Permit CITY TIGARD PLUMBING PERMIT
14 i4 �1� DEVELOPMENT SERVICES 'r PERMIT #: PLM1999 -00175
l ATE ISSUED: 6/8/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 ��
SITE ADDRESS: 10960 SW SPRINGWOOD DR ® PARCEL: 1S134AB -00100
SUBDIVISION: ENGLEWOOD TERRACE ZONING: R -12
BLOCK: LOT: 090 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 1 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
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace existing water heataer with like kind.
FEES
Owner:
Type By Date Amount Receipt
ENGLEWOOD TERRACE APTS PRMT GEO 6/8/99 $50.00 99- 315959
10960 SW SPRINGWOOD DR MISC GEO 6/8/99 $2.50 99- 315959
TIGARD, OR 97223
Total $52.50
Phone 1: '
Contractor:
GEORGE MORLAN PLUMBING
9806 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone 1: 624 -6895 Final Inspection
Reg #: LIC 000027
PLM 26 -60BP
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other 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 - 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: le //1�/i Permittee Signature:
Call (5'. 639 -4175 by 7:00 P.M. for an inspection needed the next business day
JUN -01 - 1999 14 :49 H. 171
rY OF TI Plumbing Application
Dale Recd
125 SW HALL BLVD. , RECEIVED . Commercial and Residential Date to P E.
3ARD. OR 97223 Date to DST +
)3) 6394171 , JUN 0 41999 Permisgoi 51.1-`5/75"
Print or Type Related SWR s
COMMU ,
1c8 Q& r illegible applications will not be accepted Called
t-i a/0e/4 / g FIXTURES (Individual) QTY PRICE AMT '
. ' Name of CeveloomenuProlea ,
• O Sink 9.00
Job �if 44 y� _ -ret - Lavatory 9.00
Address t•e _Ado s 1 �+ in ��_I Dr, TuD or Tuo/Snower Como. 9.00
cJ
51ag s yrS a 'Z ip [X Shower Only 9.00 J
r fd jt 9 7c 3 Water Closet 9.00
..tme 4- / Dishwasner 9.00
e1Lr ��rl'QCf_ ' ' �] "`;� ' Garbage Disposal 9.00
Owner IO Address V - ,
3 r; tic (tad .Dr Washing Machine 9.00
c ,/state Zip •--i Phone Floor Dram 2 9.00 l C 122aIN 3" 9.00 I
Na 4 9.00 1
faa address Butte Water Heater 1 9.00
Occupant 9.00
• Laundry Room Tray
City•State s Dp Phone Urinal 9.00
Other Fixtures ISoeafy) 9.00
N ° • rflpr I can pt wrnhln3 9.00
Contractor Awing Address Suite J 9
1 9Jo(D JLU 11 C 1 S 9.00
Pnor to issuance _C& ,State n P p on . e . I 9.00
aDpucsnt must] arti Or '17 V 9.00
provide an OregokiConst. Cont. Board Lief► Exp. ate
contracdrs Q 0 ela, . 9.00
license Plumbing Li s Exp. ale Sewer -1st 100' 30.00
information t ry -(00 0 6)j 94 Sewer • each additional 100' ,
25.00
for COT COT Business Metros Eutdald Water Service - 1st 100' 30.00
l q >r
oaraoasel. 1l Z 4
Name Water Service • each addittonat 200' • 25.00
Architect
Storm & Rain Drain • 1st 100' 30.00
•
or
Mailing Address I Suws Storm & Rain Oran -cart addiional 100 .- 25.00
Mobile Home Space
Engineer c f1State Zip I Phone Commercial Baca Flow Prevention Cevtce or Anti- L 25.00
Pollution Device
:esxbe work New O Act a ' tan t O .alteration 0 Repair O Residential Bacxflow arevention Device' I 15.00 •
a :e cone: Residential lir Non•residential 0 Any Trap or Waste Nct Connected to a Fixture I I 9.00
•comonal ddescnotion (work C ato+ 3asn I 1 9.00
l� - ti - e i ` 1.2'1 lA) �L'e!- hea.��,- insp, of Existing F.umomq 40.00
•
per/hr
r ���. Specially Requested Inspections 40.00 ' I
airing use :f I oer /hr
uilcmg or property Rain Drain. single family Cwelling I I 30.30 I
:cosed use of Grease Traps I 9.00 I
■
,nding or property
QUANTITY TOTAL I I
., Ist�rretrc at nser ccas' is recuc.d ! Ouanny Total' a . 9 _
�if -.-e tau caooiny . moving or replacing any fixtures? Yes [ No ] 'SUBTOTAL I .�
, ?es see back of form)
'erety acknowledge that I have read this application. that the information 5' /• SURCHARGE I
- .en !s correct that I am the owner or authorized agent of :he owner. and f
at pans submitted are in ;omoliance with Oregon State Laws. PLAN REVIEW 25% OF SUBTOTAL I
:i3nature of Owner/Agent Oats q�„� a „ y 11 rvr er/ citai.! > 9
• ,,,. :.te •' • .(41 ... • ... TOTAL
:..Hutt Parson Name Phone
"Minimum permit foe .s a25 - 5% surCarge. except Resae Ba eairloww '
.. f >, /i 2�4- Prevention Dome. 'arm" is St5 - 5% surcharge
L (•( i:Asts'.plmapp.doc 8196
TOTAL P.01
6/8/00 Activities for Case #: PLM1999 -00175 - Op/''
2:52:31 PM ' 8e')
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMD003 Application received 6/4/99 GEO MAIL No Hold GEO 6/8/99
PLMD005 Permit Created 6/8/99 GEO DONE No Hold GEO 6/8/99
PLMD799 Final Inspection 6/8/99 6/8/99 2/18/00 MRS NOTE No Hold AKJ 2/21/00 manager will arrange time with
tenant and call for insp
PLMD050 (F) Issue permit 6/8/99 GEO PASS No Hold GEO 6/8/99
PLMA845 Request inspection research 3/24/00 JMT DONE No Hold JMT 3/24/00 we need to contact manager
again ? ??
PLMD850 Expired by limitation 6/7/00 HAP DONE No Hold AKJ 6/7/00
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