7410 SW TAYLORS FERRY ROAD ADDRESS:
i:\record s\microfilm\ta rgets\building.doc
CITY OF TI ARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing (_q c
Plbg.Und/Flr/Slab Plbg.To ut Insulation
Post/Beam Struct. Mech. Rou h-i Gyp. Bd, Bldg,
San. Sewer Gas Line Appr/Sdwlk9 Reins.
Other: --
Date: A.M. /�- ,P.M.,._. Ent�p—/�
Address:
Tenant: _ Ste: _. MST:
BUP.
Con/Own: _ --- MEC:e'm�a
PLM-
THE FOU.OWING CORRECTIONS AHE REQUIRED ELR: _ --
Inspector -- -- -- D„w ----
___ PPROVED __.DISAPPROVED/CALL FOR REIIJSP. CF C
M
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL. i RMIT
13125 SW Hall Blvd., Tigard,OR 97223 503 639.4171 PERMIT #t ELC97--0052:
DATE ISSUED: 01/2'-j/97
PARCE'.1_: '.S125CA-0001-301
,ITE ADDRESS. . . : 07410 SW TAYL_GR5 FERRY RD
"JUB'D I V T S T ON. . . . : ZON I NG:R--4. 5
BLOC;K. . . . . . . . . . ., L G T. . . . . . . . . . . . . .
Project Description: instl 1 service/feeder & branch circmits
--RES 1 DENT IAI._ UNIT---- ---TEMPI SRVC/FEEDERS---•- ___.__.._M I SCELLANEOIJ 5----•--
1.000 9F OR I_FGr;. . . . : 0 0 ;'00 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L.. 500SF'. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 1b S I GNAT_/rIANE1... . . . . . . . 12.1
MANF. UM/ SVC/FDR. . : 0 C01 +amps-1.000 volts. : 0 MINUR LABEL ( '0) . . . : 0
._.- - 5E RV ICE/FE:E<.DER-.---. CIRCUITS---- _._.--ADD' I_ INSPECTIONS— -
0
NSPECTIONS--- -
0 - 200 amp. . . . . . : 1 W/SF_RVICE OR FEEDER: c_ P> R INSPECTION. . . . . : 0
='01 4001 ,amp. . . . „ ., 0 1 5i; W/0 9 RVi-' OR FDR. t 0 PER HOUR. . . . . . . . . . . 0
401 - 600 amp. . . . . . : 0 EA ADD' 1.. BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
E-01. - 1%)00 amp. . . . . : 0PFVIEW
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Rec.,orner^t, only. . . . .. : 0 SVC/FDR > = 225 AMP'S. . : CI_.ASS AREA/SPEC OCC. :
Owner: -__._______.__.___- _.,_ __._ ___.__ . _.__ __ .---_, _ ____._.__ FEES
TOM OLSON type ino'.rnt by date rec:pt
7410 SW TAYL.OrS FERRY RD VIRMT $ 70. 00 TAT 01 /29/97 97-269616
5PCT $ ?. 50 'TAT 01 /;=.9/97 97--289616,
'T I GARD OR 97223
Phone #:
Contractor. -
GRF ELECTRIC It '73. 501 TOTAL_
154E,O SE PARADISE LN
REQUIRED INSPECTIONS
MULINO OR '37040, Ceiling Cover Undergrol_rnd Cove
Phone #; 50.3. 829-4146 Wall Cover Elect' l Service
Rpg #. . : 1.01543
Thit -Pr4
t is issued subject to the regulations contained to the "'•'�/ ►r���___ _
Tigard Municipal Code, State of Che. Specialty Codes and all other Perm ittleea :=,iyna
applicable laws. All wo:-� will be done in accordance with
approved plans. This per:it will expire if work is not started \ %
within 188 days of issuance, or if work is suspended for sure VA
l
than 18N days. I s sig e d By r
-OWNER INSTALL.ATION ONLY--_.--.
The installation is being made on property I own which is not intended for
sale, li-Ase, or rent.
OWNER' S SIGNATURE:: , _ DATE:
T.NST ALLAT ION ONLY.____..
SIGNATURE OF SUPR. FLEC' N; M� _ DATE:
LICENSE NO:
Call for inspection -- 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Nall Bh,d.
Tigard, OR 97223 Permit #
Date Issued _
Phone (503) 639-0171
CITY OF noAao FAX (503) 6847297
TDD No. (503) 6842772
Inspection (503)630-41 F
1. Job Address: r4. Complete Fee Schedule Below:
Name of-Deve"fne�lnt �U(�Y1 1� ��-- t Numbs. of Inspections Per permit allowed
Address (l ��, rn UI n r„ F°rrLA Srrvice included Iters Ccsgea) Sum
City/State0p_ 4a. Residential -per unit 4
1000 sq ft. or lase $11000
O! D,^ E"edWlonal 500 w.s.a
Name (or name of business) ! r l t�oo
portlm Mweol �
Commercial ❑ Residential urrrtedEf1 Vy -- $2500 —
EC.:h S1t,.:rrd}!ire c. Mudu1+ 2
D&* q Swvwm or Faeder $ea 00
2a. Cor.tractor installation only:
4b. Services or Feeders
/f kmasetlon.sterstion.or reWAttoe I
Electrical Conhactc r ����1 e G� J��! Ci 200 ur"or Wu seo oc (l 2
Address_ Qlr] �, F�4.Y�/-�4,�f.,i1� ml.nvstor00off" -� 330DO - - 2
sol amps to eo0..w $120.00 _ 2
City_ 11Y State_ Zip. )7 Q 4�- 60/,,,,,p,to 1000 W. :18000
Phone No. . i— Ljo Over t00o arms or vo.. $340.0° - — 2
Job NO. Romm"dorrry $5000 ?
contrar:tot'f, license NO-_ 4c- Temporary Services or Feeders
Contrarto,'s Board '?eg NO. /0'f lnstatetlm.aeereuan.;x 1"lorsitron
Signaturr_` of Supr. Eia::n ?00 enva of bass _.__
/ 2
- 2ot amps to 400 anile SW 00 �
Li(-snS�' No. (� J one No. 401 anpa to 60n amps _ $7500
ver ----
O 600 urea to low volts $100 no --
2,5. For owner installations: "M"a'above
4d. Branch Circuits
Print Owner's Name-- _ __ N".Wersom or ar"Woar vM pwo
Address — e)TIM tee for resod CtIN Wtnr 2
City —� `_- —_ State -- Lp E mor�or deedar foe- s5 00
+.
Phone No. _..__ b)Tht f"r«txaILn aMA&T WicK'" 2
The installation is being made on property I own which is ourcha"at sov o'or'a'edw f" 2
FM bran"G*UW
not intended for sale, lease or rent. Esar wwinno b.srrdt arcus $5,00
Owner's Signatury �______ 4e. Mlxcellaneass 2
(Serviro of inert-r ...e !wtluded? 2
Fach 3. Plan Review section (if required): EWhs""pa`"no11g Moll"`'a --- 114000
Eactr sign a outinr t)phtlrp __ 1140 00 ?
Signal ckwit(s)or v*pled enw W
PC W
Please check appropriate item and enter fele in section 513. pares,sltaratlon at extenssan -__
_ 4 or more residential units in one structure Mr"Lab"(10) —
Service and feeder 225 amps or mote
4!. Each add
System over 600 volts nominadditional InspecN;,n over
_ the allowable in any of the above
Classified area or structure containing special occupancy
as desrnbed in N E.0 Chapter 5 r er hsr>torm-i�ar $35 0o
Per hr" $55 00
In Pta,1 s.S5 00
Submit 2 sots of plans with application where arty of the rbove
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees s
5%Surcharge! 105 X tr tal ffees)
PERMffS BECOME VOID IF WORK OR CONSTRUC 710N Subtotal s
5b. Enter 25%of fine A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS. OR IF Plan Review it required (Sec-3) S _
CONSTRUCTION CR WORK IS SUSPENDED OR ABANDONED FOR Subtatal
IA PERIOD OF 180 DAYS;AT ANY TIME AFTER WORK IS
COMMEN.ED. T rust Account tr :
P–as Balance Due
CITY OF TIGARD
DEVELOPMENT SERVICES L_ _.EC.TRICAL i..,ERMIT
13125 stV Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT
DATE ISSUED: 01/26/97
r.
PARCEL_. 1 ,1c:5CA_.00�,01
liP(DJRU, F-L:RRY RD
SUBD T t'T 8 'ON. „ . : 7.ON I NC,:!-7-4. 5
BLOCK.. . . . . . . .. . . . I-OT. . . . . . . . . . . . . .
Pru.je:�t Description : INSTL 1 BRANCH CIRCUIT
------RESIDENTIAL UNIT---- -----1 EMF' SRVC/FEL.DERS---- ------M I SCEL.L_ANEOUS----.----
10P..''� SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 9005F. . . : 0 201 – 4O0 amp. . . . . . . : 0 SIGN/OUT LINE L.TC. . : 0
L.TMITED ENERGY. . . . . : 0 401 - ,000 amp. . . . . . . : 0 SIGNAL/PANEL_. . . . , . . : 0
MANE. HM/ SV`'/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL_ ( 10) . . . : 0
-- -_ADD' I_ INSPECTIONS—-
0
NSPECTIONS.---
0 200 a, �,. . . . . . e 0 W/SERVI"E OR FEEDER: 0 PER INSPECTION. . . . . : 0
.'01 - 4001 }ntp. . . . . . : 01st W/O SRVC OR F"DR. : 1 PER HOUR. . . . . . . . . . . . 0
401 - 600 amp. . . . . . : 0 EA ADD' L PRNCH CIRC: 0 IN PLANT. . . . . . . . . . . .. 0
601. - 14")00 amp. . . . . : 0 __...__–_----._–__..._.__PL..r,N REVIEW SECT IUN_.__..___–_____.______,_
1000+ amp/volt. . . . . : 0 > -4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL— :
RNconnect on 1.y. . . . . : 0: SVC/f-DR > - 22", AMPS. . : CLASS AREA/9PE:C OCC. :
Owner: -------------------------------------------------------- FEES
TOM OLSON type amount by d a+-e r-ec_pt
6419 SW T'AYL.ORS FERRY RD PRMT f 35. 00 TAT O1/28/97 97--289581
SPCT E 1 . 75:; TAT 01 /28/97 97 -r 695'31
T T CARD OR 97223
Phone #:
Contractor,
CONTRPCT'OR NOT ON FILE. $ .36. 75 TOTAL_
REQUIRED INSPECTIONS
Cei I inrA Cover L.lndergroi.trtd Cove
Rhone #: Wall Cover Eler_t, I Service
Reg
This peroit is issued subject to the regulations contained in the
Bard Municipal Code, State of Ore. Specialty Codes and all other F'ermitt Sicloat1.tre
3pplicahle laws. All work will be done in accw-dance with /
approved plans. This perait will expire if vnrk is .it started
within 180 days of issuance, or if work is suspended for ■ot e
than 190 ,1ays. Isso.ted By
_.._.. .__....._.. _ .._.._. _. ._...___......_._ _.. ....__.._._.-OWNf::'R INSTAL LATION 0N1_Y----_
The installation is being made un property I own which is not intended or
11P, leiAse, or rent.
WNER' S SIGNATURE: DATE t
----------CONTRACTOR INSTAI__L.ATTON ONLY--.___________________.____--
' LiNATURE OF SUPR. ELE:C' N. DATE;
CENSE NO:
Call for inspection - C>39-4175
t✓ommunity Development ELECTRICAL PERMIT APPLICATION
n 3125 SW Hall Blvd.
Tigard, OR 97223 Ranck/Pec. #
L16-t4, Permit # 14 ` ' `
Phone (503) 639-4171 Date Issued
CITY OF TIG.4RD FAX (503) 684.7297 Issued by
TDD No. (503) 084 2772
Inspecti:,lt (517,13) 639-4175
1. Job Address: 4. Complete Fere Schedule Below:
Name of DJlevu,upri-lant�,�m V c�-n Number of Inspections per permit allowed --
Address "I LLL,(� `1�'"� LL
j1 r `� SHrtiicH included ltHnls Cost(Ha) Sim
City/State2ip'�n r A--\c`rL C� _��1� 011 2 _. 4s. Residential-per unit a
1000 ey fr or lose $11000 _
Name (or name of business) f_a&r addruorW 500 nq it or
portion thereof $2 A
Commercial El ReSidential,0 LimitEach Energy $2500 2
Each Manufd Home or Modular
IhvetLng Semrae or Feeder ti86 00 _
2a. (Contractor r►atallation only:
4b.Services or Feeders
Installation,alte ration.or relocation 2
Electrical Contractor,` k(.,4 AA YY<< Ll l 200 amps Ions $60 no
Addr S ,V f�1 C l 201 amps to 400 amps _ $8000 2
401 amps to 600 amps $12000 2
citync l c r t Stately Zi I 601 amps to 1000 amps $18000 2
Phone No. 7 '�'� 11 Over 1000 amps or volts $340 OC _ 2
Contractor's License No. L{L L) _ Reconnect only $5000
Contractor's Board Reg. No."k ?-c 04c.0 __ 4c. Tempore y;.services or Feeders
Iretallafron,alteration,or relocabr.n 2
Signature of Supr. Elec'n /f2= 2*� 200 amps less syn u0 _ 2
License No.1 j C� L f 4 _ Phone No. 1 ?,; _ 201 amps to 400 amps $7500 a
401 amps 1a 600 amps $10000
Over 60u amps to 1000 volts
2b. For owner installations: see W suave
4d. Branch Circuits
Print Owner's Name New atterr.lion or extension per panel
Address a)The foe for brarrrh circu,le aslh
purchase of sarvks or lsedlet he. z
City State Zlp Each branch circuit $5 00
Phone No. _ b)The leo for branch circuits Wlhout
The Installation is being made on property I own which is purchase of service or Aredrr Ara. C , 2
not intended for sale lease or rent. First brarrh circuit iL $3500 --1
Each additional branch circvrf %5 W
Owner's Signature 4a. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or rrngatron circle $40 00
Each sign or outs me lighting $4000
Signal cacu4fs)or a limited energy .—
Please check appropriate Item and enter tee in section 513. panel altershon or extension $4000
4 or more residential units In one structure Minor t,hnls(10) 10000
Service and feeder 225 amps or more
!�System over 600 volts nominal 41. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N E C Chapter 5 "P :a5 00 --
P-r,o.,r $5500
Submit 2 sets of plans with application,where any o1 the above --- $56 DO
'—
apply. Not required for temporary construction services. a. Fees:
5s. Enter total of above fees $ r 1
NOTICE 5%Sutuharge((`j X total fees) $ �-
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b.Enter 250 of lit e A for
CONSTRU^.TION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if 'equired(Sac 3) $ -
A PERIOD OF 180 DAYS AT ANY TiME AFTER WORK IS �subtrtal $
COMMENCED L J Trust Account to $
Salarwe Dire $
rpM�rd�✓`Wrprm lap
CITY OF T I G A R D MECHAN I CAL
DEVELOPMENT SERVICESPERMIT
PERMIT #. . . . . . . .. MEC97-0019
13125 SW 11all Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 01 /28/97
PARCEL: IS125CA--00301
SITE ADDRESS. — 07410 SW TAYLORS) FERRY 'RD
SUBD I V I S I GIN". . . I : ZONING; R--4. 5
BLOCK. . . . . . . . . . .
I.-OT. . . . . . . . . . . . .
CLASS OF W(.)PK. . - REP FL...00R FI.IRN. . . . -. 0 [.VAP COOLERS. 0
TYPE U'r- USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY [SRF. . :R'3 VENTS W/O APPL: 0 VENT SY,91-1-MS: 0
STORIES. . . . . . . . : ID BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL 0-3 HP. . . . 0 DOMFS. INCIN. 0
3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 1.5--30 IAP. . . . : 0 [?F-.'PA I R UN I TS: 0
FIRE DAMPERS?— : 30-50 HIS. . . . : 0 WOODSTOVES. . .- el
GAS PRESSURE. . . : 504 HP. . . . : 'I) rl-0 DRYF'-'R1"1. . - 0
NO. OF UNITS---------- AIR HANDI-ING UN I TP OTHER UNITS. : 0
FURN ( 1001-1 FATU.- 1 1000171 cf7m . 1. GAS OUTLETS. : Q1
IFUR.19 ) --).00 ( BTU: 0 10000 cfm- 0
Remat-lis .- INSTL FURNACE, TS R VENTS 8. AIR HANDLING UNIT
Ownet-c FEES
T0,.1 0!.-.S 0 N type amaiint by date V'ecpt
74tO SW TAYLORS FERRY RD VIRMT $ 25. 00 TAT 01/28/97 97-289581
5FICT $ 1- 25 TAT' 011 8/97 9'7-28195RI
TIGARD OR 97223
Phone #:
C
MCCAl-l- HEATING R. COOI-ING CO
1650 NE LOMBARD
PORTLAND OR 97211
Phone #: 503-231-3311 $ 26. 25 TOTAL.
Reg #. . - 00I0E-10
-------- REQUIRED INSPFC ,' IONE;
This pervit is issued subject to the regulations contained in the Gas Line Ins
Tigard Municipal Code, State of O-P. Specialty Codes rind all other First/Beam Insp
applicable laws. All work will be done in accordance with Mechanical Insp
approved plans, this permit will expire if work it not started Misc. Inspect ion
within 180 nays of issuance, or if work is suspended for sore Final Inspection
than 180 days.
F Pt-mitt eP Si gn At I.(
P L
i e d 11.1 y
639-4175
Call for i.nspertion
City of Tigard MECHANICAL_ FERMIT Planck/Rec. # _
13125 sw Hail Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171
� ---- srxtpuah
Table 3A Mechanical Godo olY PRICE AMT I
Job .«- C. 1) Permit Fee _ 0 -0 10.00
Address � 3.00
Permit
i I - ,'f / `� !� 7 2) Supriemental PetU—ot _
Furnace a 100,, BTU
1) ind.ducts&vents _-- 6.00 --
.,. umace tO0.000�3T)7-.
2) incl.duds&vents 7.50
Owner 4 or umance
.w
3) ir.d.vent 6.00
Y,w. eater
4) or floor mounted heater 6.00
Vent not r to
Occupant 5) appliance Permit 3.00 —
{ Repair of heating,re rig.
6) cooling.absorption unit 6.00
.,. ter or imp,Wat pump,atr cc
Cc �� 7) Ic 3 HP absorp unit to 100K BTU 6"00
�.q .,. ode, o'— r comp, at pump,air Gond.
/ / 8) 3.15 HP absorp unit to 500K BTU 11.00
t2dContractor Boiler or comp,heat pump,air co
9) 15-3C HP absorp unh.5-1 mil RTU 15.00
Boiler or comp,heat pump,air pond.
10) 30-50 HP absorp unit 11.75 mil BTU 22.50
-1 hereby a ow ge iat have rea is aP tcatton, t e ter or comp, t pump,air co
information given is correct.that I=the owner or authorized agent 11) >50 HP absorp unit 1.75 mil BTU - 31_50_
of the owner,that plans submitted are in compliance with State Atr an
ing unit to
law.;,thrit I am registered with the Construction Contractors Board, 12) 10,000 CFM �— 4.50
that the number given is correct_ (If exempt from State registration, tr an ing urut
please give t,ason below! 13) 10,000 CTM+ _ 7.50
Non portable
14) evaporate coolor 4.50
Vent tan connected
15) to a single dud 3.00
-- enU aUon system not
16) intAuded in appliance permit 4.50
sip ..to,,a - o sery
17) mechanical exhaust 4.50
sorbs wort. new addition a teretwn repTx Commercial or d sl'n.-.I
30.00
to be done vasidontial Q non-residential O 18) type incinerator -
sang use o Other te.,w ;leve,water
buiH.ing or property_ 19) heater,solar,clothes dryers,etc _ 4.50 _
Proposed use of ?0) Gas piping one in four outlets — 2.00
building or property -.
r 1) More thin 4-per outlet —_
Type of fuel -of Q nabuat gas O LPri O moctric 0
OT C —�
Minimum Fee$25.00 SUBTOTAL .�
PERMITS BECOME VOID IF WORK OR CONSTRUCTION �
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE I_
IF CONSTRUCTION OR WORK 13 SUSPENDED OR
A13ANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL
Special Conditions
Date issued -- ---- by
RECEIVED
JAN 2 8 1991
C"MU ViIY UEVELOPMI NI
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
!nspection:
Footing Susp, Ceiling Sprink. Rough-in Appr/Sdwlk
Foundatiun P(bg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Pibg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. �r Gas Line -Bldg.
Plhg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect..2 rQj
Date Requested: _ Time: AM PM
,. `._
Address:
Builder: 1001F Permitri ���� 'S-,57
THE FOLLOWING CORRECTIONS ARE REQUIRED:
ICA-—
i
Inspector: Date:
��- PROVED ._DISAPPROVED APPROVED SUBJECT 10 ABOVE
,—Call For Fieinsp.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall 91vd.Tigard,Oregon 07223.8129 (503)030-4171 PLUMBING PE PM I T
T"'CRMIT it. . . . . . . : PILM95--0155.1
DATE ISSUED: 07/06/9`)
PARCEL: 1 S125CA--00.300
SITE (ADDRESS. . . : 07410 SW TAYLORS FERRY RD
;.JEIDIVISION. . . . : BOULEVARD HEIGHTS ZONING: P-4. 5
,'-LOCI). . . . . . . . . . . LOT. . . . . . . . . . . . . . 6
CLnGS OF WORK. . .REP GARBAGE DISPOSALS. . : MOBILE HOME SPACES.
YPE Or-' USE. . . . :SF WASHING MACH. . . . . . . a DACKFLOW PRE=VNTRG. .
XUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . : TRAPS. . . . . . . . . . . . . . .
TORIES. . . . . . . . : I WATER HEATERS. . . . . . . CATCH BAUINS. . . . . . . :
IXTURC;---_._-_,_._ .__..__.__ LAUNO RY TRAYS. . . . . . . ,F TRAIN DRAINS. . . . . :
6INKS. . . . . . . . . . .. URINALS. . . . . . . . „ . . . . GREASE TRAPS. . . . . . . .
AVATOi7IES. . . . . .. OTHER FIXTURES. . . . . :
JB/SHOWERS. . . . - SEWc'R LINE: (ft ` . . . . : 10
, aTE:R CLOSETS. . : WA , _INC' (ft ) . . . . :
DISHWASHERS. . . . : RAIN .:RAIN (ft ) . . . . :
Rem,ar-,ks: REPAIR 10' T.)” SEWER. 1—INE
Ovmer^: — ---_.._..._______.___.w_._...__..__-___...__..._._.._._.___._.._.__.__.___.___.._. FEES _______-_-__-._
Trll OLSON l ypp amra,.mt t.)y dat e r•ecpt:
+10 SW TAYLORS FERRY RD PRMT 1 30. 00 SW 07/06/95 —
SPC;T f 1.. ',--0 SW 07/06/95 --
TIGARD OR ')7.-;'-!:'3
P-1hone #:
Canty^ac:t ur;
RESCUE. ROOTER
W I L SONV I LLE (IN _._.___._..._..._..___....._..--
PI-Iane #. 60,5 -9050 'b 31. 50 TOT(1L
Reg #. . : 44677
—.._._.__ .-- REQU ,RED INSPECTIONS _
s permit is issued suoi.ect to the regulations cintained in the Gewer Inspect i ori
Tigard Municipal Code, State of D-i. Specialty Codes and all ether MisC. Inspection
applicable laws. All work wiil be done in accordance with f=incl Instac�r_t iurn
app^oved Plans, This pewit will expire if work is not started
within 16® days of issuance, or if work is suspended for more
than 180 days.
F'e r^m i t t e e
� r
Lall for iiNspectinn — 639 4175
� tie
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit # Pi 95 -t)155
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
�1 1. <� c. P. - poi-='
Now Single Family Residences Only
...... ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
.lob r � ❑ 3 BATH HOUSE$225.00
Address coo / 1 no Fee includes all plumbing fttures in the dwelling and the first 100 feet
of water service, sanitary sewer and storm sewer. See fees below.
"- we. >n.n..reurwni FIXTURES QTY PRICE AMT
Sink 9.00
m"M.r.... Lavatory 9.00
Owner Tub or Tub/Si._aer Comb. 9.00
;naau. a, Shower Only 9.00
Water Closet 9.00
. .,> ...a w...•, Dishwasher 9.00
Garbage Disposal 9.00
Occupant �-» Washing Machine 9.00
Floor Drain 9.00
anrs:u. -
no Water Heater 9.00
Laundry Room Tray i 9.00
Unnal - 9.00
Otho, Fixtures (Speedy) 9.00
w.a s,... A.. 9.00
Contractor / // 9.00
vn ar. ar 9,00
Sewer 1st 100' 30.00 ,L a"
sr.rtgr.rn w: �'�• r••"• Sewer -ea. Addd. 100' 25.00
Watur Service 1st 100' _ 30.00
I here,.y acknowledge that I have read this application, that the Water Service A. Addit. 200' 25.00
inion cation given is correct, that t at i the owner or authorized agent of ---
the owner. that plans ►ubmrtted are ,n compliance with State laws, that Storm &Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storrs & Rain Drain Addit. 10(7' 25.00
number given is ccrrect. (If exempt from State registration, please
Mobile Home Space 25.00
grvn reason below.) -
Back Flow Prevention
G
/ I Device or And-Poltution Device 9.00
�.•...•.....s.ami
e Any Trap or Waste Nct
Connected to a Fixture 900
Descr be work new Q addition O alteration O repair (�� Catch Basin 9.Ora
to be done residential 0 non-residential Q Insp. of Exist. Plumbing 40.001hr
Specialty Requested Inspections 40 00/hr
Existing use of Rain Dram, single family dwelling 1000
budding or property -.__�.
Residential backflow prevention
devices 15.00
Proposetf use of
budding or property _�- "
.,Except residential backflow i
prevention devices) _
i
NOTICE 'Minimum Fee $25.00 SUBTOTAL
_E
PERMITS BECCME VOID IF WORK OR CONSTRUCTION I !
591. Sl1P,CHARCE � I
AUTHORIZED IS NOT CCMMENCED WITHIN 180 DAYS. Oil IF
_�I ,(
CONSTRUCTION OR WCRK IS SUSPENDED OR ABANDONED -----' " --'-'
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
PIAN REVIEW 25".4 OF 3UBTaTAL
COMMENCED
TOTAL
Scecial Conditions
Date issued 7) Ct