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INSPECTION NOTICE
City of Tigard Building Department
13125 SM 8111 Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: r- 10
Footing P:.bg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/I'•eam Strict. San. Sewer Framing -Bldg.
Poet/Be?m Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Waiter Line Gyp. Bd. -Mech.
Date Requestedd: (O -//�' Time: AM --PM
Address: CCC+ /�y 7 �` t Permit f:C�Y` �✓���
Builder: i� e_ice- t Li> 1 P1
THE FO NG CORRECTIONS ARE REQUIRED:
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APPROVED DISAPPROVED Ai'PROVED SUBJECT TO ABOVE
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CITY' OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hell Blvd,Tigard,Oregon 97223.8199 (503)839-4171
PLUMBING PERMIT
PERMIT #. . . . . .. . : PLM94- 010,
t :5l-4111 DATE ISSUED: 06/14/94
PARCEL: 1 S 1;?5DB--0392'1?I
SITE ADDRESS. . . : 09635 SW 74T1-1 AVE
SUBDIVISION. . . . : BOULEVARD HEIGHTS ZONING: R-4. 5
:3LOCK. . . . . . . . . . .. LOT. , . . . . . . . . . . . :27
CLASS OF WORK. . :AL'T GARBAGE DISPOSALS. .. MOF!ILf= HOME SPACES. :
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : i
(OCCUPANCY GRP. . : R3 I•L.DDR DRAINS. . . . . . . : TRAPS). . . . . . . . . . . . . . .
3l"URIES. . . . . . . . I WATER HE=ATERS. . . . . . : CATCH BASINS. . . . . . . :
FIXTURES------_--.--.--_. LAUNDRY TRAYS. . . . . . .. SF RAIN DRAINS. . . . .. :
SINKS. . . . . . . . . . : UN 1 Nf4LSa'. . . . . . . . . . . . l HSP .}.RHPIS. . . . . . ..
LAVATORIES. . . . . : OTHER FIX'TURES. , . . ,.
SUB/SHOWERS. . . . : SEWER LINE=' (ft ) . . . .
WATER CLOSETS— : WATER I...INE (ft ) . . . .
DISHWASHERS. . . . : RAIN I)R'4SN kft ) . . . ,
.'-marks : BACK PI—OW DEVICE
owner.; ------------------------------------------------ FEES
f`RANK LOHR type amol.lnt by date 1^ecot
'4.-35 SW 74tH AVE PIRMI $ 15. 00 SW Ob/14/94 --
5PC T Is 0. 75 SW 06/1,+/L)4 —
YARD OR 972,23
Dhone #:
( ontr^ar_tar^: ---- —_._--._—_..__--_--__--_.__—_
BEAVEERT01V 1='I_UMB N(3, INC.
13980 SW TUALATIN VALLEY HWY
BEAVERTON OR 97005
-'hone #; 643--1619 $ 15. 7`3 TOTAL
NEWUI RLD 1NSPE.L—1 IONS
This permit is issued subject to the regulations contained in the RP/Backflow rev
Tigard Muricipai Code, State of Ore. Specialtv Codes and all other Final Inspection
applicable laws. All work will be done in accordance with _
approved plans. This permit will expire if work is not started i
witf'ir 180 days of issuance, or if work is suscended for more
;,. than IN days.
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City Tigard PLUMBING PERMIT Planck/Rec. #
13125 SW Hall Blvd. APPLICATION Permit #
PO Box 23397
Tigard, OR 91223
(503) 639-4171
•,•• —' scripnon �
ORS 81421-610 QTY PRICE AMT
Job Ad*.w ,5 746 FIXTURES
Address ap S 0 -50
1 72Z 3 -vator,, 7.30
.»au or u ower Comb. -
Shower Only s0
—
7.
«. afar oset 7.50
Owner 35 ZV-'�4e i washer 7.50
n Garbage Disposal
Washing Machine 7.50
a r Drain T50 _
S � � � afar eater 50
n �» au ry Room Tray
OCCUpant Unnal 7.50
.� ther rixtu�res(Spec ) .� !-
-- 50Ab JdA
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N 7.50
r 7.Sa— t
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/ `V, MISCcLLANEOUS
Contractor —�—
7LIVSewer 1st 100' 30.00 —
�R.9"Sown me e Sewer-ea. t� 15.00
/Z:ffy 1117e,4Water. (vice 1 st 100' 20.0k)hereby acknowlodge that I have read this ap kation,that the Wwor Service ea. Addit. 200' — 15.00
information given is correct, that I am the owner or authorized agent of
the ownw, that plans submitted are in compliance with State laws,that I Storrs d Rain Drain 1st 100' 30.00
am register with the Construction Contractor's 9oard, that the number Stom,. a Rain Drain Addit. 100' 15.00
given is L (If,exempt from Stato registration,please give reason --
below Mobile Hama Space 25.00
Back ow ProvontF6n
/ Device or Anfi-Pollution Device 7.50
« + ny rap or aste—Not
Connw:tod to a Fixture 7.50
Ddscribe work new qddition 0 a teralton U repair %atc isin 750
to be done residential n r sidential Q — 4000
Insp of Exist. Plumbing per hr
—^
Specialty alty Requested Inspections pFr hr IJ
t"n�•nn co nli Patn r?;ncinnla imi
budding or property _ dwelling y 1500
Residential backflow prevention
n. devices 1500
r, Proposed use of
building or property
y ( xcepf rear endai ac low
prevention drvi'ces)
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NOTICE 'Minimum Fee$25.00 SUBTOTAL /15 6)0
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w PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5%SURCHARGE �
—' AUTHORIZED IS NOT COMMENCED WITHIN 190 DAYS,OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED PLAN REVIEW 25%OF SUBTOTAL
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED
TOTAL ��75
Sp9aal Cotttiitions
Date issued by
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