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CITY OF TIGARD --
PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM1999-00359
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 GATE ISSUED: 11/01/1999
SITE ADDRESS: 14660 SW 89TH AVE PARCEL: 2S'111AD-02600
SUBDIVISION: PINEBROOK TERRACE ZONING: R-4.5
BLOCK: LOT: 023 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R? FLOOR DRAINS: TRAPS:
STORIES: W.".I-E'R HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
T JB/SHOWERS: SEWER LINE: 80 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace existing sewer line.
FEES
Owner: -
Type By Date Amount Receipt
TOUSEY, FRANCES B TRUSTEE
11992 SVS' ROYALTY CT'APT 15 PRMT DST 11/01/199£ $50.00 99-319437
KING CITY, OR 97224 5PCT DST 11/01/199 _$4.00 99-319437
Total $54.00
Phone 1:
Contrac+.:,r:
MILLER : SONS CONTRAI. TORS INC
23880 SW MIDDLETON RO
SHERWOOD, OR 97140 REQUIRED INSPECTIONS
Phone 1: Sewer Inspection
Reg #: LIC 00003644 Final Inspection
ORIGN\L
This permit is issued subject to the regulations contained in the Tigard Municipal Cede, 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 adoptee by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through Or\R 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
/ L.
Issued ByY- � _ Permittee Signature:��-,
'� Call (503) 639-4175 by 7:00 P.M. for an inspection needed the n"t usines ay
ll%29 'fl8
FRI 10:013 F_1\ 503 "9b L96U CIT)i OF TIGxRD 10002
CITY OF T;GARD Plumbing Permit Application Plan Chock A
13126 SW HALL BLVD. L,ammercial and Residential Recd By
TIGARD, OR 97223 ( _ Dateaecd
(503) 639-4171 Dale to P.E.
Dale Ic OST _
Print or Type Pe�mItlC r11(
Incomplete or illegible applicatic ns will not he accepted Related SWR
Called
- — Name of.evelopment/Project I FIXTURES (Individual) QTY PRICE AMT
Job Sink
Street Address Sulte Lavatory
Address --
I E'q o 5L,t ,8� Tub or TubrShower CDTIb. SJ
9 dg!r cityiState Zip Shower Only 5D
17-1 c,,4/4',),Cl11. 9 7?? Mater CloseUlhfnel (speclfy� 1 50 —~
Nama
�� Cishwasher `_ _
MlWIrng Address uOe Urinal 1 i,SD
Owner _ 11.50
< <�, r 1\ Garbage Disposal
Ctylsta?e if,pPhone La,,•,dryTray 11.50
�s .�. Washfnp Machne/Loundry Troy (Specify) 11.50
Namrh' —T- 11.50
G4' F cor DralwFloor S rk 2"
Occupant Maning Address ufla 3" 11 50
sw 8 9 4,.
City/state Z;p 1150
g_� 2 y r-1 b Wete'Healur O curveraion O tlka K rd
/ L495 la r y-e ulres a separate mechanical errrn
Nome,,, �f C] 7 MFG Home New lveter Sewice e
Mailing Addreae ` 1 SuJlto "+FG Home New SenlStarm Sewer 28
Contractor Hose Bfbe 11 50
,nor to permit city/State Z p Phone Root Dra'rs 11 50
Issuarrq,a copy _ DrM rg Fountain 11.50
of e 1 licenses are Orebcn Const Cool.Board LICA Exp Date Other Fbdures,Specify) 1500
•equlrec if
expired in COT Plumbing Lia r► Exp Dale
database
Name
Architect _ sewer--lot 100' 38 00 < '
or Malllnp Address Sii1 P Sewer-each addlllorial 100' 32 00
Water Service-tat 100' 38.DO
Engineer Water Service-each addltlonal 200 Cltl--y/S�a�—
ZIP Engineer 3200,
Des^ribs
Storm 8 Rain Drell-'5t 100'
work to he done r0
Now O Ropelr • Rep ace w!!!,likF kind Yes • No 0 Sicrm 6 Rein Dram each addltbrrel 100' fL.00
Res dentlel • Commercial O Commerclal Back now Prevenilon Device 32 00
Add tional//descrlpllon of workr / 1 Roaldentlal BactRaw Prevention Device' 1900
r, KJG��/(/- -r f`A i/(), er/ Catch Basin — 11.5(1
Are you capping,moving or replacing any fixtures? Insp of Existing Pit,mbktg or Specially Rnquerlad 50.90
Yes O No*O Insuectlon! perthif
If yea,see back of form to Indicate work Derformed by Rein Drain single family dwelling a5 00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
he eby acknowledge Ilial I have reed Ods apo Icatlon.that the infornailon honr•trlc o rlwr o1. r.n!s r•q�Y•d r]ua�tn Tra s_-9
n gPren Is orroc;,that I am the owner or 1 ',hbrized agent hl the nwrer and 'AUSTOTAL L
> ;ret 0 suhmltted are In rorn Ilr rice ilifiti Ore cn Stats Laws I Mi N S�•w
81on n of ownarf gam. CZ f0l�
• I S°�SURCHARGE
o tact Person-Namehccon• -- —:-PLAN REVIEW 2a%OF SUBTOTAL
�l fes'
6F heal nd only d rxi qty lau is>a (�
l; i T}I.F�fiFyg 00 a 1 _ r "� C OTAL L
� ATL#ftOl18 60 D0 °,�EI m �4 ��_
3 ATH WFa1J9E�4BE f�
(This 191011ROU1110 all plurllhlrig flxlerox In thsdwll�Mlq, 1 � 'M!r)MUM p•rmlt fee is$50+e%aUr_h•rg•,•rept Resicenllsl9•ckrlow Provelik?
'OQ felly Q_)rMnM�uj t. •,_ Device.Which•!96•1%au-charge
$" 11Wti1i11lIt ,t7! „..fid
"Ali N•wCemrnareld BLIldlnpa requke pl•IV rxlh norMrie or riser dlapnr•r rt
31111 review
I'.d11i for T4,V-U r rp-3doc t b'1 i d1
•- �;�)����1 hl � '�r...T t- COT-" --
O F T I G A R� - ENGINtER�,NG PERMIT
PERMIT#: EPJG1999 OOC61
CIT
DEVELOPMENT SERVICES PRIM, PERMITM ENG1999-00051
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/3/99
SITE ADDRESS: 14660 SW 89TH AVE PARCEL: 2S111AD-02('00
SUBDIVISION: PINEBROOK TERRACE `, ZONING: 11-4.5
BLOCK: LOT: 023 C� JURlSDlCTION: TIG
\�I
PERMIT TYPE: SOP PUBLIC IMPRV QUANTITY LIN FT VALUE
AGREEMENT DATE: GRAIEROS:
ASSURANCE EXPIRATION STREET: "
PERFORMANCE: SAN SEW: "
MAINTENANCE: STM SEW:
PATHWAY.,.
ALL OTHER: '"" $1,2.00.00
TOTAL: $1,200.00
Remarks: STREET OPENING, TO INSTALL A SIX INCH PUBLIC SANITARY SEWER SERVICE LATERAL AND
CLEANOUT (SERVING TWO PARCELS).
Owner: __ FEES
TOUSEY, FRANCES B TRUSTEE _Type By Date Amotut Receipt'
11992 SW ROYALTY CT APT 15 OPEN JSH 11/17/99 $150.00 99-319842
KING CITY, OR 97224 BOND DEB 12/3/99 $1,200.00 99-320154
Phone: Total $1,350.00
Engineer:
P;,one: _ REQUIRED INSPECTIONS
STMISAN SEWERSTREETPermittee/Applicant: MH/CBICO ,^ CRB LINE & GRADE
MILLER & SONS CONTRACTORS, INC PIPE LN & GRD SUBGRADE
23880 S W. MIDDLETON RD. BCKFLL & CMPCT BASE ROCK
SHER�VOOD, OR 97140 AIR &TV TEST LEVEL COURSE
WEARING COURSR
RAFF & PED CON T
Phone: GRADING MONUMENTATION
CONTOURS STREETLIGHTING
Pe nnIttee/ DRAINAGE WALKIAPRON/RAMP
EROSION CNTL.
Applicant
Siguat re: Q -��•
REPR'S/ADJ'S PATHWAYS
Issue By
FOR INSPECTIONS, CONTACT THE CITY OF TIGARD,
SPECIAL CONDITIONS: (SEE \TTACHED) ENGINEERING DEPARTMENT, AT: (503)639-4171
CITY OF '`IGARD BUILDING INSPECTION DIVISION MST i
24-Hour Inspection Line: 639-4176 Business Line: 039-4171 - !
BIP _
-C'ate Requested �" r ( —AM _PMS BLD
Location /4('�L' -%U-) 3 l f _ — Suite _ MEC
Contact Gerson S�e�l�l^-" �AjL SIFY.-S _-- Ph (o ff r`(o��� PLM
Antractor— — _ Ph SWR _
BUILDING — Tenant/Owner _-- ELC �_—
Retaining Wall ELR
Footing Access: l FPS
Foundation / - ------
Ftg Drain SGN
Crawl Drain Inspection No
Slab — _ __ -- SIT
Post& Beam rv_ �� (c,
Ext Sheath/Shear
Int Sheath/Shear
Framing -- --- --
Insulation
Drywall Nailing ------------
Firewall
Fire Sprinkler T - -----
Fire Alarm r ' /y � j 4f �hz
Susp'd Ceiling 1 �((»
Roof �
l
Misc:
Final
PASS PART FAII-
PLUMBINGyf��l
Post& Beam ' �T
Under Slab _.
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL ��� . ;,' OF
r
Post&Beam
Rough In
Gas Line
Smoke Dampers )
Final j
PASS PART FAIL G
ELECTRICAL
Service _
Rough In
UG/Slab
Low Voltage
Fire Alann
Final
PASS PART FAIL ---SITE
Backfi)llA5LPding --- — _—
Sanitary Sewer
Siorm Drain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13-i25 SW Hall Blvd
Catch Basin ( ]Please call for reinspection RE:__ _— _ [ )Unable to inspect- no access
Fire Supply Line
ADA
Appr -ch/Sidewalk pate __Inspector / —__Ext —
Other
4 > i PART FAIL DO NOT REMOVE this inspection record from the job site.