Permit _UrI
•
NG P PERMIT
CF1Y OF TIGARD
DATE I ISSUED: 01 / 19/966- Dv117
COMMUNITY DEVELOPMENT DEPARTMENT •
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 1 S 125DD- 0560111
SITE ADDRESS...: 09870 SW VENTURA CT
SUBDIVISION ° WASHINGTON SQUARE ESTATES NO.2 ZONING: R -4.5
BLOCK ° LOT .64
CLASS OF WORK. ,:ADD GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE °SF WASHING MACH 0 BACKFLOW PREVNTRS.. s 0
OCCUPANCY GRP..:R3 FLOOR DRAINS . 0 TRAPS • 0
STORIES 0 WATER HEATERS.....: 1 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)..: 0 •
WATER CLOSETS..: 0 WATER LINE (ft)...: 0
DISHWASHERS.... 0 RAIN DRAIN (ft)...o 0 ' •
•
Remarks: Install hot water heater '
' Owner: - •- •-- - - - - -- •- - - - - - - --
DAVID SODERQIJIST type . amount by date recpt
9870 SW VENTURA CT PRMT $ 25.00 JSD 01/19/96 96- 275104
5PCT $ 1.25 JSD 01/19/96 96-275104
TIGARD OR 97223
Phone #:
•
Contractor: - - - --
HEATING SPECIALIST
9300 NE HALSEY -
•
PORTLAND OR 97220 - - - - -- - - --
Phone #tl 257 -7000 $ 26.25 TOTAL
Red #..0 056628
REQUIRED INSPECTIONS
This peroit is issued subject to the regulations contained in the Misc. Inspection ---
hoard 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 pereit will expire if work is not started - -- _
within 180 days of issuance. or if work is suspended for, pore ___________
than 180 days.
_________
Permittee Sign tree •
Issued P
• Call for inspection - 639 --4175
•
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•
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City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125; SW Hall Blvd. Permit # ('e. -- 9 - °-
• Tigar OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Ne.ne a1 Ownio New Single Family Residences Only
Address 0 1 BATH HOUSE $140.00 0 2 BATH HOUSE 5195.00
Job g p z_to U e tia, (LZ 0 3 BATH HOUSE $225.00
Address wsm ar Fee includes all plumbing fixtures in the dwelling and the first 100 feet
•...2C Lek, 9 7 .2 .23 of water service, sanitary sewer and storm sewer. See fees below.
Nome (at Kama a a°"'°) 02 4 -5 3 ( FIXTURES QTY PRICE AMT
, 1 1 . . v Sink 9.00
Wing Pots= Phone Lavatory 9.00
Owner 9' $ 7 n 5 co Li2� iz�a_d CA, Tub or Tub/Shower Comb. 9.00
ctwsNe. no Shower Only 9.00
ts-Vc� .-4. 9 7 2-2-3 Water Closet 9.00
None (e, nem of banns) Dishwasher 9.00
Garbage Disposal 9.00
Occupant ,r,r,o#,,,,,, Phan. Washing Machine 9.00
Floor Drain 9.00
mow. ao Water Heater 9.00 9 v v
Laundry Room Tray 9.00
Nem .. 5 7 - 70 0 o Urinal 9.00
,9_/zx., Asis2_e n,� k j , �ie.,,z_C Other Fixtures (Specify) 9.00
rwiq hose' °""" 9.00
Contractor
9.3o a y) E A/ _y, 9.00
CROW. ao 9.00
pcn. -ti , (2_,L, 9 7 �...),3 Sewer 1st 100' 30.00
Mats Rasulnalen No. city eus. T° M. Sewer - ea. Addit 100' 25.00
2 (o '4-1 1 4 PO . Cc is S(0 G, 2-g 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
Back Flow Prevention
cti� _ / 9_96 Device or Anti- Pollution Device 9.00
^� Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new Q addition 0 alteration 0 repair 0 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 S
building or property C . 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 2 Soo
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE /
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 26 -F
Special Conditions
Date issued by
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location 7 ?w g/6 Suite MEC 76 — 60/ I
Contact Person PLM 76 --6(7 d 7
Contractor Ph SWR
BUILDING Tenant/Owner C��� e c / 15o e c_ t ELC
Retaining Wall �d d n e° h on r ELR
Footing
F c C ,3,:
Foundation NOT REQUESTED FPS
Ftg Drain FOUND DURING RESEARCH SGN
Crawl Drain
Slab NO INSPECTION(s) IN FILE SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation •
Drywall Nailing
Firewall
i ex/...z.,
Fire Sprinkler 4""
Fire Alarm
Susp'd Ceiling 411 ... i .IA /
Roof ' 7 / ,/ /P f p
t (V1/
- ASS PART FAIL / ( 2 ��i`
,z 6 . ,...„, , PLUMBING
Post & Beam ) ------- ) ------- Undder Slab
Top Out
Water Service
Sanitary Sewer
Rai Drains
PART FAIL
M HANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
r PART FAIL
CTRICAL
Service •
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk f
Other Date I r Insp ec t o r `i` Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. -