Permit . .
CITY
• ITY OF G.
PLUMBING PERMIT
^ ���������U���������U�����
� ������"�n
DEVELOPMENT SERVICES
PERMIT #.......: PLM98-0378
°:4�' 10125 SN/ Hall Blv� 97223 (503)638 DATE ISSUED: 10/14/98
PARCEL: 2S104DD-01700
SITE ADDRESS...: 12945 SW RIDGEFIELD LN
SUBDIVISION -,MOUNTAIN HIGHLANDS #2 ZONING: R-4.5
BLOCK ^ LOT.. ..... ......:@14 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
I TYPE OF USE :SF WASHING MACH ^ 0 BACKFLOW PREVNTRS..: 1
OCCUPANCY GRP..:R3 • FLOOR DRAINS......: 0 TRAPS ^ 0
STORIES ^ 0 WATER HEATERS : 0 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: Kerrigan
Owner: FEES
TOM KERRIGAN type amount by date recpt
12945 SW RIDGEFIELD LN PRMT $ 15.00 JSD 10/14/98 98-309983
TIGARD OR 5PCT $ 0.75 JSD 10/14/98 98-309983
Phone #:
. .
Contractor
TERRA-SOL LANDSCAPING
, 21685 SW HEDGES DR
•
TUALATIN OR 97062 .
'
Phone #: 692-6389 $ 15.75 TOTAL
Reg #..: 000050
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP/Backflow 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 plan�. Thi� 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: 40:0110 ' ~ Permittee Signatu ,—. A 1�4.4y(4A,`
NW'
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ± +++++++++++++++
Call 639-4175 by 7:00 p.m. for an inspection needed the ne\ °usiness day
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
'
.
._
CITY OF TIGARD Plumbing Permit Application Plan Check#
13125 -SW HALL BLVD. Commercial and Residential Rec'd By .
TIGARD, OR 97223 Date Rec'd 0 / 1
(503) 639 -4171 Date to P.E.
Print or Type Date to DST
MU
Incomplete or illegible applications will not be accepted Permit # j, -I 7
Related SWR #
Called U" G
Name of Development/Project F I X 9 R E S : 0 n d i v i i l u a l j _ - " - MP RICE== A AMT =
Job Sink 9.00
Address tre tAddress ( --- 1 Suite Lavatory 9.00
Z� s i * F t t L" Tub or Tub /Shower Comb. 9.00
Bldg # City /State Zip Shower Only 9.00
Water Closet 9.00
( 'DVV\ K A• 4 tam\ Dishwasher 9.00
Owner Mailing "d es� s Suite Garbage Disposal 9.00
Washing Machine 9.00
City /State Zip Phone Floor Drain/Floor Sink 2"
9.00.
Nam a 3" 9.00
‘ V\IZ- 4" 9.00
Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 9.00
Gas piping requires a separate mechanical permit.
City /State Zip Phone Laundry Room Tray 9.00
Urinal 9.00
r Llr -5 0 V L., j-1 1V. ,5 VeS1D4 ►.Vl\ Other Fixtures (Specify) 9.00
Contractor Ing A dr ss r Su ite n e\ 9.00
�� r OLA,4 \-" \l 9.00
Prior to permit ' /State C3T'.`1• _n i �� C_ L G Z ip Phone �� ` wer - 1st 100' 30.00
issuance, a copy ,O wer - each additional 100' 25.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if S j> I C.( (2_, 9 S Water Service - 1st 100' 30.00
expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 25.00
database Storm & Rain Drain - 1st 100' 30.00
Name Storm & Rain Drain - each additional 100' 25.00
Architect Mobile Home Space 25.00
Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00
Pollution Device
Engineer City /State Zip Phone A Residential Backflow Prevention Device* 15.00
rigation timing devices require a separate ��
Describe ork to be done: rtricted energy permit.) r
New epair 0 Replace with like kind: Yes O No 0 Any Trap or Waste Not Connected to a Fixture 9.00
Reside tial 0 Commercial 0 Catch Basin 9.00
Additional description of work: Insp. of Existing Plumbing 40.00
per/hr
Specially Requested Inspections 40.00
- per/hr
Rain Drain, single family dwelling 30.00
Are you capping, moving or replacing any fixtures?
Yes O No O Grease Traps 9.00
If yes, see back of form to indicate work performed by QUANTITY TOTAL
fixture. FAILURE TO ACCURATELY REPORT FIXTURE / s
I sometric or riser diagram is required if Quantity Total is > 9 & •a � % F �x.,. ;;:�,
WORK COULD RESULT IN INCREASED SEWER.FEES. *SUBTOTAL � ` , ,,, .
by ' - • • a that I have read this application, that the information,, L ?.,
given is , • rre • that I :m the owner or authorized agent of the owner, and 5% SURCHARGE ileiV , " , >
that plans submi' _ • . e in compliance with Oregon State Laws.
; f
Signature , Owner, • gent Date **PLAN REVIEW 25% OF SUBTOTAL -4-
Al / o / y/G Required only if fixture qty. total is > 9 =,yyr °', , , i. qy> •
G _ TOTAL K , . , �;;: >; °
• Contact Person ame Phone K. , _, -, ? h - -y i �
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
* *All New Commercial Buildings require plans with isometric or riser diagram
and
I:tdststplumapp.doc 712/98 /
I .)V
PLEASE COMPLETE:
...
• • .....
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain/Floor Sink 2"
3 "
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
lAdstskplumapp.doc 7/7198