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10980 SN ERROL ST. �'
CITY OF TIG�►R RIG
PLUMBING PERMIT®EVELOPMENT SERvICL � PERMIT#: PLM1999 00285
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 6304171 DATE ISSUED: 9/10/99
SITE ADDRESS: 10960 SW ERROL ST
PARCEL: 2S 103AD-00400
SUBDIVISION: ZONING: R-4.5
BLOCK: LOT: 012 JURISDICTION: URB
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES_ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
''UB/SHOWERS: 2 SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Cap off lav in main bath and move to another wall. Remove tub/shower unit and install new tub/shower and
valve in main bath. Revove and install new toilet in main bath. Remove and install new shower& valve, toilet R
vanity in maste bath. _
Owner: ^ = FEES
NUKE, STEVEN C + Type By Date Amount Receipt
CHRISTOPHERSON, BARBARA J PRM4 DEB 9110199 $69.00 99-318248
10980 SW ERROL ST 5PC2 DEB 9/10199 $4 83 99-318248
TIGARD, OR 97223 Total $73.83
Phone 1: f ILI
Contractor:
NICHOLS PLUMBING
PO BOX 68551
4375 SE MARK KELLY COURT REQUIRED INSPECTIONS
MILWAUKIE, OR 97268
Phone 1: 653-2069 Top-out Insp
Reg#: LIC 132527 Final Inspection
PLM 03-114PB
This permit is issued subject to the regul3tions 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 tenter. 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 (§03) 246-1987.
Issu d By: � �Q � Id_.�11, Permittee Signature: %
Call (503) 639-4 75 by 7:00 P M for an inspection neede he next business Ay
CITY OF TIGARD Plumbing Permit Application rlanChk#
13125 SW HALL BLVD. Commercial and Residential Rec'dB
TIGARD, OR 97223 _ Date Recd D
(503) 639-4171 f Date to P.E.
Print or Type � (�i Date to D�ST) .---
Incomplete or illegible applications will not be accepted Per
Related SWR#
Called
Name of Development/Proiect FIXTURES (individual) QTY PRICE AMT
.JOt1 Sink ^� - 11.50
Address See A dr y,^ Suite Lavatory 11.50
1 1 Tub or Tub/Shower Comb. 1 11.50 i sn
Bldglate Ip �j Shower Only 11.50
Na Water Close Urinal (Specify) 11.50 c
�J Q Dishwasher 11.50
Owner Mail(
ail g Ad ess 1 n Sufle Garbage Disposal 11.50
�^1 �r+/ Washing Machine/Laundry Tray (Specify) 11.50
Clt/State Zi t+o
T , � �� � Floor Drain/Floor Sink 2" 11.50
Name 3" 11.50
4" 11.50
OCCUt 31nt Mailing Address Suite Water Heater O conversion O like kind 11.50
Gas piping requires a separate mechanical permit,
City/Slate Zip Phone MFG Home New Water Service. 28.00
MFG HGnie Ncw San/Storm Sewer 28.00
Nam ` +� Hose Bibs 11.50
Contractor ddr s Suite Rain Drains 11.50
+ Drinking Fountain 11.50
Prior to permit t /St a Phone Other Fixtures(Specify) 15.00
issuance,a copy
of all licenses are O n Cows! 3ont.Board -
required If I
expl-ed In COT Plumbing Lic # P. ate
database Ly_� /' --
Name Sewer-1st 100' 38.00
Architect Sewer-each additional 100' 32.00
or Mailing Address Suite Water Service-1st 100' 38.00
Engineer City/State Zip Phone Water Service-each additional 200' 32.00
Storm&Rain Drain_1st 100' 38.00
Describe work to be done Storm&Rain Drain-each additional 100' 32.00
New O Repair O Replace with like kind: Yes)d No O Commercial Back Flow Prevention Device 32.00
Residential Z Commercial O Residential Backflow Prevention Device' 19.00
Additional description of work: --
Catch Basin 11.50
____ _ Insp of Existinq Plumbing 50.00
Aro you capping,moving or replacing any fixtures? perthr
Yes R No O Specially Requested Inspections 50.00
If yes,see back of form to indicate work performed by perthi
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain,single family dwelling 45.00
WORK COULD RESULT IN INCREASED SEWER FEES. Grease Traps 11.50
I hereby acknowledge that I hsde read this application,that the Information QUANTITY TOTAL
given Is correct,that I am the owner or authorized agent of the owner,and Isometric or riser diagram Is required a Quantity Total is >9
that tans subOml n d ar intcomliance with Oregon State La 'SUBTOTAL�M
q 0
!,son ` 7%SURCHARGECon actPeName Phon
"PLAN REVIEW 25%OF SUBTOTAL
1 BATH HOUSE$178.00 Required only 0 fixture qty total is>9
2 BATH HOUSE$25000 TOTAL �• '
5 BATH HOUSE$285.00 -
(This fee Includes all plumbing fixtures In the dwelling and the first
100 feet of sanitary sewer storm sewer and water service) ' m permit fee Is E50 7%surcharge,except Residential Bactnnw Preveneon
Device,evice,which Is$25•7%surcharge
**All New Commercial Buildings require plans with isometric or deer diagram and
plan review
11dsWforms�plumapp doc 7119r99
PLEASE COMPLEI E:
�— Fixture Type ------- ---- Quantity byy*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/Floor Sink 2"
411
Water Heater
L_aunclry_ Ro_orti Tray _
Urinal
Other Fixtures (Specify)
COM1.41,11ENTS REGARDING ABOVE:
I%d%W(mM%Vwmspp duc i i.9194