13672 SW LAUREN LANE-1 � 1
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13672 SW LAURM LN ...
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard,Oregon 972,'.3.5199 (503)539.4171 PLUMBING PERMIT
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PERMIT #. . . . . . . . f-11193--I11,iJ.1ii
F.3:) 4171 DATE` ISSUE r r. 1.0/16/95,
PARCEL: 201 a 14GA-013 00
L TE ADDRE47S. . . : 17,672' SW L_(.+UREN LN
,UBDIVISION. . . . : HILLSHIRF_' ZONING: R-7 PD
BLOGI... . . . . . . . . . . LOT. . . . . . . . . . . . . :035
CLASS OF–wnp)-�. . :N1=W_-- GARBAGE DISPOSALS. . : MOBILE HOME_ SPACES. :
TYPE OF' USE. . . , :ESi= WASHING MACH. . . . . . . : BACRFL.OW RRE:VNTRS. . : 1
Or;CLJPANCv GRP. . :R3 FI_E:IOR DRAIN7. . . . . . . . TRAP'S. . . . . . . . . . . . . . .
ST0R I Els. . . . . . . . :2 wriTlE R HEATERS. . . . . . : CATCH BASINS. . . . . . .
F I X'TURErS------------ LAUNDRY TRAY;. . . . . . : SFS RAIN GRAINS. . . . .
SINKS. . . . . . . . . . a UR I NG '_S. . . . . . . . . . . . . GREASE: TRAPS. . . . . . . .
I._)VAT'ORIES. . . . , : OTHER F-IXTURF a. . . . . :
TUB/SHOWERS. . . . : SE=WE=R LINE (ft ) . . . . :
WATER CLOSFTS. . : WATER LINE ( ft ) , . . . .
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . . :
Remar^I-(s : It-t-iyati.on backflow prevention device
Owner: ----..._._.-_._....__._.._.._____..__._...__ _...._._.__. _._.__...__.__..__.____–_..---._._.–__.___
FEES
()USTIN type amal.rnt by (date recpt
1562'9 SW 14911A F'L PRMT $ 15. 00 GTR 10/16/95 9`--271699
5PCT $ 0. 75 GTR 10/1.6/95 95-1271699
Phone #:
Ccint r-actor- :
AlJF3T I N IAOMCS
15629 c--")W 149TH F'I_
1IGART1 OR 590--0658
Phone #: 590 -065R f 15. 75 TOTAI.
f?era #. . - 77439
REQUIRED INSPECTIONS -This permit is issued subject to the regulations -ontained 1n the RF'IB;—,ckfIow Pi' e — _ .•_•,-______--�_, „_,.
Tigard Municipal Code. State of Ore. Specialty Codes and all other Final. Inspec:.tion
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is nct started
Within 180 days of issuance, or if work is suspended for more
than 180 days.
Ri mittee '�iynat�_rre :
d By
Call for- inspection – 639--4175
City of Tigard PLUMBING PERMIT APPLICATION PlancklRec. #
15125 SW Hail Blvd. Permit # 7/0
Tigard, OR 97223
(503) 639-2,171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
�•m• '�•°•'^•^' Now Sinale Familv Residences Only
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MRM ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Job �'z(, �� ti ❑ 3 BATH HOUSE$225.00
Address awm.t. zip Fee includes all plumbing flxtvres in the dwelling and the first 100 feet
of water service, sanitary sewer and storm sewer. See fees below.
N.m.ra nrn..r S"••'•••i
FIXTURES QTY PRICE AMT
Sink 9.00
MMnp MRM °^0°• Lavatory 9.00
Owner (r• l T ib or Tub/Shower Comb. 9 00
M^•• �^ P rower Only 9.00
"later Closet 900
�... . .°,..1.. —�-}-� D, washer I a00
Garbage Disposal —1 9.00
Occupant M.i,d AM M- Washing Machine 9.00
Floor Drain 9.00
w,m+• 7 Water Heater 900
Laundry Room Tray 900
N.— Unnel 9.00
�� r 1tj� Other Fixtures (Specify) 9.00
MNny MRM °r'°,» 9.00
Contractor c 3
Sewer i st 100' Jo
•'•P.O.--,� �" • '•�N.
Sewer -ea. Addit. 1n0' 25,00
Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application. that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authorized agent of
the owner, that plains submitted-we in-sampliance with State laws, that Strrm &Rain Drain 1st tOD' 30 0D
I am agistered ttla�struction Co,itracr?N's Board, that the SloTo & Rain Drain Addit. 100' 25.00
numbergi en i re (If exempt .om Stab,)registration, please
giv reasa b ow.)
Mobile Home Space 2500
r Back Flow Prevention
Device or Anti-Pollution Devict 900
v• • .w w w.nr "^ Any Trap or Waste Not
Connected to a r;xture o 00
Describe w rk new Q addition alteration repair O Catch Basin 9.00
to be done residential Q non-residential O Insp of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr
r:+cisting use of Rain Drain. single faro ly dwelling 30.00
building or property — _
Residential backflow prevention T
de4ices / 15.00 J ,�
Proposed use v.
building or property -- (Except residential backflow
prevention devices)
NOTICE Minimum Fee $25,30 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5°/n SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED -- ---
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 75°/n OF SUBTOTAL. 7
TOTAL S,?
Special Conditions
Date ssued
7
CITY OF TIGARD 13UILDING INSPECTION NOTICE
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Inspection Line (Rec-O-Phone): 639 4175 Business Phone:
Inspection: Appr/Sdwlk
Susp. Ceiling
Footing Fireplace
Sprink. Roug
Mg.
Underslab Mech. Rou
Foundation FINAL.
g Top Elec. Rough-in
Post/Beam Struct. p Out
Gas Line
Post/Ream Mech. San. Sewer lumb)
Plbg. lJnderlloor
Rain Drain Framing _r
Water Line InsulatiOn
Ala'ri G Bd. -Elect.
Underllr. Insul. Shear Wall yp'
Time'. AM PM
Date Requested:
�
Pel hfit4T
Builder:--,_
c(
THE FOLLOWING CORRECTIONS ARE REQUIRED:
--------'--— r--- i—
Date r
_APPROVED —__DISAPPROVED __APPROVED SU[3JECT TO ABOVE
Call For Reinsp.
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