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PLUMBING PERMIT
CITY OF TIGARD PERMIT #. . . . . . . : PLM96-0145
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/14/96
13125 SW Hall Blvd,Tigard,Oregon 97223.8199 (503)839.4171 PARCEL: 1 S135CD-09100
1 I L . . : 1 1. '169 aW 6PLENDURG RD
-,,UBDIVISION. . . . : MLP94-0003 ZONING: R•-12
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . ..002
CLASS OF WORK. . aNEW GARBAGE-: DISPOSALS. : 0 MOBILE—I-,OME—SPACES. : 0
TYPE OF USE. . . . :W WASHING MACH. . . . . . : 0 BACKFLOIJ PREVNTRS. . e 0
OCCUPANCY GRP. . aR3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0
STORIE:S. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
r'IXTURES-------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
5INK5. . . . . . . . . . a 0 URINALS. . . . . . . . . . . ,. 0 GREASE TRAPS. . . . . . . . 0
LAVPTORIES. . . . . : 0 OTHER FIXTURES. . . . : 0 .
TUB/SHOWERS. . . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. . : 0 WATER LINE (ft ) . . . a 300
DISHWASHERS. . . . a 0 RAIN DRAIN (ft ) . . . .- 0
Remarks : Wates- service to 3001=t.
Owner: .----------------------------------------_.___—_—_-- FEES
JOHN DRE.NNAN type amount ty date recpt
PO BOX 2:5603 PRMT $ 55. 00 CJS 06/14 96 96-280368
5PCT f 75 C,TS 06/14/96 96-280368
T IGARD OR 97P81—,3603
Phone #: 503-639-5792
Contractor: ------_____--___--_...._._—_--_--_.__.__
STRAIGHT & STURDY FENCING
PC) BOX 23603
T IGARD OR 97281-3603 --_—._—._---_---_.-----------------_-_---
Ptione #: 51213 -639-5792. f 57. 75 TOTAL
Keg it. . : .:7194
--- ---— REGIU I RED INSPECTIONS -----_
This permit is issued subject to the regulations contained in the Water Line Insp _
Tigard Municipal Code, State of Ore, Specialty Codes and all other Water :service In
applicable laws, All stork will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 188 days.
e r m i t t e e G i y n a t i.11r e : _-_!_ j tai. ► 1{ _._ ___ ._.. __
Call for inspection - 639--4175
i
:ty of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # b
13125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
New Single Family Residences Only
AOOata U 1 BATH HOUSE $140.00 0 2 BATH HOUSE$195.00
Jobu�), l'�i� Mr)a'F'l- ►<<� O 3 BATH HOUSE $225.00
Address urosi.. c Fee includes all plumbing fixtures in the dwelling and the irst 100 feet
],' 1. 3 of water service, sanitary sewer and storm sewer. See fees below.
"""•'""""' " FIXTURES QTY PRICE AMT
1.4N V�/I ( C'/vA/AA/ Sink -- 9.00
"•'"v A"... °A°"• Lavatory 9.00
Owner 0, b0 7� Tub or Tub/Shower Comb 9.00
c4y'S'"• 'a' Shower Only 9.00
(� I(_'A t,�� 0 2 122 8/-3 6 0 3 Water Closet i� 9.00 -
"•" Dishwasher 900
Garbage Disposal 9.00
Occupant M.&V A"— �«. Washing Machine 9.00
F'r,
U _ Floor Drain 900
ti N `"'�"'• Water Heater 900
Laundry Room Tray 900
I' L Urinal 9.00
_)f Uo'i)y Fa_lt!(. i A.l;.- Other Fixtures (Specify) 9.00
Contractor Mailing A00.a. Ph— 9.00
U,6 o)( 2 3(1 0), r; 3`3 S -7q,, 9.00
9.00
7_7
r 6. 4/z,) 3LU j Sewer 1st 100' 3000
N. '�tv""' '"N. Sewer -ea. Addit 100' 25.00
Cl I — 5-5-L e Water Service 1st 100' 1 30 D0 0Q
I hereby acknowledge that I have read this appliratio,i, 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 Contractors Board, that the Storm &Raul Drain Addit. 100' 25.00
number given is correct (if exempt from State registration, pease
give reason below) Mobile Home Space 2500
Back Flow Prevention
Device or Anti-Po(lution Device 900
/°i' Any Trap or Waste Not
�►i ,�n _ - V Connected to a Fixture 900
Describe ork new addition kj alteration U repair Catch Basin 900
to Led a residential o non-residential Q Insp. of Exist. Plumbing 40 00/hr
Specially Requested lnsoections 40 00/hr
Existing use of —
/ Rain Drain, single family dwelling 3000
budding or oroperty ,-__- _
Residential backflow prevention
devices 15.00 -
P,oposed use of
budding or property
(Except residential backflow
prevention devices)
NOTICE Minimum Fee 525.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION ~
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 SUSTOTAL
'OTAL
Sr,4c al Conditions
Date ssied � r_��, by