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CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMTT
13125 SW hall Blvd.,Tigard,GP,97223 (5N)634-4171 PF RM I T #. . � : . . . : PI.11137--0086
I7ATF; ISSUED: 07-,/26/97
PARrEL_ :
5 T Tr_ nDDREGS. . . : i 5i:'81 SW 100TH
t.lFl11I V I r I ON. . . , GLII_� T DE E ITATF S NO, w ZONING: R--7
BLOCK. . . . . . . , , . . L_C1T. . . . . . . . . . . . . :23 JURTT".DTrTInI%J: TIr;
7I.ASS OF WORK. . :A1_T GPPSAGE DISPOSALS. : �?r mnSTl_F HOME ,'",.FAC'E'S. ;
i—Y1��F tlF '.ISE. . . , :SF WASHING MACH. . . . , ., : 0 SACKFi_.OW PREVN7,rs. . : 4'_f
`.7CCUPANCY GRr. . :R3 FLOOR DRATNS. . . . . . 0 TRAPF .. . . . . . . . . . . . . . 0
f:1TOP T17S, , . . ,. . . . . 0 WATER HEATERS. . .. , . . 171 CATCH R(-1STNS. . „ . . . . i:A
FIXTURES__.-.___...____._..._._.._._ I-AI INOPY TRAYS. . . . . : 171 SF RAIN DRAINS. . „ " . : 0
SINKS'). . . . . . . . „ . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. .. . . . . . 0
i-AVATnRTES. . . . » 171 OTHER F'TKT1iRFS. .
TUB/';HOWE RS. . r 171 SEWER L..T NE (ft ) . . . » 0
WATER rI._tJSE7'F,, : 171 WATER LINE (ft ) . , , : 0
DI 7HWA5HFRS. , . . : ID RAIN DRATKI (ft) . . . : 171
Ro,m it�!4y : DTSCH,"iRiwE PUMP FOR WASHTNG MA1'_1H11\1F, PRT.N7 I,IASIING, MACHTI\lr TO SANITARY
REWER LINE, MEET HOMEOWNER FOR ACCESS. (PER FINANCE 032697, T R I SH,
HOMO TS COhaNM ED TO SEWER. THIS APPl..T gNCE I,; .Tus-r NOW CONNFF r T NG. )
Owner• _....___,. _______.___._.._..___ __._ _..._ _..__.__._..__ _.._. -_ — FEES
IJFL.LY SAINJI)FRS Amol.rnr, by (1at(-� reri-31-
4 5;.1SW1.21 1T1f ABMT 25. 00 ._TMH 0 /1.9/S7 "T7--c_'9.1
"11APP OR 97222 1711_.rK It 6. P7, JMH 03/19/97 `:37•--i'",11
9PC,r 1., i2.5 JMH 03/1.9/97 57-- 91
`ITona #:
1;FNINFOY Pl...L)Mn I NG
.; 3985 X985 rW FPRM I NGTOIV RD
h()TlL�EAL'CRYC11+l64t�k
_. r..? �f» 7 55 3'1 11G. 50 TOTAL.
v(a r] fk. , : 117.11'1"T67
REOUIREP INSPECTIONS
-his pertit is issTred subJect to the replations rontained in the Sewer- Tne:pec-ti.nrti
Tigard Municipal Code, State of Ore. %ecialty Codes and all other Watpr F. :inp Tnsm
jrplicable laws, All work will be done in accordance with Waf e t- s]PY �R . �r Cf., ) n
appros rd plans. This oerait will expire if work is not started Rn ugh--in I n s p
+ithin IN dive of issuance, or if Werk is susmeed for tore PL.M/I)r'dpr-fInot-
han IN days. 'rap--acct Tnsp
Fi.nm 1 7 n spec^t; i an
1 '
Olt ark- 11l(fit.
"�I. 1 f .)r' i Tl t,I.l:IC l: i.�jn -- F,3S--4175
r
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Siervice FINAL:
Foundation Water Line Ceiling -Plumb.
Post/BQam Mach. Shear/Sheath Framing -Mach.
Plbg.Und/rlr/Slab F hg.Top Out Insulation -Elect.
Post/Beam Struct. Much. Rough-in Gyp. Bd. 431ug.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: A.M. P.M. En
Address: ri�.�-
Tenant: St : MST
� �/ SUP:
Con/Own:— MEC._
er PLM,
T FOLLOV dORRECTIONS ARE REQUIRE . ELR: _
V 7 -00
r-
G]
111
ns ector: _ Date
1 -
APPROVED __ DISAPPROVED/CALL FOR REINSP. CF CO
.w..v
City of Tigard PLUMBING PERMIT APPLICATION Plantk/Rec. #
13125 SW Hall Blvd. C-(3( Permit # .I'��-� = �:+,
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Nam.of°i"'`°m l New Single Family Residences Only
,lob ❑ 1 BATH Hr.USE$140.00 ❑2 BATH HOUSF$195.00
❑ 3 BATH HOUSE$225.00
Address zip i Fee includes all plumbing fixtures in ti a dwelling a, : ;ne first 100 feet
.,i,_ "�` r of water service, sanitary sewer and stcnn sewer. See fees below.
wm. 1.01katt . FIXTURES
QTY PRICE .41VIT
{ Sink 9.00
M."•Ad&-Q, Ph- Lavatory P.UU
Owner � LL1�{�c1 L Tub or Tub/Shower Comb. 1.00
CnyiMt. ZIP Shower Only 9.00
_r cf U Water Closet 9.00
N.-i..W.of w..,..i Dishwashar 9.00
Garbage Disposal 9.00
Occupant M.�y„d*... pna. Waashin5 Machine 9.00
Floor Dra'n 9.00
`ti^s"'• Water Heatb• 9.00
Laundry Room Tray 5.00
Urinal 9.00
`t }J � Other Fixtures (Specify) 9.00
Contractor �, •� } 9.U0
9.00
cMibr.n. ZM+
9.00
�'r ? ? � _ Sewer 1st 100' 3G.U0
W.I.r.g."o-Nn cny dn.n.N. Sewer-ea. Addit. 100' 25.00
•l q -L� �7 Water Service 1st J' 30.00
I hereby acknowledge that I nave read this application, that the Water Service er 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 IOU' 30.00
I am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, pleaba
give reason below) Mobile Home Space 25.00
Back Flow Prevention
Device or Anti-Pollution Device 9.00
91�• ""•0"' °Mi Any Trap or Waste Not
Conry^ted to a Fixture 9.00
i Describe work new (- addition Q alterL.,on Q repair 0 Catch B isin 9.00
f to be done resijentlal Q non-residential Q Insp. w Exist. Plumbing 40.00/hr
Specially Requested h spec;lcns 40.00/hr
Existing use of
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
v devices 15.00
F_. Proposed use of -
building or property
-� --'-' - "(Except residential backflow
co prevenf;on devices)
CD
4r NOTICE 'Minimum Fee $28.00 SUBTOTAL
�
PERMITS BECOME VOID IF WORK OR CONSTRUCTION -
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% ;URCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED J
FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS
COMMENCED PLAN REVIEW 25% O;"SUBTOTAL
TOTAL �Special Conditions Conditions _
Date issued by