Permit A- CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
j PERMIT # • PLM97 -0238
��.. 1 3125 SWHaI1Blvd.,Tigard,0R97223 (503)639 -0171 DATE ISSUED: 06/20/97
PARCEL: 25110CD -00600
SITE ADDRESS...: 15420 SW ROYALTY PKWY
SUBDIVISION • ZONING:
BLOCK - LOT • JURISDICTION: KIN
CLASS OF WORK..:REP 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:
REPLACE EXISTING HOT WATER HEATER
Owner: FEES
BETH FERRELL type amount by date recpt
15420 SW ROYALTY PKWY PRMT $ 25.00 GEO 06/20/97 KING CITY
KING CITY OR 97224 5PCT $ 1.25 GEO 06/20/97 KING CICTY
Phone #: 624 -6452
Contract or
GEORGE MORLAN PLUMBING & APLIANCES
12585 SW PACIFIC HWY
CCB (EXP 6/2002)
TIGARD OR 97223
Phone #: 624 -6895 $ 26.25 TOTAL
Reg #..: 000027
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 Rough—in Insp
applicable laws. All work will be done in accordance with PLM /Underfloor
approved plans. This permit will expire if work is not started Top—out Insp
within 180 days of issuance, or if work is suspended for more Final Inspection
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 -001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By:41 I 'tt Permittee Signature:
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
____ __,_ -20 -' 97 FR I 13:27 I D: FAX NO: #166 P02
s. Reed By
.ITV OF TiGARD Plumbing Application Date Reed (.sIZ j91
31irgif HALL BLVD. Commercial and Residential Date to P.E.
IGARD, OR 97223 Oate to DST
�C,1 N ea- Permit re P 01 9-7 -0 R3'
503) 639 -4871 Print or Type Related
Incomplete or illegible applications will not be accepted Caned
1 031,3443 QTY PRICE AMT
FIXTURES (individual)
- Name v( peveloprnendPreiect Sink 9.00
Job e..11 1t- G ITV Lavatory 9.00
Sheet address �"
Tub or Tub/Shower Comb. 9,00
Address I561 � �
BSdg # Zio Shower Only [CIIYISISIO Water Closet
Nape _, t--L. Dishwasher 9.00
9.00
Garbage Disposal
Owner Mailing Address Suite 9.00
�r,.r
154+2,,p 51.43 '_' 1P1 GK�/�0� Washing Machine Fir Drain 2 . 9.00
City/State Zip P
ZL� h4n �, 3 . 9.00
4 . 9.00
Name
Water neater 1 9.(10 e;, , t5l
M ailing Address State 9.00
Occu Laundry Ream Tray '
9.00
Clly /State Zip Phone Urinal 9.00
.-• Other Fixtures (Specify)
Natrle 9.00
� MOtlu. R-� ( r - 9.00
Contractor ,Mdi**5 Subs 9.00
12. �eutt�c, , II
9.00
(prior to issuartee City/State Zip r� 9.00
applicant must - h( s A�7 peas 0 24^
provide as Oregon Conat. Cont. Board Um% Exp. Date 9.00
contractors v'13 - 30.00
license Plumbing Lie. # Exp. Date Sewer - 1st 100
infennatton 1.1/e 0 Pg Sewer - each additional 100' 25.00
for COT COT Bueinees Taht or Metros Exn. Data water ;, - -: •tai 100, 30.00
database). 1 I Watcr vice - each aodklonat 208• 25.00
'Name Storm & Rain Drain - let 100' 30.00
Architect Storm & Rain Drain - each additional 100' 25.00
NatUnO r
j 4tE5s
Of suite ; Mobile Home Space 25.00
Zi Phone Commercial Beet Row Prevention Device or Anti- 25.00
Engineer ClgrState ta Pollution Device
Residential! Bedtflahs Prevention Device' 15,00
L
'es be done: wont New 0 Ad9Won 0 Alteration
Residential 6 Non residenarai 0 0 Repair 0 Any Trap or Waste Not Connected to a Fixture 9.00
e hon tial 0 9.00
•cdltional description of wort Catch Basin
"EaPL Jt 4 E ,e L La 54 Insp. of easting Plumbing 40.00
pe
Specialty Requested Inspections 40.00
eer/hr MI
Juisting or of �.ri �A1 30.0
JuiIding or plvpe Ra Grain, single family dwelling
Grease Trans 9.00
?reposed use Of
bulletng Or property QUANTITY TOTAL ' I
feaMMe or Owl xtie Is required if Cuanity Total is > 9
W capping , 1p►otnng or replacing any fixtures? Yes No 0 'SUBTOTAL 1
' :11 yes ace beck of form)
hereby acknowledge that I have read this application, that the information 5°,L SURCHARGE I a
given is correct, that I am the owner or authorized agent of the owner. and
, that plans submitted are in compliance witln Oregon State Laws. PLAN REVIEW 2596 OF SUBTOTAL
Signatu Owner/ goof Required a ty lr art s% qty. total is • 9
('7A TOTAL I 141.
Contact Person Name Phone -Minimum permit fee is 525.5% surcharge. except Residential Baetcftow
G Ylet Al--t) OMOf D0 &a.4f 10 ( Prevention Device. which la 515 + 5% surcharge
I : \plmapp.doc 12/96 (dst)
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Ph. e: 639 -4171
n
(
Date Requested: .' — J - ( 7 � P .M. MST:
Location: /6 ._) _�l L ��.� BUP:
I I '
Tenant: Suite: Bldg: MEC:
I
Contractor: _ILO 1 ( .Aril Phone: / PLM: 7 7-40.238' Owner: L --- G / 11 Phone: - 6 (/5;........ ELC:
ELR:
SIT:
BUILDING BLDG (con't) ' LUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab 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 Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved cue Approved Approved Approved
Appr/Sdwlk Not Approved ved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
D Call for reinspection O Reinspection fee of $ r u befor next inspection O Unable to inspect
Inspector: / 1% / / A Date: ✓ 7 Page] of )