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INSPECTION NOTICE
City of Tigard Building Department
13125 SA Ball Blvd. Tigard, Oregon 57223 ;t
Inspection Line (Rec-O-Phone): 639-4175 business Phone: 639-4171 a,
Inspection:.�_11�1_� nL•��r�V�� V� r �_ ( 1�\
Footing Plbg. Undermlab Mach. Rough-in ;ppr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL-
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Un erfloor Water Line Gyp. Bd. -Hoch. y. V
Date Requested: *1-0 / - L11 _Times AM PM
cv �Ir 0,9�I- ��lQC1
Address:-� C � Pe//omit
Builder: Lt�_k-k . - r` JC9"L CL✓`.� lay �r� S 3 7 O
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
01
2
Inspector �/!_� _ Dates 17
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
__Call For Reinep.
Ab I NOL
I ry -
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223#099 (503)639-4171
PLUMBING PERMIT
r, R''"IT d#. . . . . . . . PL1194-0109
G30-4171 Dry ICSI CO.
P(Ii;CEL: 1-3,11 OCA -IZ0900 1
"1i"':'E I,DDRESS. » . 11694.'*- SW 1',ING CUORGE DR
SUBD:IV?G " "� 70N'NG!
.
9 0CK . ., . » . : i n"r.
(';.-,,M3 Or WORK. . r.PDO GnpsnGr D T 5F'03A!__S. . : MQD I I z vIOMG sPnCES. :
7Yr"E OF UCE. . . . :5r- W•' SPING MACH. . . . . . . . HACKF"LOW PREVNTRS. . : 1
CUPANCY GRP. . : R? FLOOR DRAINC. . . . . . . : I R
OCAPS. . . . . . . . . .
270RIES. . . . . . . . .. WATER I-:EATERS. . . . . . . CATCH BASTN'S. . . . . . . :
I Al.INnaY rpnv" _ „ . . : Sr- RnIN Dt2AIN^a. . . . . s
lJR ''NPL..S. . » . . , , . . , . � rREASF ' RADS. . . . . . . :
Lr,VAT0PIE3. . . . , , OTHER r, TXTURES. . . ., . .
TUB/SHOWER9. . . . S,EWEn LINE (ft ) . . . . :
WnTER CLOSETS. . : W(ITf R LINE (ft ) — .
D10HWASHERS. . . » : Rt1TN DRAIN (ft ) , . ,. , c
Remai-ks -. 8PRINV1_.ER SYSTEM
Owner". _..__..,.._._...___._ _. ... ._.._._..._. _...__._..__...._..__...._._._.._. _ _.__... .__.._..__._._...- FLES _.__..----__.__ __....._..
PAUL.INE WORLETN type alno'.lnt ijy date r^ec_pt
t1kr4l," ,-_ , VTNG I,EORCE PPMT 4t 15. 00 SW 06/2t/94
--)PrT t 0. 71? x W 0&/R1/94
Phnne tk�
OWN!7P
Phi o ri e f: fi 1 S. 7' TOTAL
Reg 4.
___ ....... REQUIRED INSPE'CTIONr
This nrreit i5 issued c0*4 to +hp »P^!.I'-� r`nntained ;n the RP/BRf"kfinW PF-"V
Tira'•d Municipal Code, State of Ore, Specialty Cades and all other F"ina.1 Inspec, i.on
applicaMe 'laws. All work will be done in accordance with
F
approved plans, This permit will expire iF work is not started
vithin 182 d'ays (,,f iscaance, or if aorl, is C,�5wded f43r more
"-a^ IN days.
S'
Call r;,r• inspect ion C- ) 4175
a
f � �
---City-of Tigard I'LV!VIE3ING PERMIT Planck/Roc. #
13125 SW Hall Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171 j
•^• • Description - —
ORS 814-21-610 Tu;l PRICE AMT '
Joh C L j (� FIXTURES
Addr, Sink
Lavatory -75-6--
N.-
5N.- ^ n^^ u or u iower Com— 7.50 �
hoover Only --7-50 —
Water
PO
• o rt• �» a er Closet —
Owner tY c 21 -6isTiwas washer i- 7.50
r
Garbage Disposal
Washing Machina '
.m .1 Floor rain 11
„• �• Water Heater Tff—
_,
• Laundry Room ray
QCCU(Jaltt r na
OtFeTiFix uses(Specify)
i
7.50
7.5
7.50
Ph-
MISCELLANEOUS
Contractor Y,. ,. —
ewer 1st 100'
.. .a,ti..MF9 --tom rr ewer-3a. Addit.
ater ervice 1st U 0.
ere y acknowledge that I have read this application, that te Water Service ea. Addit. 200' t 15.00
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' - 00
I am registered with the Construction Contractor's Board, that the Storm &Rain Drain Pddit. 100' 15.00
number given is correct. (If exempt from State registration, please
give reason below.) Mobile Home Space 25.00
,, ---- ac owreven ron _-
( �? LL l c' Device or Anti-Pollution Devine 7..50 j
•u°" '° Any rap or Was
o
Connected to a Fixture 7.50
Describewo new a r ron after- m r,parr a c assn
to tAt done residential on-residents ---4T56—
i Insp, of Exist. Plumbing per hr
4 .
Specially Requested inspections per hr
Existing use ofam-ran, singe family
building or property dwelling 15.00
Residential ac tow prev�nh- o'n
devices 15,00
Proposed use of
building or property —
'(Except residenilat backiflow
prevention devices)—_
NOTICE •M;nimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5%SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF
CONS TRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS A r ANY TIME AFTER WORK IS PLAN REVIEW 25%OF SUBTOTAL
COMMENCED.
TOTAL
SI tciat Conditions —
Date issued -- — by
WiR.0"T
wr,Mm+Aw
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KING CITY
mol 15300 S.W. 116th.avenge.King City,Oregon 972.34 Phone:1139.4082
E�LTI LTz -LNC Ell FF?MTZ' 7apE> _T :r Aml (Digi
s,
DATE KIPiG CITY BUSINESS LICENSE NO
NAME OF APPLICANT �Car1�►hPHO14E7-
A D O R E S S Com- E=G7___T�- _— — —_ •
NP-ME AND ADDRESS OF PROPOSED IMPAOVEMFNT^
NAME OF f:'(1NTRAr'TQA PHlINF NO.
ADDRESS---- — -- — --CCB LICENSE
TYPE OF CHANGE OR IMPROVEMENT FOR WK-ICH PERMIT IS ! z UEjTEI.). 1)
DESCRIBE BRIFFLI ' - ATTACH A COPY OF THE PLAN On DRAWING OF PROPOSED i
pRr1.TFCT �r Y^-LL11� �
SIGNATURE OF APPLICANT*APPROVED APPLICATIONS APPLIf ATIONS AAF VALID FOR SI't MONTHS ONLY*
NOTE: Oregon Hamebuilders Law requires that all persons who contract, for wor- on
a residence be registered with the Builders Board which
mems the
contractor is banded and insured ^n the Job site. For your protection, be
certain v^ur contractor is registered by calling the ronstructiar.
Contractors Boar,: at 1-303-378-4521 Extension °;000.
_ FOR. OFFICE USE ONLY
APPLICAT-'ON RECEIVED BY E'' --.DATE
o�
APPLICABLE IEE RECEIVED $` CONDITIONo/(:(:,MMENTS�
APPROVEn Bv- C .e�'a/ 1 DATE !;
Note. A perm must be attained from the City of Tigard Department of
Community Development Yes__2<_ No
CITY OF TIGARD INSPE-'TION REPORT
ThiG proiurt hac been inspected and: Approved Denied
Com. men t c
Signature ------- -- Date
----- -- --
(Building inspector please return one copy to King City) —
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NF'tf�IC. WCIFiI..EAN, 1YfaWLW I NFr t::t��iFl i1�+!t 11 tI J I u►.
111090 �3W KINI1 (A-'-IJRV;V O1? t'F1'ft11 hJ1 lits"I w:. s 4.r J.,rcr�>
KING C;1:7Y, OR �In�l? tVl.! Lt1N x
y lP24
+ �......�, ' ..._..1. ,_.,.. . .'... ...... .t..._. .'_ '1.1.._. .. _,..1 1 r h1{ t�!I
N t IR PO yi CIF F 4YMVNI AMt'I IIV I t r 11 l� t•I..IFt1 l (it G f C
..._..w. .. . ... M .... __.....
` PLUMBING
K'h FtM Fyl.M��t (A t.�� I`�, bill► ';I , fat.l 1 1. 11 R�E:F3 rA. 7_+
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