Permit CITY OF TIGARD
40111 I' 1 DEVELOPMENT SERVICES PLUMPING PERMIT
PERMIT # PLM97 -0524
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 12 / 09 / 97
PARCEL: 2S1O2BC —THPO3
SITE ADDRESS...: 12715 SW WATKINS AVE #PREV
SUBDIVISION ° THOMPSON PARTITION ZONING: R -4.5
BLOCK LOT °003 JURISDICTION: TIG
CLASS OF WORK..:ADD 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)...: 200
DISHWASHERS ° 0 RAIN DRAIN (ft)...: 300
Remarks: Install sewer, water & storm drain lines.
Owner: FEES
DAN THOMPSON type amount by date recpt
12765 SW WATKINS AVE PRMT $ 190.00 DRA 12/09/97 97- 301576
TIGARD OR 97223 5PCT $ 9.50 DRA 12/09/97 97- 301576
Phone #: 639 -4747
Contractor
CURTIS HAYS •
24305 SW BOONES FERRY RD
TUALATIN OR 97062
Phone #: 682 -9353 $ 199.50 TOTAL
Reg #..: 113286
REQUIRED 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 Water Line Insp
applicable laws. All work will be done in accordance with Water Service In
approved plans. This permit will expire if work is not started Storm Drain Insp
within 180 days of issuance, or if work is suspended for more Rain Drain Insp
than 180 days. ATTENTION: Oregon law requires you to follow rules Misc. Inspection
adopted by the Oregon Utility Notification Center. Those rules are Final Inspection
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.
I ued By: , ( 1 1,�� _ Perm Signature: 40 1111 y�
Y 9
+ + + + + + + ++ +++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Application Rec'd By _
'� Date Rec'd /s -
15125 bW HALL BLVD. Commercial and Residential Date to P.E.
TIGARD, OR 97223 Date to D
(503) 639 -4171 Permit # t'LM (11-0 f
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°(Inillvldual)' P QTYY7 PRICE, AMT-:
Address Street Address 4/4 Suite Sink 9.00
27 / t4 v&GtwS' Lavatory 9.00
Bldg # City /State Zip Tub or Tub /Shower Comb. 9.00
N me T6 1 Shower Only 9.00
,,, is`- Water Closet 9.00
Owner Mailing Address t Suite Dishwasher 9.00
0 Aprrie nS MS Garbage Disposal 9.00
f42 ate Zip Phone Washing Machine 9.00
1 - 6 0 63 7
Name Floor Drain 2' 9.00
3' 9.00
Occupant Mailing Address Suite 4" 9.00
City /State Zip Phone Water Heater 0 conversion 0 like kind 9.00
Laundry Room Tray 9.00
' h /d J Vitt
Urinal 9.00
` / Y / ku / 11 ,lfA� S -S V /G+• Other Fixtures (Specify) 9.00
Contractor t ing Address Suite
-- - - - _ -9.00 - - -
9.00
. , & ewe /5932 00
Prior to permit Ci_q State Zip Phone
issuance, a copy / (-- QC (g $Z -93sa 9.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date 9.00
required if //3146 S/ = 9 Sewer - 1st 100° 30.00 3O
expired in COT Plumbing Lic. # Exp. Date Sewer - each additional 100' i 25.00 2.5-, database
Name Water Service - 1st 100' ' 30.00 3d
Architect Water Service - each additional 200' 25.00 2s-525
Or Mailing Address Suite Storm & Rain Drain - 1st 100' I 30.00 3 q;1
Storm & Rain Drain - each additional 100' a 25.00 �
Engineer City/State Zip Phone Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Describe work Newer Addition 0 Alteration 0 Repair 0 Pollution Device
to be done: Residentially Non - residential 0 Residential Backflow Prevention Device' 15.00
Additional descnption of work: Any Trap or Waste Not Connected to a Fixture 9.00
Catch Basin 9.00
Insp. of Existing Plumbing 40.00
per /hr
Existing use of Specially Requested Inspections 40.00
building or property _ per /hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information -
Isometric or riser diagram is required d Quanity Total is > 9 •
given is correct, that I am the owner or authorized agent of the owner, and
*SUBTOTAL
that plan bmitted ar in c omplia nce with Oregon State Laws. ,; , 1�'� S Owner/ ent Date 5% SURCHARGE
, 97 PLAN REVIEW 25% OF SUBTOTAL
•
Contt� Person Phone
LiiA 6 &_ 93 3 Required only if fixture qty total is > 9
I` TOTAL
"Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge / 9
I Wstsiplmapp doe 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 ldstslplmapp.doc 5/97