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WgPECTION NOTICE
City of Tigard Building Department
124Y0 S.W.Main St.
Tigard,Oregon 97223
Phone: 639.4171
A
Type of Inspection
Date Requested �'"
_ 72{ Z'� Time A.M. / P.WI.
I Address
Permit #
Owner Lot # tr
13140c11er
The following Building Code deficie cies are required to be corrected:
-_
Phla"tw t0 r
L Approved
Insilo tW
L..I Disapproved
{ nate
CALL FOR REINSPECTION
❑ YES ❑ NO
CITY OF TIGARD Plumbing Permit
Building Department 3 6 7
Residential. Commercial No.
New Installation Replace El Addition Uj Alteration El Date�21-43
Licensed
Plumber Owner
AddressAle-,d Job Address 1,3 Li-5 -n
Phone -- YI--—.— Applicant
CITY 13','SINESS LICENSE REQUIRED FOR ALL CONTRACT(WITr
!�.D ,CONTRACTORS
—ITEM NO. FEE T0jj&L—. 40. FEE TOTAL
Fixtures-Traps 7.50 er:F' 30.00
Dishwasher 7.50 /,4qKE-4tV/AA16dit 00 ft. 1 15.00
W�
Garbage Disposal 7.50 CoorPumP A A.Ir 7.50
je
Water Healer 7.50—,—_LZ W96 r:"F"f t2r.00----
Backflow Preventer 7.50 Eac itA0A 1 5.00
Drai : ft.
---4
fh" &Rai DkaIrst 160 ft 1-1
Each Rai
1.. 0
r
Mobile Home Space A 25.00
Other(Specify): Rain Drain-Single Fam.Dwelling 15.00
PERMIT FEE Comments: -7
STATE % Issued By:
TOTAL • Receipt No. Applicant
SiqnalurO
For Plumbing Inspection Phone 6394171
Y-14c?
Address Ae Permit No. lav
Pcrmit charge
Owner- Z lci Aj(.c' Connection fee asp *4�
Paid by
Type of Building- Date connected
Service. Rate inspection fqe
Contractor Paid by---.— -Date
Size of connection Assessment Paid
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 1222 DATE
PURMIT IS GIVEN TO
N
OF
TO CONNECT A.
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST HE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED,
PERMIT FEE PAID ... . ... TIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPhOVFD
Date Superinteadent