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Permit si CITY OF TIGARD Ar .:�� DEVELOPMENT SERVICES PLUMPING PERMIT "+ PERMIT # PLM98 -0390 +L c_ _.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 10 26 PL 9 M9 8 8-0390 PARCEL: 2S1O2BA -00901 SITE ADDRESS...: 09570 SW TIGARD ST SUBDIVISION • NO.TIGARDVILLE ADDITION AMEND. ZONING: I —P 1 BLOCK • LOT •058 JURISDICTION: TIG CLASS OF WORK..:OTR 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)...: 200 WATER CLOSETS.: 0 WATER LINE (ft)...: 0 DISHWASHERS • 0 RAIN DRAIN (ft)...: 0 Remarks: Installation of 200 feet of sewer line. Owner: FEES DOUGLAS ALLRED & GEORGE ENGEL type amount by date recpt 9380 S. W. TIGARD STREET PRMT $ 55.00 DLH 10/26/98 98- 310297 TIGARD OR 97223 SPCT $ 2.75 DLH 10/26/98 98- 310297 Phone #: Contract or KEEFER PLUMBING INCORPORATED 52300 SW SOUTH RD GASTON OR 97119 Phone #: 503 - 640 -7451 $ 57.75 TOTAL Reg #..: 065481 REQUI RED INSPECTIONS This permit is issued subject to the regulations contained in the Sewer Inspection 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. 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 OIJNC by calling (503)246 -1987. Issued By: _ Permittee Signatu 11// 1 +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + +•+ + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OFIGARD Plumbing Permit Application Plan Check# - 13125 SW HALL BLVD. Commercial and Residential Rec'd By . Ar TIGARD, OR 97223 Date Rec'd • -,' (503) 639 -4171 /ri Date to P.E. Print or Type Date to D T _____- Incomplete or illegible applications will not be acc pied Permit # LF44 � - a35�® Related SWR # 5 to g-.51 62, Called, 87, !D -.y- 9,- Name of Development/Project FIXTURES (individual) QTY? PRICE; AMT Job Sink 9.00 Address Street Address v Suite Lavatory 9.00 6 1 5 70 S (.7 I k 4 Tub or Tub /Shower Comb. 9.00 Bldg # City /State Zip Shower Only 9.00 Name 4A cV I N G `7 '72--Z 3 Water Closet 9.00 Q Lu /.�, N (et Dishwasher 9.00 Owner Mailing Address , Suite Garbage Disposal 9.00 T 3 9w1- A&4 d Washing Machine 9.00 City/State , Phone Floor Drain/Floor Sink 2" 9.00 - T;o ca nr , b✓ G'1Z- 7- 3. 1 Az S -6o2- Name 3" 9.00 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 Name �� Other Fixtures (Specify) 9.00 Contractor Mailin Address Suite 9.00 0 O, 4-7f 56 Z 9.00 Prior to permit ciN/qtate Zip Phone r I S Sewer - 1st 100' ( 30.00 3Q , d- 0 � � issuance, a copy \ s, (3V C i11 Z3 � �p � 7�' `f I Sewer - each additional 100' 25.00 Z5 of all licenses are Oregon C99nst. Cont. oard Lic.# Exp. Date UU required if /„ 5 ' 3l/ a Water Service - 1st 100' 30.00 expired in COT Plumbing Lic. # III . ate Water Service - each additional 200' 25.00 database 3 41 - l-.f Pg 3 a( /Gf CI Storm & Rain Drain - 1st 100' 30.00 Name l 1 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 Residential Backflow Prevention Device' 15.00 (Irrigation timing devices require a separate Describe work to be done: restricted- energy permit.) , New ,t. Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00 Residential g Commercial 0 Catch Basin 9.00 Additional description of work: ek` - �- Ns I I '314-'\-- Insp. of Existing Plumbing per/hr Specially Requested Inspections 40.00 per/hr Rain Drain, single family dwelling 30.00 Are you capping, moving or replacing any fixtures? Grease Traps 9.00 Yes O No O If yes, see back of form to indicate work performed by QUANTITY TOTAL q , fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is required if Quantity Total is >9 • WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL /--� I hereby acknowledge that I have read this application, that the information . "� 7(� given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE • that plans submitted are in compliance with Oregon State Laws. /_;ir ,nature of •wner /Arent Date "'PLAN REVIEW 25% OF SUBTOTAL I ' 01 01 Required only if fixture qty. total is > 9 4110 1 II if►r \� r7 / -C I f l I Q TOTAL q 7S Contact Person Name Phone © `k 0 c - - \Q(l rU -145 I *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow �S�J� `�f Prevention Device, which is $15 + 5% surcharge **All New Commercial Buildings require plans with isometric or riser diagram and plan review il6, 005- 2.ry e--- Mi 7/2/98 U O // Ay Vf . PLEASE COMPLETE: Fixture Type Quantity::by. Work Performed : New ,: >... ;....:....:. .` Moved;:: :I Replacedi <; < /Capped.,;: 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: Mists 7/7/98