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1311U SW FALCON RISE DRIVE
CITYOF TIGARD _ PLUMPING PERMIT
DEVELOPMENT SERVICES PERMIT#: P 00152
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/113/99 3i99
SITE AD!),RESS: 13'110 SW FALCON RISE DR PAR:EL: 1S133DC-03900
SUBDIVISION: MORNING HILL NO.1 ZONING: R-4.5
BLOCK: LOT: 032 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Residential backflow preventio❑ device
FEES
Owner: —
-- —' – Type By Date Arnol.int Receipt
STAFFORD, LYNN & BECK PRMT BON 5/13/99 $15.00 99-315357
13110 SW FALCON RISE DR ` C BON 5/13/99 $0.75 99-315357
TIGARD, OR 97223 MIS —
Total $15.75
Phone 1: 524-5026
Contractor:
GROWCO LANDSCAPING
KEITH M SEE
164 HARDING BLVD REQUIRED INSPECTIONS
OREGON CITY, OR 9704✓ - -- --
RP/Backtlow Preventer
Phone 1:
Reg #: LIC 00006895 Final Inspection
PLM 10497BFL
0Ririn! �i, l_
This permit is issued subject to the regulatie is contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable law, All work will be done in accordance with approved plans.
This permit will expire if work is not started w;thin 180 days of issuance, or if work is suspended Tor more
than 180 days. ATTENTION: Oregon law :eqt ires you to follow rules adopted by the Oregon Util;ly
Notification Center. Those rules are set forth � i OAR 952-0001-0010 throug 1 0 "AR A52-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued BY: �^�ll 1,�_-Y u�l-V 1.-�- Permittee Signature:.
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
J � i
'Y OF TIGARD RECEIV(-� Plumbi.ig Application � � , 1 Recd By )u
125 S1►'J HALL BLVD. 'Commercial and �esidzntia► 0810Rec'd -1Z -_
3ARD, OR 97223 MAY 1 0 19grDate to P E.
::3) 639-4171 !0 to DST
COMMUNITY UEVELUPME141 Permit• OLE=-- i7jZ_
Print or Type Reiated SWR s
Incomplete or illegible applications will nc,t be accepteel tailed
Name of D-iveaapmen iP.ptact FV UREBjln.dlvldual) !!7(12 Job sink AddrQss Street Addross sults L"i1on'
Tub w Tub/Sho~Comb.
9.00
Bl1g a City/State by Shower Only 900
--- Narrne Water closet 9.00
ti pi 4 ,i R V V 4�:-D DWmashw 9.00
Owner Mn9 Addwas
Suite Garbap Clleposal 9.00
'i71 ! r N li WsslWnp Medlkne 9.00
City/stale Zip Phone Flow Orson
F4-'
. .
900
11c
9.00
9.00
Occupant "V"w mdress Sude Wear Hester
Lour ky Room Tray 9
City/mate ZIP Phone Urinal
.00
9.00
yh Name Other Fixtures(Specify) 9,00
I
9.00
Contractor mailir 9 AddOess sun: 900
�a '1UINE -
rkw to issuarnce cdy/Staa Zip Phom 9.00
applicant must LAN , / �{J�14 9.00
provide all 011`990111Const.Cont.Berard 1.1c.0 Exp.Oats 9.00
contradtxa ,, i r' 2 25� O[� - 9.00
license L►r= Exp.Das Sewer-1 st 10(r -
informatkxt
for COT COT eusneas Tao'rx aaloltro• Sanies -each additional 10& 23.00
O 30.00
y Exp.Dale
database). �'L�i'U 0 t F Waw Service-ist 100' 30.00
Nana - Water Service-each additional 200' 25.00
Architect Stour,&Ran Oman-t-,t 100'
or M&'a09.tea Suite StOrtn d Rar Oran-seta stiditi0rnal lar 25.00
ire Hans Space 25.00
engineer GtyrStaM Zip Phone Commercial Back Flow Prevention DOwce or Anti- 25.00
I _ _ Pollution Device
anbe work New 9� Addition O Alteration O Repair O Residential Backfbw Preventkxt Dewce• / 15.00
7000: Residential 9' Non-fesidenbal O l!�
oval description of worn Any Trap or Waste Not Connected to a Facture
9.00
l P1�i'1 A V1.-Pc1 1 Gt-� C 1ch Basun ---
c�r9.00
Insp of Exosting P1uniMnq --
40.00
Specialty egtiested R 40,00
,nig use of Sinspections 40,00 -
iding or Props',,_ 21GGi\I7Fzh1�]�V -- Rain Dram,single tamitr dwetliN - perfhr
30.00
,nosed use of "�7�� Grease Traps --- 9.00
,Iding or property 1-•rl7t (2L t,3TI r°t L--
QUANTITY TOTAL
rou capping, ma,nny or reptwvq any bRures7 Yes QF No p Isometric(W riser dingram is reaurw R owney tow a �9 :k,
Yes see back of forth) *SUBTOTAL _••
,rpb),acknowledge that I have tad this application,that the information
S c0lIM that I am the owner or authorized agent of the awnM.and 5% SURCHARGE
aneithd in comoliance with Oregon State Laws. _ - raJ
n t7- Ao'f�nt Osa PLAN REVIEW 25% OF SUBTOTAL
I -- 4eaur"onN f Rahn_ sty total rte>_9 -
l TOTAL
t Person Name phots
wry; rI uMinimum permit fee a$25-5%su0c�narge.except Residential Backflow
JuIrr Lobo L-1 Pu- ft,'(� -1 I iPrewnnon Device,which is 515.5%suricharge
I:'plmapp.doc 12.96 (dst)
! EASE QONIPLETE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced Oty
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
:OMMENTS REGARDING ABOVE:
L: plmapp.doc 12'96 (dst)