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' i:\records\microflm\targets\building.doc
CITY OF TIGARD BUILDING INSPECTION NOTICE �—
Inspection Line (Rec-O-Phone): 639.4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-i 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 Rain Drain Framing lum
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear We I Gyp. Bd. -Elect.
Date Requested: Time: AM PM
Address:,_/_4P__U
Permit #4
Builder:
THE FOLLO G CORRECTIONS ARE REQUIRED:
Inspector: Date- `
�OVED --DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF T I GARB
COMMUNITY DEVELOPIRAENT DLPARTMENT PLUMBING PERMIT
131 c.,SW!: "Blvd Ti1j,ird.Oregon 97223*8199 (503)639-4171 r-
-,ERMIT it. . PLM951211B7
DATE ISSUED: 08/02/95
PARCEL'. 101 Df 1 0- 100
'TE t�DDPESS. . . : 06960 SW YARNS ST
JbDIVISION. . . . : VARNS ACREE;
.-OCK. . . . . . . . . . . L.Q . . . . . . . . . .
�_AOS Or WORK. . ;NEW ommoE DispnGALG. MOBILE 1-01C. SPACES.
PE OF USE. . . . :COM WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : l
DROINS. . . . . . . . TRAPS. . . . . . . . . . . . . . I
.,CUPANCY GRP. B 2' FLOOR
'PRIES. . . . . . . . : t WATER HE(VTERS. . . . . . .. CATCH BASINS. . . . . . .
'XTURES LAUNDRY TRAY7. . . . . . .. S)F RPIN DRAINS. . . . . .
GREPSC TRAPS. . . . . . .
Jia/SHOWERS....: SEWER LINE (ft ) . . . . :
ATFR CLOGETS. WA'Tr_r. LINE (ft ) . . . . ;
ISHWASHERS. . . . RAIN DRAIN (ft) . . . .
(mz.r,ks : jtistallaticii of commevc-ial backflow PvUvellti0f) device
FEES
amowmt hey date i,ecpL
RESOURCES typl�
,X60 SW VARNS r-,RMT $ 25- 00 JDA 1218/021/9-1
JLJA OB/0'/,)!�
3PCT $
IGAnD on 07LI'__�
41u11e #: 503-68406"'cl
Z_NNISI 7 DE,IS
ORTLAND OR 97206
hor.c #: -177 -77177 2 6. 25 TOTAL
Reg #. . : 3009 REQUIRED I NSPECT I ONC5
iii permit is issued vibject to the regulations contained in the Rr-'/Ba0if low Pv,ev
eard Municipal Code, State of Ore. Specialty Codes and all other Final ITIs'pen'tifin
pplicable laws. All work will be done in accordance with
,;proved plans. This permit will expire if work is not started
thin 182 days of issuance, or if work is suspended for more
.
,war 180 days.
JDY . ............
u p j.,c,t i o T-, 6.31-4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #'IS-�6 8�a
13125 SW Hall Blvd. Permit # L
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT PEE+ ST. SURCHARGE
New Single Family Rsaidences Onto
p
er,r,. I 0 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Job (Pct(DQ S�0 �a��?�
car/ O 3 BATH HOUSE$225.00
Address arr. Fee includes all plumbing fixtures In the dwelling and the first 1W trot
f( q 7 Z 3 of water service, sanitary sewer and storm sewer. See fees below.
,,.. ,.,...err..w FIXTURES CITY PRICE AMT
/C0_ ''_�ot! <rL-�.� Sink 9.00
A.&M err.n �. lavatory 9.00
Owner i h o 6a) 17 C,'/ y11E Tub or Tub/Shower Comb. 9.00
,lw ft, a Shower Only 9.00
C/ 7 72 Water Closot 9.00
..
rrr �.� c Dishwasher _9.00
k. y) l ,S Lr r+C+ Garbage Disposal 9.00
Occupant w.r er— Washing Machine 900_
Floor Drain 9.00
ar Water Heater 9.00
22�� Laundry Room Tray 9.00
--- — / Urinal 9.00
Other Fixtures (Specify)
sort. — --
900
Contractor
( _ l�7 9.00 777,
9.00
Sewer 1st 100' 30.00
�,�.w,,...e. r. --,L— c+►w t�^" Sewer-ea. Addit 10, _--_— r 2500
16 r) Water Service 1st 100' 30.00
1 hereby acknowledge that I have read this .oplicatJon, that the Watek Service ea. AddiL 2G„ 25.00
Information given is correct, that I am the ow:,er or authorized agent of Sloan 8 Rain Drain 1st 100' 30.OQ
the owner, that plans submitted are in cormliance with Slate laws that
I am registered with the Construction Conbactor s Board, that the Storm &Rain Drain Addit 100' 25.00
number given Is correct (If exempt from S.ste registration, please Mobile Home Space 25.00
give reason below.) -- -
- Back Flrnv PrFvention
Device or Anti-Pollution Onvice 9.00 I
Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new Q addition O alteration O reoalr 0Catch Basin 9.00
wo
to be done residential non-residential Q Insp. of Exist Plumbing 40.00,'hr
Specially Requestrrd Inspecttorl 40,00rn,—
ExIsting use of Ran Drafn, single family dwelling 30.00
building or property — —__ -
Residential backflow prevention
devices ( 15.00
Proposed use of
building or property — .(Except resldenflal backflow
prevention devices) —_
NOTICE '101nlmum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5%SURCHARGE / 15
AUTHORIZED IS NOT COMMENCED WITHIN 180 GAYS, OR IF
C;nNSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTFR WORK IS PIAN REVIEW 251,4 OF SUBTOTAL
COMMENCED. —
TOTAL ?S
Special Conditions
Date Issued --- _--_ by
BUILDING PERMITAPPL!CATION TIGARD OATE__�
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHON ,�O_l
OR S SHOW D APPR IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE -
/ LOT N0..
OWNE Jp(3ADDRESSti/ 4 O 12�
ARCHITECT
C:O")a,Le
• EHGINEEll t�k
BUILt)"k'ADDRESS ' i DESIGNERSTRUCTURE ❑ MODEL !IS ADDITION—'l! REPAIR O RENEWAL Cl FIRE DAMAGE Cl DEMOLITION
CI RESIDENCE IBJ COMM ❑ EDUCATIONAL CI GOVT Cl RELIGIOUS Cl PATIO ❑ CARPORT ❑ GARAGE ❑ (1RAGE 0 SLAB❑ FENCE
OCCUP NCY LAND USE 70NE BLDG.TYPE --FIRE.ZONE' '--PLAN CHECK BY HEATAf
467
�—
'' d
SEWER PERMITS ----
__Lj .--- NO.BEDROOMS "_'VALUE
OCC.LOAD `--fI-0OR LOAD HEIGHT N0.STORIES AREA
BUILDING DEPARTMENTSET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit � _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check _ (J `� WORK WILL BE DONE_ IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
>� LICENSE.SEPARATE PEWMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
Total S SDC— ymv
PDCM _ APPLICANT OR AGENT
By
Receipt o. ADDRESS — — PHONI
Approved - --- _-
BUILDING PERMIT APPLICATION �oF TIG,,A1RD DATE_-- -1 . t�' ,E' No � v
Fes.
;HE UNDE RSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED 13UILDERPHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLA 5 ND SPE "'CAI IONS. OWNER PHONE--Od
- LOT NO. —
JOB KESS OME ADDRESS
ARCHITECT
ENGINEER
ADDRESS _ DESIGNER
O E E�Wv `CI REMODEL �AI-
—CDDII10NN _ REPAIRC
_--0R-ENEWAL OFIRE DAMAGE r-1_ DEMOLITION
-1_!oL)t NCE ❑COMM OEDUCATIONAL OGOV'T OREL.IGIOLIS OPATIO ❑CAR PORT ❑GARAGE O STORAGE OSLAB OFENCE
POND .MOVING _ ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
U E 70NE___ .__ _BLDG.TYPE __� FIRE ZONES PIAN CHEC YY
LQ9lL___.
BUILDING UEPARTMEN__ � CET BACKS FRONT _ REARLEfT SIDE ' RIGHtSIDE
I {'r.rmlt
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
°1 an Check REGULATIONS AND ALA APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT 'NAIVE
--- RESTRICTIVF COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINFRF
';tate T LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
by APP4I_CA NT OF ACLNT _— --- ---
Approved - i Receipt No.
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