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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection L ne (Rec-O-Phone): 639.4175 Business Phone: 639-4171
Inspection: �Q CZE k4 /y LJ
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/c3eam Struct. Plbg. Top Out Elec. Rough-inFINAL;
Post;Beam Mech. San. Sewer Gas Line
Plbg. Underfloor Rain Drain Framing tPI—um b ,
Alarm Water Line Insulation -Mech.
Underfir. Insul, Shear Wall Gyp. Bd. -Elect.
Date Requested:__ _�-_ //9�_Time: AM PM
Address:�S
Builde•: sa Ir a-9 U G117/ Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:��
Inspector: Date:
v
1---'A'PPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
__Call For Reinsp.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)831t-4171 PLUMBING PERMIT
PERMIT 0. . PLM)': 01. 1.
G.?9--4171 DACE ISSUED: 06/211/95
r F'F�RC['I_: ;�'a 1 1.'CN �?k3(►2�QI
ADOrESS. . . : 17)'7'174 "W ASHFORD GT
3USDIVIE"ION. . . . : RENAIISSANCE_ WOODS ZONING: R-7
:iL"lCl;. . . . . . . . , . . LOT. . . . . . . . . . . . . s 10
'i..r
OF Worm,— -.ADCI GARBAGC. 10T11POSALa. . : MOBILE HOME.' SPACES,
rYr'E CSF-- USE. . . . tSF WASHING MACI•I. . . . . . . t BACKFLOW PRi VNTRS. . : 1
;CCUPONCY C RID. . .Ci?, FLOOR DRAINS. . . . . . . s TRAPS. . . . . . . . . . . . . . .
STORIES. . . . . . . . :a, WATER HEATERS. . . . . . : CATCH BASINS. . . . . . . .
1'IXTURES- - LAUNDRY TRAYS. . . . . . s SF RAIN DRAINS. . . . .
INKS. . . . . . . . . . .. URINALS. . . . . . . . . . . s GREASE: TRAPS. . . . . . . .
.AVATOnIES. . . . . . OTHER FIXTURES. . . . . .
_UB/al•1014tR '►. . . . : SEWER LINE (ft ) . . . . :
DATER Ci._OGET . . : WATCR LINO: (f+ ) . . . . ..
'IISHWASHERS. . . . „ RAXN DRAIN (ft ) . . . .
liemarks : INSTALL LkACKi`LnW >vIwIJICC
lwnel.. _._.. ......__._. _ ...._. .-._ _.__..-..__. .._._....._..._.___.___ FEES)
•1AKOT0 yPKAGUCiit tYPe amount by (iat. P r�1c:pt
574 SW ASHFORD STREET PRMT t 2 . 00 r',iJ 06/211/95
SPIET $ Icy. 7t-i SW
"TCARD OR 97084
'hone #t
�Iontractor,t _._...____ ..___...._..__. _.. .._, . ....._. ....._
ANEP
".I—np 'tiff: 15. 7r TOTAL
F# #. . . 2+0(000
REQUIRED !WSPECTIONS
"his perait is issued �Ibject to Pit regu"Oicns cvrtained in the Rr" i3ackflow 01,er
-iovI k-unicipal Code. "Mate of CMB. Spe:iolty Codes and all athe• F"i na) Inspection
applicable laws, All Mork will be done in amordacoi with
-pproved plans. This perait %i*,l expire J Mor is not staa'ted
-,ithin 180 dogs of issua-:ce, or if work i� suspended for sore
nan IN days. -- .._.. .._..
._.. ..Ii.1ttE
Gall fnr inspection 639 4175
City of Tigard PLUMBING PERMIT APPLICA CION Pland/Rec. #
13125 iW Hall Blvd. Permit # �
Tigard, OR 97223
(503) 639-4-171
MINNUM $25.00 PERMIT PEE f ST. SURCHARGE
Niii1Qi"'*"°" !slew§Ingle FamIM Rerwmcss ring
lit
"""" O 1 BATH HOUSE$140.00 0 2 EATT-i HOUSE$198.00
Job l� � 5-N S a 3 BATH HOUSIE 5228.00
Address ori. Fee kK*Kbs of pkat" fbdurest in the dw*the and the fist 100 feet
7� r N, VR S7 2 L y` of water service. sanitary sewer and ato mi sewer. See fees below.
ftm Iw*"`N O""" w ) FIXTURM QTY PRICE AW
'VI/�k�Ty SRkl1�, V cN/ Sink 9.00
me"^� �� n.e lavatory 9.00
Owner s�the R S ti l t-1+� Tub or 7ub/5 Comb. 9.00
w V0 Shower Onl; 9.00
Water Closet 9.00
Dishwasher 9.00
qtr nano 6�4 lig f Gs, . Disposal � 9.00
Osxxrp�srrt vvssh(v Mach:ns 9.00
Floor Drain 9.00
Water Heater 9.00
Laundry Room Tray 0.00
Urinal 9.00
iJ / e1 Other Fbctures (Specify) 9.00
W.""'"" P"_ 9.00
Contractor
9.00
9.00
Sewer lot 100' 30.00
�"^"�""""• _�__ mr b.To"" Sewer-ea. Addit. 100' 25.00
Water Service lot 100' 30.00
I hereby acknowledge that I have read this ap0cation, that the Water Service so. AddiL 200' 25.00
information Ftvtn is correct, that I am the owner or authorized agent of ------
the owner, that plana submitted are in compliance with State laws, that Storm it-Rain Drain 1st 100' 30.00
I am regWersd with this Constructkm Contractor's Board, that the Storm 8,Rain Drain Addit. 100' 25.00
nwrbsr given is correct- (If exempt from State registration, please
give reason beloar.) Moblis Homs Space 25.00
Bads Flow Prevention
�i Device or Anti-Pollution Device 9.00
'�"�'•r'r"' �e"^ 0ow Any Tromp or Waste Not -
Connected to a Fixture 9.00
Describe worts nowitbn alteration rep - Catch Basin 9.00
to be done residential non-residential Q Insp. or Exist. Plumbing 40.00/hr
4peclally Requested Inspections 40•001hr
Existing use of �//•• --
building or property i)>'_Si[tel t t ti CL _ Rain Drain, single family dwelling 30.00
F
lesidenbsi backflow preventiondevkx9 15.WProposeduse of / ,_._�
building or property A / (7�+t U2 --
*(Except res/dsntYa!L>rrciMow
��� Wvvendon davrsts)
NOTICE *Nnimum Fee $26.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5% SURCHARZIE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A P£RK)D OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25'i* OF SUBTOTAL
IOTAL
Sped&! Condlticns
Data issued
i+_ __a .. �...��,�.._. .�_ _....�...�....�. _..,.�.... �._�_......��..._�..��.�. .�....�_��..-........�—�_��—.._—._.....�..._ _....�._. .._......._�__
i
i
I Y OF T f SARr. — kECE I RT OF PAYMENT RECEIPT NCI. e 95--266 10 7
I CHEF,K AMOUNT 15. 75
NOME § + HKC'7UCHT, 'IAKOTO CASH AMf31.11SH a 0. 00
Ai. DQ t 7574 :3W ASF i GIRD STREET PAYMF NT DATE s 0E P7,1 /95
TIGARD, 0't SUBDTUTSION n
97,:'.'4—
PURPOSE :,;= PAYMENT AMOUNT RAID PURPOSE Or PAYMENT AMOUNT PA 11)
Pt_111ABINf3 PERM RL.M9T5' t�11f3 i . OQ+ f7» E41�I�I) F�EK 0. 75
I
I
757if SW ASHFORD >,TREET
TU'rm. PMOUNT PAID
INSPECTION NOTICE 1
City of Tigard Building Department
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639--4175 Business Phone: 639-4171
Inspection:__ �---,__---- — _,—
Footing Plbq. Underniab Mac i. Rough-in < Appr/Sdwlk
Found. Plbg. Top out Gas line FINAL-
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor. Water Line Gyp. Bd. -Mach.
h (y
Date Reques
ydsy -"Pz" Cl Time: �, AM /_�,_PM
Address: ��/Ll ��, Permit 1:
BA)iider: ! �.� L.4-,c —
THS FOLLOWING CORRECTIONS ARE REQUIRED-
Inspector:
11PPROVlD DISAPPRO PROVED SUBIECT To ABOVE
Call For Reinsp.