Permit :CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PLUMBING PERMIT
PERMIT > : ° ° ° ° ° °° o PLM95 -0192
639 -4171 DATE ISSUED° 08/09/95
PARCEL e 1S126®1C- 1111107
SITE ADDRESS° ° ° o 0940.10 SW WASHINGTON SQUARE RD 4FMERVN
SUBDIVISION ° ZONING, C —G
^LOCI: ° ° ° ° ° ° °. °.° LOT ° ° ° ° ° °. ° ° °
CLASS OF WORR,. ° : ALT GARBAGE_ DISPOSALS..: MOBILE HOME SPACES.
TYPE OF USE -COM WASHING MACH.......: BACKFLCW PREVNTRS °°
OCCUPANCY GRP° ° gB2 FLOOR DRAINS° ° ° ° ° ° ° 2 1 TRAPS
STORIES ° ° ° ° ° ° ° °a2 WATER HEATERS °1 CATCH BASINS ° ° ° ° ° ° °:
FIXTURES LAUNDRY TRAYS......: SF RAIN DRAINS
SINKS ° °. ° ° ° ° ° ° °e3 URINALS GREASE TRAPS ° ° ° ° ° ° °°
LAVATORIES..... OTHER FIXTURES
TUB /SHOWERS ° ° ° °o SEWER LINE (ft) ° ° ° °g
WATER CLOSETS..: WATER LINE (ft) ° ° ° ° ,;
DISHWASHERS RAIN DRAIN (ft) ° ° ° °o
Renarkso Install plumbing fixtures
Owner: - - -- -- — FEES - --
MERVYN' S type amount by date recpt
22333 FOOTHILL BLVD PRMT $ s 72.00 JD 08/08/95 COMP DOWN
SPCT $ 3.60 JD 08/08/95 COMP DOWN
HAYWARD CA 94541-8521
Phone ;
Contractor:
- - - - --
JOHN RE I N;l'.ARDT PLUMBING
P 0 BOX 129
NEWBERG OR 97132 - -- - -- - - - -- - - - - --
Phone #0 538 -9464 75 °621 TOTAL.
Reg :% ° ° 001870
— REQUIRED INSPECTIONS
This percit is issued subject to the regulations contained in the Rough—in Insp
Tigard fiunicipal Code, State of Cre. Specialty Codes and all other PLM /Underfloor
applicable laws. All work will be done in accordance with Top —out Insp
approved plans. This percit will expire if work is not started Final Inspection
within 180 days cf issuance, or if work is susper.de; for core
than K2, days.
Pa,- i `.ee S' uree
Issu y ;��_ �
Call for inspection — 639 -4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit # qc - O i9 Z
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name or Development i New Single Family Residences Only
'iNoLQ.,0 t
�� ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job 1 ' x - 8; S.W. WASHINGTON SQUARE RD. ❑ 3 BATH HOUSE $225.00
Address onwsra. no Fee includes all plumbing fixtures in the dwelling and the first 100 feet
TIGARD, OREGON 97223 of water service, sanitary sewer and storm sewer. See fees below.
Name (ar name of Business) FIXTURES QTY PRICE AMT
Sink 3 9.00 2 7.
Marling Address Phone Lavatory 9.00
Owner Tub or Tub /Shower Comb. 9.00
Ceywstate 2113 Shower Only 9.00
Water Closet 9.00
Name (or name of business) Dishwasher 9.00
Garbage Disposal 9.00
Occupant M.fn Adtraw Phan. Washing Machine 9.00
Floor Drain C lWb `ZRRvZ 1 9.00 7
City/State ZIP Water Heater 1 9.00 ? 6 0
Laundry Room Tray 9.00
" erAe Urinal 9.00
JOHN E. REINHARDT PLUMBING, INC. Other Fixtures (Specify) 9.00
laming Hosea. Phone )�y-t%- \ W - L�•• f 9.00 9 GG'
Contractor P.O. BOX 129 (503) 538 -9464 Zg 9.00 7 G O
City/State VP i= S v...-�c�- l 9.00 ICU
NEWBERG, OREGON 97132 Sewer 1st 100' 30.00
State Registration No. SPY tom. Tex No. Sewer - ea. Addit 100' 25.00
001870 00003075 Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addit 200' 25.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm & Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit 100' 25.00
number given is correct. (If exempt from State registration, please
give reason below.) Mobile Home Space 25.00
Back Flow Prevention
a y Device or Anti- Pollution Device 9.00
�� er / 8/7/95 rmta Any Trap or Waste Not
'''' �� Connected to a Fixture 9.00
II ' cribe work new 0 addition 0 alteration 0 repair 0 Catch Basin 9.00
to be done residential 0 non - residential 0 Insp. of Exist Plumbing 40.00 /hr
Specially Requested Inspections 40.00/hr
Existing use of
. building or property \\_ t? Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of
building or property` 2 .1e5P \l► flt{_ j
'(Except residential backflow
prevention devices)
6
NOTICE 'Minimum Fee $25.00 SUBTOTAL
7,Z °
PERMITS BECOME VOID IF WORK OR CONSTRUCTION C
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL 75, /,
°
Special Conditions /� Q�"' �
Date issued CJ (J-' 9 ' by
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection:
Footing Susp. Ceiling , Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post /Beam Struct. Plbg. Top Out Elec. Rough -in FINAL:
Post /Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. - Elect.
Date Requested: Cl l I (3 ( AM PM
Address: �T v 6 (LJ S Q
Builder: Permit #: 95 d ( Z
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspec�� Date: ��/3"
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 63's '1
! A
Inspection: Ail 1 ALA �
Footing Susp. Ceiling Sprink. Rough -in Wr/ dwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post /Beam Struct. g. Top Ou Elec. Rough -in FINAL:
Post /Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing - Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. - Elect.
Date Requested: 31/ b [ / G . T AM PM
Address: 9 L /i" S _ KB
Builder: 5 3 S ,' alp y� - Permit #: fL 95 ---- M 0 1 9 Z--
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Date:
ROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.