Contract or:
CONTRACTOR NOT ON FILE
Phone #: $ 31.50 TOTAL
Reg #.. .
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 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
!1
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. p i�ie . i A_LQ a , t ' 74 S w Permit # Ptkr\ 9N -a all
Tigard, OR 97223 D v�.T to o w s* A- f L- •
(503) 639 -4171 y
(1. t, off• y O MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
N01ne of Derealopment New Single Family Residences Only
Maass a.e. ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
66 So s w Raw owl LANE. ❑ 3 BATH HOUSE $225.00
Address abate. Fee includes all plumbing fixtures in the dwelling and the first 100 feet
T / 1 C -AA of water service, sanitary sewer and storm sewer. See fees below.
P A '„.f ) FIXTURES QTY PRICE AMT
c, Tt� v5 7- Sink 9.00
Mailing Andress Phone Lavatory 9.00
Owner Tub or Tub /Shower Comb. 9.00
-
aaylstate 230 Shower Only 9.00
Water Closet 9.00
Name (or name
� - af business) e...i Dishwasher 9.00
Occupant F ' • S p P G a Garbage Disposal 9.00
maim Ada. Ph°^° Washing Machine 9.00
Floor Drain 9.00
ZIP Water Heater 9.00
Laundry Room Tray 9.00
NaT° Urinal 9.00
0 E,A-■ PvA Y_r s. N PLici, Other Fbdures (Specify) 9.00
M•dw nea... 9.00
Contractor
3tk\ S J 3 9.00
zip 9.00
POR-11,,4- 97 @-0Z. Sewer 1st 100' 30.00
State Registration No. City Bus. TQ ND. Sewer - ea. Addit. 100' 25.00
/\-A-E--1 P.-- O It I 1 % Water Service 1st 100' , / p b‘ 30.00 30 Q°-
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
give reason below.) Mobile Home Space 25.00
Back Flow Prevention
Device or Anti - Pollution Device 9.00
Signature (owner of agent) Date Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new addition 0 alteration 0 repair 0 Catch Basin 9.00
to be done resid tial 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
a
Proposed use of
building or property C b C.I /4 i) F ee
'(Except residential backflow
prevention devices)
Dpi
NOTICE *Minimum Fee $25.00 SUBTOTAL 30
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 TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
SO
TOTAL (3 J -
Special Conditions
Date issued by
■
05/30/2000 Activities for Case #: PLM94 -00211
2:20:07 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC007 Application received 09/15/1994 MAB 09/16/1994
PLMC010 Plan check by • 09/16/1994 MS APPR MAB 09/16/1994
PLMC060 (F) Issue permit 09/16/1994 KAS PASS MRS 09/23/1994
PLMC800 Case Fineled 09/23/1994 MS PASS MRS 09/23/1994
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