10460 SW 66TH AVENUE ADDRESS:
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CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : PLM97-0154
DATE ISSUED: 05/01 '97
PARCEL: i.5136AD-00400
STTF_ ADDRESS. . . : 1.0460 SW 66TH AVE_
SUBDIVISION. . . . : VILLA RIDGE NO. 2 ZONING: R-4.
BLOCK. . . . . . . . . .. . L_01.. . . . . . . . . . . . . :�=' JIJRISD:CTION: TTG
CLASS OF WORK. . :AL_T GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . : R:3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . . 0 WATER HEATERS. . . . . . 0 CATCH BASINS. . . . . . . . 0
FIXTURES---_-__-.--.___- I_AUND?Y TRAYi3. . 0 SF RAIN DRAINS.. . . . . : 0
S I NKS. . . . . . . . . . 0 UR T NAI S. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 0 OTHER -'IXTL.IRES. . . . : 171
TUB/SHOWERS. . . : 0 SEWER , INE (ft ) . . ,. : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DICHWASHERS. . . . : 0 RAIN DRIIN (ft ) . . . : 0
Remarks : Water- Repi.pe Basement
Owner.: __.._-----._-_._____.._____---_.___--- ----____----__._____-- FEES --____---.-_-.__-
HOWARD STRINGER type amol-M., by nate -,ecpt
10460 SW 66TH AVE' PRMT $ 1?5. 00 ,.TSD 05/;M /97 97-294021--
T IGARD OR 97223 5PCT $ 1. 25 JSD 05/01/97 97-29401-2
Phone #:
244-5245
RAYBORNIS PLUMBING INC
19990 SW C I POI__E RD
TUALAT I N OR 97062 -----------------------------------
Phone #: 503-6922-4139 $ 26. 25 TOTAL.
Req #. . : :7.100876
--- ---- REQUIRED INSPECTIONS
--- --
This permit is issued subject to the regulations contained in the Misc. Inspection
liaard Municipal Code, State of pre. Sperialty Codes and all other Final Inspection
applicable laws. All work wi:l he done in accordance with
approved plans. This permit will expire if work is not started
within IAA days of issuance, or if work is suspended for mare
Than 18A days.
Permittee Signatiwes
Call f r inspection - 639-4175
I
I —-- --
04-30.97 10:50 '$503 884 7297 CITY OF TIGARD 10002-003
CITYPF TIGARD Plumbing Application Recd By
-13125 SW HALL BLVD. Commercial and Residential Dale Recd
Date to P.E. I
TIGARD, OR 97223 Date to DST
.03) 639.4171 Permitx rL•+,'Viii- C 05 rr
Print or Type Related SWR 8
Incomplete or illegible applications will not be acr-opted Called _
Name of DevelopmenN ro)ect 'FIXTURES (individual) QTY PRICEAMT
Job sink 9.04,
r
Street Addass Suite Lavatory 9.0
Address Street 6 6.NLS Tub or TuWShower Comb. 9.00
Bldg s City/State ZIP Shower Only 9.00
I-N4 d Water Closet 9.00
N me - -
O Dishwasher 9.00
Owner Mailing Address � � Suite Garbage Disposal 9.00
b .5 6 j Washing Machine 9.00
C11 Istate ZJp hone Floor Drain 2" 900
7" '.2 d -J:5615'S 3• 9.00
e 4' 9.00
OCCUpat'It Malting Address Suite Water Heater 9.00
Laundry Room Trey 9.00
CltylState Zip Phone Urinal 9.00
me
Other Fixtures($-"city) 9.00
-
S G 6 N 9.00
Contractor
ei Adares: Suite 9,00
0 6 9 _ 9.00
(Prior to Issuance City/State . Zip Phone 9.00
applicant must Ya 17
provide all Oregon Const.Cent.Board Lic.0 -Exp Date 9.00
contractors - q.
license Plumbing Lie.r Exp.Date Sewer•1 a 100' 30.00
information 3 -166 PB - -
Sewar-each additional 100' 25.00
for COT COT Business Tax or Metro 0 Earp.Date
database). �(��_ Water Service tst 1 0.00
,
Name Water Service•each additional 200' 25.00
Architect
Storm&Rain Drain•1at 100' 30.00
Or Marring Address Suite Storm 6 Rain Drain-Noah additional 100' 25.00
Mobile Home Space 25.00
Engineer CltylSlate iphone Commercial Back Flow Pfuvention Device or Anil- 25.00
Poflutlan Device
Describe work New O Addition O Alteration O Repair O Residential 98CAflow Prevention vice' 15.00
ri be done. Residential O Nan-residentlal O Any rep or Waste Not Connected to a Fixture 9. 0
d�kl_onal d�escription o(,work p � Catch Basin 00
1�1 ger" t CAltG�t� Insp.of Existing Plumbing 40,00
per/hr
---- Specialty Requested Inspections 40.00
ExisOng use of _ oedhr
building or property -Talm brain,single family dwelling 30.00
Propused use of resse Traps 00
d building or property,
Ir -- QUANTITY TOTAL
1- Are you capplmg, moving or replacinq any fbdures? res❑ No� homenle or r1mr diagram u required it Owenlly row is>a
N -SUBTm'rAL
If se tae beck o/ferrtl_L A
'' 1 hereby acknowledge that I have read this appliCatlon.that the information
�• given to Correct,that I am the owner or authorized agent of the owner and 6%SURCHARGE
"I that l2ru submitted are In compliance with Oregon State Laws. -
PLAN REVIEW 2S%OF SUBTOTAL
co rte rr of O erlOge Date --.
►fir. Requires aml it elnoq IOlal is s 9
w /N1da� ---
5--/-f7 TOTAL 6d
tact Person nine _� 'hone •MInlfMum J
�A 4 permit Is s26++5%su urge.except Residential ac ow
A , !Ch_ b 1pr -/��� Prevention Device.which is$15+5%surcharge
Hplmap doc 12'96 (dst)