Permit CITY OF TIGARD
`^ ,: 116 DEVELOPMENT LOPMEN R SERVICES I F'ERMI 'LUMMBING PERM I LM98 -0040
DATE ISSUED: 02/11/98
PARCEL: 2S111BD -01100
SITE ADDRESS...: 09685 SW SATTLER ST
SUBDIVISION • DARMEL ZONING: R - 3.5
BLOCK • LOT •012 JURISDICTION: TIG
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 • 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)...: 99
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Replacement of less than 100' of water line. No Street Opening permit
required per Engineering.
Owner: FEES
RODNEY FURLOTT & ELIZABETH FURLOTT type amount by date recpt
9685 SW SATTLER PRMT $ 30.00 DRA 02/11/98 98- 303235
TIGARD OR 97224 SPCT $ 1.50 DRA 02/11/98 98- 303235
Phone #: 624 -9439
Contractor
NORTH'S PLUMBING
17120 SW SHAW
BEAVERTON OR 97007
Phone #: 649 -5544 $ 31.50 TOTAL
Reg #..: 000003
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 Misc. Inspection
applicable laws. All work will be done in accordance with Final Inspection
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 ' -0010 through OAR 952 '•'.'.180. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued y /(/' 4 F Permittee Signature: � _
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + ++ + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Application Recd By i
13125 SIN HALL BLVD. Commercial and Residential Date Recd -
TItARD, OR 97223 Date to P.E.
(503) 639 -4171 Date it DST
Permit # �• 0
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project On back Indicate Work Performed by fixture.
Job FIXTURES(IndIvIdual) - . ' • QTY PRICE AMT
"
Address Street Address - Suite Sink 9.00
? ' if 5 5,,,/ S &t - ECL Lavatory 9.00
Bldg # City/State Zip ,I Tub or Tub /Shower Comb. 9.00
- T1 A
Na l rz-4) 0 z- '7 7 22- T Shower Only 9.00
l� 0 r4F ._( Li_o rt Water Closet 9.00
Owner Mailing Address Suite Dishwasher
bgs 5' 5A- t-n-F� 9.00
1
Garbage Disposal 9.00
City/State Zip Phone
-1-16,A--to , on '1-7 Z zz l z - ?437 Washing Machine 9.00
Name Floor Drain 2" 9.00
(Z_D 0 A 01 Rj✓L L_.o C 3' 9.00
Occupant Mailing Address Suite 4' 9.00
ci 6 5� 5 trfcrt_ Water Heater 0 conversion 0 like kind 9.00
City/State Zip Phone "I ,
'1 G t f) S 7L2-.4 _ G. a-4 ?4 q I Laundry Room Tray 9.00
Name Urinal 9.00
/"-L o R- -I p L-i r"\ 3 C P F l Other Fixtures (Specify) 9.00
Contractor Mailing Address Suite
9.00
Prior to permit City/State Zip Phone 9.00
issuance, a copy 9.00
of all licenses are Oregon Const. Cont. Board Licit Exp. Date 9.00
required if Sewer - 1st 100" 30.00
expired in COT Plumbing Lic. # Exp. Date Sewer - each additional 100' 25.00
database
Name Water Service - 1st 100' ` 30.00 ib r tso
• O
Architect Water Service - each additional 200' 25.00
Or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00
Storm & Rain Drain - each additional 100' 25.00
Engineer City/State Zip Phone Mobile Home Space 25.00
' Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New 0 Addition 0 Alteration 0 Repair X Pollution Device
to be done: Residential Non - residential 0 Residential Backflow Prevention Device* 15.00
Additional description of work:
2G PL � ��f a C I/A 5 &L DtC-(_ Any Trap or Waste Not Connected to a Fixture 9.00
�%4 e _ a- -TO c-a-F� -- -' � 5 Q v"-6--. Catch Basin 9.00
��`� M Insp. of Existing Plumbing 40..
00
per/hr
Existing use of
Specially Requested Inspections 40.00
building or property 2r �i ‘ I) 6--0-E 01 _ per /hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL � 60
I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quanity Total is > 9 0�
given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL
that plans submitted are in compliance with Oregon State Laws.
Signature of Owner /Agent , �( Date 5% SURCHARGE
(< L �.c�.��" ` z if 098 ',..5-0
Contact Pe on Name Phone PLAN REVIEW 25% OF SUBTOTAL
i only if
Required ony fixture qty. total is > 9
20 0 Ni 6- 1 1-vi/Z_Lo 'tt 62- 14 TOTAL
'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
`dstslplmapp.doc 5/97
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I: lastslplmapp.doc 5/97
IW
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: / S-60 n
/ 6 / ..- 9(p A.M. P.M. MST:
Location: T6 PS S- _ )r2 .ttiiit / �
Tenant: Suite: Bldg: —� q 7 �} a y oV�
Contractor: - Phone: . .1%- _ -�/ _ N ' — PLM: 'n p. _ VIJ)
Owner: �� � '' , 4 � 9— 9 3 /Phone: ' i'' /' / ELC:
... �'e .4"1 ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam o eam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling
Slab Framing l5 Gas Line Rough -In UG pnnkler
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 Qurorovgcl, Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL . FINAL FINAL FINAL
P p t r7 � L 614r �Gi1./ s At vs La £ &.
1I
I- t.A.-c l, iy■Ac.,k_ d- b 4: /f I, (9L
0 Call for rein . •= O Reinspection fee of $ r aired fore next ' 'on 0 Unable to it
/ / nspec
Inspector: / /,,,,,,L„ _41,1„../101, _41,1„../101, Date: c 2 f Page of