InitiallyGood ADDRESS:
i ,records\microflmltargets\building.doc
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639.4175 Business Phone: 639-
Inspection:--
Footing
39-Inspection:Footing Susp. CeilAg Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech, Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing
Alarm Wac4r Line Insulation -Mech.
Underflr Insul. Shear Will Gyp. Bd. -Elect.
Date Requested: c�_ Time: AM PM
Address: ---
Builder: Permit
THE FOL-LOWING CORRECTIONS ARE REQUIRED: '
Inspector: Date:PTT/OAB(0�1VF OVED ,DISAPPROVED __APPROVED SUBJ
_Call For Reinsp.
CITY OF TIGARD
COMMUNITY DFVELOPMENT DEPARTMENT
1131125 SW Hall Blvd.Tigard,Oregon 97223*6199 (503)639-4171 PLUMPING PERMIT
DATE
� pmxcEL
-!Tt ADDR[3G. . . t 0771� SW ASHFORD CT
� 3UBDIVI8ION. . . . : ZONINGs R-4. 3
� BLOCK. . . . . . , . . . : LOT.
�
� -LASS OF W0RK, . uADD CARBACE DISPOSAL
� YP9 Or USE. . . . mSF WASNIN(i MACH. . . . . . ' v BACKFLOW PREVNTRS" . x1
� 1CCUPANCY 8RP. . tR3 7L8OP DRAINS. . ' ' . . TRAPS~ . . . . . . . . . . , . . o
�TORIES. . . . . . . . : 1 WATER HEATERS. . , . . . ; CATCH BASINS. . . . . . . :
LAUNDRY TRAYS, .
� SlNKS. . . . . . . . . ° � URlMALB. . . . . . . ' . ' ' ~' RAIN ~^''~`~^ ^ ^ ^ ^
OT}/Er� r,1XTUR�C. .
HOWEQS. . . ° : SEWER LINE
� �ATER CLOS-ET7. . WATER LTN[ ( ft ) .
lIBHWASHERG. . RAIN DRAIN (ft) . . . . x
�omsrks : lnstmlI residentia1 bmc14flow w-r-,vani; ian device.
]wner;
"NODSM-N type type amc^nt by
�1£ SW ASHFORD 8T PRMT $ 15. 00 JD /
-7712
55r,CT m 0° 75 Jr. 0�/��/�� 9� �6� c7�e
TIOA�� OR '
'�mntraztor�
'HOMr
45 C0113TRUCTION
PO BOX 912S3
\ pORTLAND OR 97�0�
— n #
City Of Tigan dlld PEMI� APPI.iCATIOM Planch�'Fec, #
13125 SW Hal! aA�, Permit # ;," `J s c~ 10
Tigard, OR. X7`2?
(503) &,-!-.,171
MINIMUM $25.00 PERMIT FEE+ST. SURCHARGE
rZaad.nca�inty --
� BATH HOUSE$i4U.00 ❑ 2 BATH HOUSE$193.00 !
0 3 BATH HOUSE CJ.25.00
Fee indrxles to plumbing flxturae in the dwetYng and the *m 100 faa4
i' of water ser ice. sanitary sewer and storm sawar, Sae few babes.
FIXTURES QTY PRICE _ AMT
k Sin --__.
9.00
Adl �— ^""' Lavatory — 9.00
Owner 5Qp7L .;� Tub or Tub/Shower Comb. 9.W
Shower Onty 9,00
_ Water Ck" 9.00 r
Dishwasher 9.00
Occupant Garbeys D*Posal 9.00
Washing Machine 9.00
Flow Drain --- _ 9.00
WowHeater 9.00
Laurxlry Roam Tray 9.00
Urinal 9.00
+�ys r,r Other Fatures (Specify) 9.00
Contisc3or Wbe a.... 9.00
f'G 91-2,'
9.00
_ 9.00
Sewer 1st 100' 30.00 --
own "` n'w ra"` Sewer-ea. Addle. 100' 25.00
/.3G/ __ _ Water Service 1st loin 30.00
1 hereby acknowledge that 1 have read this application, that the Water Service aa. AddlL 7.00' 25.00
Information given is rxxrect, that I am the owner or authorised agent of
the owner, that plans submitted are In rompliance .with Slate laws, that Stam&Rain Drain tat 100' 30,00
I ori registered with the Construction Confraictor's Board, Ihat the Stam a Rain Drain AddIL 100' 25.00
number given is correct. (If exempt from State registration, please
give reason below.) MobMa Hone Space 25.00
Bade Flow Prevention
Device or Anti-Polluflon Device 900
w.n�..n...qan -- - -"'or. ---
Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new () addition alteration (5 Catch Basin 9.00
to be done residential . nun-rosidendalY C) Insp. of Exist Plumbing 4O,pOmr
Existing use of Specially Req rated Insperthns , +40.00ft
building �r prep" D�(3 ` _—� Rai:. ^^sin, aing7y dwtililn9 30.00
Residential ,, -kflr nrriention
S;o
Proposed use of devio" 15.00�--
buikfing or property
-— •(Except rea/dande �"-w
- prevendon *"car
NOTICE *Minimum Fee:21LOO SUBTOTAL 6
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED VMIN 180 DAYS, OR IF 5%SURCHARGE ��t
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMI;ENCED. PLAN REVIEW 26%OF SUBTOTAL
AL S `
Special t.;orxiitlons
Date issued �' //`! by �✓ 5
CITY OF TIGAPI) R[`:C[' IPT Of. POYMENT RECEIPT NO. a 95—i?65,68 I
CHECk AMOUNT a 15. pli
NAME THOMAS CONETRUCTION CASH AMOUNT 0. olp
ADDRESS STEVEN R. THOMAS Vl(4YMFNT DATE 05 5i95
rio Box 912,83 SUBDIVISION
PORTLAND OR 972?1-49en
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
5-0110 1ri. 00 ST. BUILD PCR 0. 7'°)
II
771e SW ASHFORD ST
Ti"ITAL AMOUNT PAID .5. 75