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5470 SW OAKTREE LN
CITY GF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
PERMIT #. . . . . . . : PLM97-0203
13125 SW Nall Blvd., Tigard,OR 97223 (5('3)OX4171 DATE ISSUED: 05/20/97
SITE ADDRESS. . : 15470 SW OAKTREE LN PARCEL: 2S111DH--08900
SUBDIVISION. . . . : SUMMERFIELD NO. 10 ZONING: R-7
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :550 JURISDICTION; TIG
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CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. :_0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . s 0
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . ; 1 CATCH BASINS. . . . . . . : 0
FIXTURES----------- -- LAI INnc y i,^.qY3. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . : 0 URINALS. . . . . . . 0 GREASE TRAPS. . . . . . . a 0
,LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft). . . : 0
Remar-Its : Replacinq ,n electric water heater
Owner. ---- --__._______.._---------__________________ ______ FEES
L.AVON TURIN type amount by date recpt
15470 SW OAKTREE LN PRMT f ?5. 00 B 05/PO/97 97-294778
TIGARD OR 97224 SPCT 4 1. 25 B 05/;-1i97 97-294778
Phone #s
Contractor---------------------------------
GEORSE
ontractor-------------------_.._.._---_-.._--
GEOR3E MORLAN PLUMBING
5529 SE FOSTER RD
PORTLAND OR 97206 ---------__--------_-_-_____----_____-...._.
Phone #: 771-1145 f 26. 25 TOTAL
Reg #. . : 000027
------- REOUIRED INSPECTIONS -------
This permit is issued subject to the regulations contained ai th• Misc. Inspection
Tigard Municipal Code, State of Dr& Specialty Codes and all other Final Ins pact i on
applicable laws. All work will be done in accordance with
approved plans. This permit will eupi-e if wr^k is not started ��✓ _ '
within 188 days of issumnce, or if work is suspended for more — -- I
than 188 days.
Permittee Signature: or l�Q�1- pCY
Issued By:
Call for inspection - 639--417°i
`.ITY OF TIGARD Plumbing Application Recd BY if
13125 SW HALL BLVD. Commercial and Residential Date Rec1 2 1
TIGARD, OR 97223 i Date to P E. -
(503) 639-4171 I �,)� I tp� Date to DST
PemM a �`_
Print or Tvpe Related SWR a
Incomplete or illegi 31e applications will not be accepted Caned -'
,^ Nana of Dewhipmentl roiect FIXTURES (Individual .FRW) ^ AMT
Job G -�1 \ It) Sink 9.00
Address S'ratet Addrea state Lavatory - -9.00
/,P/�U St,, cep ( rub or TvbrShower Comb.
_ 9.00
gifts ilylatme Zip Shower Orxy i 9.00
_ Water Closet "' 9
Mame ,,p
Dishwasher 9.00
Ma�Nrt�Address / Gwbage Disposal
( Own�►r _ �h ;� �}r/ 7- .ti aM 9.00
1 ( re.l+. Waum+q Machine 9.00
~ zip Fbor Dram 9.00
; �_� 9.00
Ntwne
Sr'MAC 4 9.00
Occupant k4l +9 Address mud! wow Heater
9.00
_ Laundry Room rap 9.00
Gty/�'tate -�.r Zip Phots t.hMat 9.00
Nana �"- ' Other Fixhnss(Specifyl 9.00
C Ar/A�� 9.00
OOntMetor !!Ua dross � Suite 9.00
MIT S StJ0 �I fi'! 9.00
Ci rstatt. Zip Phone
OK 1 ••a 9.00
nn Const.Cont.Board Lie.# Ex ate 9.00
Attfe•!1 Copy of 9.00
c eirvent P*MbiN Lim s Z6� Fx Dap-q� S wK.let 100* ao.00
Sewer-each additional IM -� 25.00
COT Business Tax or Metro s Exp.Date waw Serves-tst tcc
_ 'A.00
Name Water Service•east sdth0rori 200' 25.00
Architect I Storm s Rain Drain•tet tar 30.00
Mai address Storm 6 Rain Drain-esti; Witionsl IW 23.00
Or an9 S�.;e
Mobile Hors Space 25.00
Engineer I C.tylState Zip Phone Commercial Back Flow Prevention Davide or An#. 25.00
Pollution Devica
Descrao wart! `law O Addition O Alteration O Repair • Residential Backftw Prevention Device* 13.00
to be dorm: 1esktsf ift O Nw-resktendal O__ Any Trap or Waste Not Connected to a Fix" x.00
n' Addit! l desc npt:on of worn
'a ! elag*k 4i 4I"*4 cath Bane, �'- 9:00
Nwaw►"�� ��"'i Insp of Existing Plumbing 40.00
rhr
ilxwory use of Specialty Requested Inspections 40.00
r#q or pmwwty^ penM
m Rain Cram,sutgta family~irg 30.00
(� Proposed alae of 1�� t3roasa Traps 9.00
W I budding or property_
_ QUANTITY TOTAL
:re you upping, moving or replacing any fixtures? Yes @ No p Isontayte or rim owpram is required d 0 Total is a
;H yes see back of t.-irm) 'SUBTOTAL
I hereby acknowleage that I have read this application,that the Infom,ellon
;even J Correct.'nat I am the owner or authorized agent of the owner.and S%SURCHARGE
that.hafts submitted aro in compliance with Oregon State Laws. _
3i9miture of OwnerlAgent Date PLAN REVIEW 2591 OF SUBTOTAL
S�Zo- Reautretf orNir t lfepxe any.total is�i
TOTAL
Contact Person Naga Phots 1 ?��S
'Minimum permit fee is 0 •1%surcriarge.except Re"Intim 6N*r. rr
Prevention Device,which is S IS+S%surcharge
i:tdsiatptmapp doe bm
2LL--EA E COMEL LEAS APPROPRIATE TQ PROJE-Q
Fixtures to be capped, moved or replaced Qui
Sink
Lavatory �_
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher _ 1
Garbage Disposal i
Washing Machin( _
Floor Drain - 2"
_ 4
Water Heater
Laundry Room Tray
Urinal � _
. _.,.
Other Fixtures (Specify)
COMMENTS REGA RDI ABOVE:
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