16345 SW ROYALTY PARKWAY-1 ADDRESS:
3A 5� -LU,� 41, PQVLk:�a,
i:\records\microfIm\targets\t)uilding.doc
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639.4175 Business Phone: 39 41/1
Inspection: ,��'
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San, Sewer Gas Line -Bldg.
Plbg. Underfloor Cain 0 inra Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: �U /,�l�;� Time: AM PM
Address:
Builder: 7 ' 3 33 fir' Permit #: ,L ' U 3
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Ingpector. Date
YSUB.
PROVED DISAPPROVED APPROVED SUBEC TO AE30 EE'
— _
_Call For Reinsp.
I
CITY OF TIGARD VI/
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd,Tigard,Oregon 97223.8199 (503)839.4171
FAX her i s tl102 PO4
City of Tigard PI-7UhA IF NG_ PERMIT APPLICATIOW Planck/Rec. # 1<1-7og clH
13125 SW Hall Blvd. Permit # &-/y195-C 63
Tigard, OR 97223
(503) 639-4171
MINIMUM S25.00 PERMIT FEE +ST. SURCHARGE
NewSlrxdP Faml ealden n
�(���S k'ay�'� PkW _ u 1 BATH HOUSE$,ao.00 r, z BATH ROUSE s,9a.00
.lob Y- O 3 BATH HOIJUE$225.00
y Fee Includes all piurnbktg (bctur'aa in the dwelNng end the ft" 1W feet
Address ` i_/ a y� j�� or water service, sani ary sewer and sbom, sower. Se.ft"below,
rIXTURES QTY PME AMT
_M_ct y ti .0 p H sink _ s oA
Owner M 1 0 3 9 5 RD y'u PkTub or Tub/Sh-aw comb. 9.00
ar Shower Only 9.00
aG g 7z z 7
Water Clow9.Q0
Dishwasher 9.00
GatbM Dispgasl 9.00
Occupant ,,, r*-- Washing Mad4ne 9.00
Floor Drain 9.00
CW*A,, sr Water Healer 9.00
Laundry Room Tray - 9.00
Urinal _ 9.00
•D ( GtK S CSP f C11J[tri other Fixtures (Spa—.1 y, _ 9.00
9.00
Cbnfroaar t t // D l t.S w 9.00
«, t. 9_ 9.tlo
q7D�i gwwe r 1st 00 30 OU
fxrwot ea. Addlt. 100' 16.00
_3 Z 3 I tarter sHrvke 1st 100' 30.00
I herr:rby eNrnawMed9e that I have rend this apokadon, B,at the --- Water Service ea- Addit 200' 25.00
infotmation 9i~ is correct, that 1 aril the owner or autholted ngerrt of Storm b Rain [pain 1st 1100' Y" ��
ft owner, that plane sutxnitted are In cormliianos with Ststrt laws, that
I am rergletoted with ft Construdiun COMM11 ot's Board, that the Storm &Rain Drain Addit 1W 2500
numbetr gkon is oorred- (If exempt from Slate registration, pkaea tubbile Hrxm Spare 26.00
give Leeson below.) ---- -
Back Flow Prov,;ntuxr
Device or Arnt-Pollurkm Device 9�V
a.�h-"rte a -- - o. - Any TT.p ex Wente Nen
Connected to a Fixture 9.00
Celch 9esin g
Describe work vnew addition Q alteratKx► Q repair -
to be done msidenHal 0 nor►meldential O Insp. of Exist Plumbing 40.001hr
- Speclaly Recl(jeslod Inspections 40,001hr
FXiatinq use of Rain Dram, single family dwelling 30.00
building or property — ResidenUpl naekflow prevention___
devices 16.00
Prcposepd use or
bullernu or property
prevonV*n devices)
NOTICE •Wnirmurn Fee %]:5.00 SUBTOTAL
PEWArTS BECOME VOID IF WORK OR CONSTRUCTION 5%9URCHAROE
AMORIZED IS NOT COMMFNCED WITHIN IAO DAYS,OR IF
CONt,'TRUCTION OR WORK IS SUSPENDED OR AOANDONFO
FOR A PFR(00 OF 1110 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 26%OF SUBTOTAL
COMMENCED.
TOTAL
Special Cenclitione i � L .� �--- /1 A ,. y