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j„l STt(ZTI91 NOTICE ��Z
City of Tigard BuA ldLng D partw mt
13125 SR Hall Blvd. Tigard, ors," 97223
Inspection Line (Rec-O-Phone)c GM-4175 Business Phone: 639-4171
i
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top O::t Cas Line wN1AU;t�
Post/Beam Struct. San. Bower Framing -Bldg.
Past/Roam Mech. Rain Drain Insulation C MAX i
Plbg. Underfloor water Line Gyp_ Ed -Hoch.
Date Requested:--
Time: ---ANPM
Addross: u J�_
Permit #I&
Builder:��(i,''
THE FOLi.OWXKG CORRECTICNS ARE REQUIRED:
7
Inspectors: _ Datet
4APPROVED DISAPPROVED APPROVED SUBJECT TO ABGVE
--Call For Reinsp.
CITY OF TIGARD
COMMUNITY OEVELOPMENT DEPARTMENT
13125 SW Heil Blvd.Tigard,Oregon 97223.8199 (503)03t-4171
PLUMBING PERMIT
PE:RMT T #. . . . . . . : PLM94- 17121716
639-4171 DATE ISSUED: 09/12/94
PARCEL: 2S 1 1*'CA-09,x;00
C;I TE ADDRESS. . . : 07510 SW ASHFORD ST
SUBD I V i S I ON. . . . : RENA I SSWNCE: WOODS ZONING: R.-4. 5
BL.00K. . . . . . . . . . . LOT. . . . . . . . . . . . . : 19
--------------------
CL.ASS OF WORE!.. . :ADD GARBAGE DISPOSALS. . : ML9I LE HOME SPACES. :
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : BACKFLOW PRr'VNTRS. . : 1
OCCUPANCY GRP. . :Ru FLOOR DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . . .
STORIES. . . . . . . . .2 WATER HEATERS. . . . . . : CATCH BASINS. . . . . . . :
FIXTURES--___. _________ LAUNDRY TRAYS. . . . . . : SF RAIN DRAINS. . . . . :
SINKS. . . . . . . . . . . URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . . .
LAVATORIES. . . . . : OTHER FIXTURES. . . . . :
TUB/SHOWERS....— SEWER LINE: (ft ) . . . .
WATER CLOSETS— : WESTER L INV. (ft ) . . . .
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . .
Remarks : SPRINKLER SYSTEM
weer: --_._----__.____._____._______ FEES
HOMEOWNER type amount by date rer_F.)t
'7510 5W ASHFORD ST PRMT $ 15. 00 JG 09/12/94 -
5PCT # 0. 75 JG 09/12/94
TIGARD OR 97224
Phone #:
Cont r ar.t or: ---___-._--------_ _-__-----_-_-
THOMAS CONSTRUCTION
PO BOX 91283
PORTLAND OR 97291 --------------------------------------
Phone
__-__----__-_--___-___-__-____----_--Phone #: f 15. 75 TOTAL.
Reg #. . r 1 027
----- REPUTREED INSPEwCTIONS
This permit is issued subject to the regulations contained in the RP/Backflow Pr-ev
Tigard Municipal Code, State of Ori. 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 198 days of issuance, or if work is suspended for more
than 180 days.
Permittee Signature-
Issued
ignature:Issued By :
Call for, inspection - 639-4175
I
City of Tigard 7WMEING P:+_ .M!T APPLICATION Planck/Rec. #
1312153W Nati I;;io. Permit # .��0 b"L 0 (P
Tigard, OR 9%t,3
(503) 639-4171
'AINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Now S!nele Family Posidences Onty --
1
L ' BATH HOUSE$140.00 ❑ 2 BATH HOUSL$195.00 l
Job � !� 0 3 HATH HOUSE S22.5 0C !I
Address �eirnw'�'/"�'� '�" irr" Fee inrJudey all plumbing fbcturas In Lie dwelling and the flisi 100 feet
of water service, sanitary sewer and storm sewer. See fees below.
FIXTURES OTY PRICE AMT
Sink 900
"""' �sm Lavatory 9.00
Owner _ Tub or"rub/Shower Camb. P 9.00
m Shower Only 9.00
Water Closet 9.!J
Dishwasher r 9.00
Garbage Disposni 9.00
Occupant Mrq wx.,..�--' -'- we... Washing Machine 9,00
Floor Drain 9,00
Water Heater - - 9.00
_ t Laundry Roan Troy 9.00
Urinsi - 9.00
Other Fixtures (Specify) 9.00
°°"». """' 9.00
Contractor
O, 0* 3 9.00
hL� 9.00--
611-
.00
61'- / Sewer list 100' 30
0.0
`ww"ftoft No. °q a..to"" Sewer-ea. Addle. 100' 25.00
Water Service 1st 100' _ 30.00
I hereby acknovrledge that I have read this application, that the Water Servlce ea. AddR. 200' 25.00
Information given is corre-1, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1sl 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm 3 Rain G7rain Addit. 100' 25.00
number given Is coriect. (If exempt horn State registration, please _
ghee reason below.) Mobile Home Space 25.00
Back Flow Preventkrn
Devld3 or Antl-Pollution Device 9.00
�'b"" •�°"'"'"'0"n °"� Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new -iddRion o6ration 0 repair 0 Catch Basin � g rn
to be done residential Q non-residential Q Insp. Of Exist. Plumbing 40. v
"m Specially Ruquesttd-In.•ne t4nns 40.00thr
Existing use of ---
building or proparty _ �T __^ Rain Drain, sing, fanny ,; ClIng 30.00
Residential backflow p.+ti:L. r
devices 15.00
15.00
Proposed use of -
building or prol.*rty
"(Fl�rcrrdbacklit.
11 prarwinMttlon on d@Wcewlcsa)
"UTICE *MI ilmum Foe $75.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF BY,SURCHARGE
CONSTRUCTION OR WORK IS SUSFENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
C')MMENCED. Pt AN RCVIEW 25% OF SUBTOTAL
TOTAL
Special Condition
_ C^te issued by
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~ . ~
'
' LllY (IF TlOAK) - Hl-I.fIf,| /U Pvi v I'll NT REUEIP[ h4i :94-����4�
CHECK AMiAJN[ u \15. 75
NOW MOMPGCOW-iTHUCTIUN CASHAMOUNT : 0. 00
A/)|`RV95 , PArM�Nl Qp|F N9// 94
8U8DlVl8I//N v
PUuP`Dsi� or PAYMENT AmOUN[ PAI ) PURP"/gF OF PAYMFNT AMLd/Nr POW
PE_________
RM 15. (ALA ST. BUILD PER IA. 7b
BACK[L8W DEW8C6 '
75169 8W ASHFORD 87 �
lnTAL #MOLINr PAID IS �
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