Permit •
NG PERM
OF T ����
COMMUNITY DEVELOPMENT DEPARTMENT
PARCEL: 2S111BD 02700
1�1 .r�a�. OreOregon_ «� mr000°ome Ju eoo� —
SITE kDD . : 14b50 SW 9 639639-4171 AVE
SUBDIVISION....: CLOUD CAP ZONING: R-3.5
BLOCK..........: LOT ^9
_______ _
CLASS OF WORK..:REP GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE.... :ED WASHING MACH......: 0 BACKFLOW PREVNTRS.. : 0
OCCUPANCY GRP.. :E1 FLOOR DRAINS.. .. .. : 0 TRAPS.. ....... .. : 0
STORIES........: 1 WATER HEATERS ^ 0 CATCH BASINS : 0
FIXTURES--- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS ^ 0
SINKS..........: 0 URINALS °' 0 GREASE TRAPS.......: 0
LAVATORIES.....: 0 OTHER FIXTURES ^ 0
TUB/SHOWERS ^ 0 SEWER LINE (ft)...: 100
WATER CLOSETS..: 0 WATER LINE (ft)...: 0
DISHWASHERS....: 0 RAIN DRAIN (ft)... : 0
Remarks: Repair 10' of sanitary sewer line
Owner: — FEES
TUALITY MIDDLE SCHOOL type amount by date recpt
14650 SW 97TH AVE PRMT $ 30.00 B 12/11/95 95-272760
5PCT $ 1.50 B 12/11/95 95-272760
TIGARD OR 97224 •
Phone #:
Contractor:
CONTRACTOR NOT ON FILE
Phone #: \ $ 31.50 TOTAL •
Reg #..
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Sewer Inspection __
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection __
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 moro • —
than 180 days.
•
Permittee Signature:
Issued By: yrl
Call for inspection - 639-4175
•
•
' „
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection: IN
Footing Susp. Ce ing Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post /Beam Struct. Plbg. Top Out Elec. Rough -in FINAL:
Post /Beam Mech. 4 ' Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing - Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. Elect.
Date Requested: � / � Time: A , PM
Address: / qc cd / 7 ( .
Builder: (e) X .3 701/4...c Permit #: ( i 1 — 3 7J
THE FOLLOWING CORRECTIONS ARE REQUIRED:
/6Z ‘ +ke-C—Irk
ze6
Arxrdiri
1
W - y
Inspector:,2M - Date: -
APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection:
Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post /Beam Struct. Plbg. Top Out Elec. Rough -in FINAL:
Post /Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing - Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. - Elect.
Date Requested: Time: AM PM
Address: - 7 -` t JQZ ‘AA. Cc\ e ' lQ
Builder: \Q( b 5\ � ck.li Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
\iLAC57...9 C-4.--: 4 \---.4 - : Q .... 0\j--ct
C • .4-- -0- .
1 Z . .....0-0J ) ...,C .e‘/*---.-e)..) -0...-"P-4-0—,"-V v•----Js.43
Inspector: Date: 2_ ( 3/ 4 .r
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE .
/-0■._6 _Call For Reinsp.
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 'SW Hall Blvd. Permit # (
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
7 1- z Development l d je - / New Single Family Residences Only
� ( ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job /G��So S( t) 9 7 �` ❑ 3 BATH HOUSE $225.00
Address city/stet. rm Fee includes all plumbing fixtures in the dwelling and the first 100 feet
�j . ( ) . 2. e ,q2e71 of water service, sanitary sewer and storm sewer. See fees below.
Name (or name of Busitess) _ FIXTURES QTY PRICE AMT
(s )Y\r) 0 ( : (x`54 . )i? ■ Sink 9.00
Meing Address Phone Lavatory 9.00
Owner Tub or Tub /Shower Comb. 9.00
City /State za Shower Only 9.00
Water Closet 9.00
Name (or name of business) Dishwasher 9.00
Garbage Disposal 9.00 .
Occupant Main Address Peon. Washing Machine 9.00
Floor Drain 9.00
City /State pa Water Heater 9.00
Laundry Room Tray 9.00
Name -, ��� Urinal 9.00
/Yes <-,...e ,D � l Other Fixtures (Specify) 9.00
Meiotg Address Phone 9.00
Contractor G C
.2T6S5 5 co ,&..Zt°��� 9.00
City/State
We/ tc ��
9.00
W ,S'cyr/v� � �r � a Sew er 1st 100' �p � � 3 0.00 �
State Regfatretion No. 'BB u s. T �_ Sewer - ea. Addit. 100' 25.00
6 77 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 plans submitted are in compliance with State laws, that Storm & Rain Drain 1st 100' 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, please
give reason below.) Mobile Home Space 25.00
J.,41 Back Flow Prevention
/ 62-l(-95 Device or Anti - Pollution Device 9.00
Signature fowler or agent) Date Any Trap or Waste Not
� Connected to a Fixture 9.00
Describe work new 0 addition 0 alteration 0 repair �J Catch Basin 9.00
to be done residential 0 non - residential 0 Insp. of Exist. Plumbing 40.00 /hr
• . Specially Requested Inspections 40.00 /hr
Existing use of
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of
building or property
'(Except residential backflow •
prevention devices)
NOTICE °Minimum Fee $25.00 SUBTOTAL • t7°
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE ( 6°
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL /,
TOTAL 7 D (, 5
Special Conditions
Date issued by