15588 SW 76TH AVENUE Iw
ADDRESS.
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 07223.8199 (503)639-4171
PLUMSTN'G PERMIT
PFr,!':',TT #. . . . , . . . PLN1075) q!
47 DATC ISSUED: 06/03/95
12100
ATC ADDR=. . . : 157nA SW 71TH AKL�,
UBDIVISION. . . . KNMISSnNCE WOOnn TI ZONING:
;,.r4s7, or WORK, CPRDA6E 017rOSALT. . MOBILE HOME 5PACr..7,.
YPA OF USE. . , 31' WASHING MACH. . . . . . . SACKFLOW PREUNTRS. . ct
rr[_ r
TGRIEE. . . . . . WATER HEP717RL.. . . . . . C.nl'CH BASINS. . . . . . .
I XTUFF 'L.PUNDRY T! CiY_, . . . . . rr RAIi"4 .
INKS. 13 R- I NALS. . . . . . . . . . . . . GiREASE T PAP!:.. . . . . . . .
7THr.'R ',-!;�T'177:.
VATCRTE
JI]A/S1-f4wCrM). . . . . GCWE7� LINE (ft ) . . . .
nTER CLO%TS. . WP-T, ,-I'k 1, T 1 If".. ( ft ', . .
Ir RnIN DDA!°+i kft ) . , . .
ON DOOZrASTEr, typR mr)u n t by date
5535 �_;W 7C.,TH AVE tPP M T 15 42)0 JG 06/08/'3
0. 771 �O 06,'0S/'L-7
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REOUIRED INSPECTION ?
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (RecO Phone): 639-4175 Business Phone: 639-4171
Inspection: !2r— ��_C, __�t.1r11f
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Flbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struet. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line Bld
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insu. Shear Wall Gyp. Bd. -Elect.
Date Reques"ad: �,= C? --_Tine-:7 AM PM
�
Address:��
Bllilder.� / � w S l N.! Permit #:
THC FOLLO-�TW'ING CORRECTIONS ARE REQUIRED:
12)
CA
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CD _ .-
Il'
Inspector: � �^ Date:
_APPROVED _DISAPPROVED y;;APPROVED SUBJECT TO ABOVE
Call For Reinsp.
1pr
1;`:.I I Y OF l l f-f RD -.. PECL I PT or, PAYk4-.N'1' RF"C`F I PT NO.
CHr.CV AMOUNT
Nnmf THOMAS C,f'lWITRUCTION GA51i PMOUNT
t-Il)t)F?IF'C-;F, a G:OYMENT DATF r06;Ob
OUBD I V'15 10N t
F='IJF�F'C1 I nF- Pf)YMC.NT AMOUNT PAID I,,IJRP0',,W OF PfkYMFNT AMOUNT PA F 1)
R F11_IJMF?.li' B PERM 15. 00 OT. SMI..F) r'FR 17a« 7,5
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T OTAl AMOONT PAID
City Of Tigard PLUMBING PERMIT APPLICATION Planck,/Rec. #
13125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Nwv Single Family Restlences Onhr
_ ❑ 1 SATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Jab 8 7G j" ❑ 3 BATH HOUSE$225.00
Address w.s. zn Fee includes all plumbing tlxtures in the dwelling and the first 100 feet
of water service, Weary sewer and storm sewer. See fees below.
FIXTURES QTY PRICE AMT
Sink 9,00
Q1.0M'1'°" """' Lavatory 9.00
Owner =� ��✓ �G' �u Tub or Tub/Shower Comb. 9.00
CA"VAN fl" Shower Only 9.00
Water Closet 9.00
Dishwasner 9.00
>c�,-c- -'� Garbage Disposal 9.00
Occupant „r,�,� Ph"
Washing Machine 9,0()
Floor Urain 9.00
a Water Heater 9,00
Laundry Room Tray 9.00
Urinal 9.00
Other Fixtures (:ipecdy) 9.00
U."A"- 9.00
Contractor
,'C! c; 11e3 9.00
C"*Aft y
9.00
e r c mac-/ j Sewer 1st 100' 30.00
owe'opmrim ""` "+""Ta N" Sewer-ea. Addit 100' 25.00
OZ �, V C
3Water Service 1st 100' 30.00
i hereby acknowledge that I have read this application, that the Water Service ea. Addit 200' 25.00
information given is correct, that 1 am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit 100' 25.00
number given is corset. (if exempt from State registration, please
give reason below.) Mobile Home Space 2500
Back Flow Prevention
I
Device or Anti-Pollution Device 9.00
Any Trap or Waste Not
Connected to a Fixture 9.00 i
Describe work new Q addition O atterauon Q repair v Catch Basin
9.00
to be done residential Q non-residential Q Insp. of Exist Plumbing 40.00/hr
Specially Requested Inspections 40.00ihr
Existing use of
building or property Rain Drain, riingle family dwelling 30.00
Residential 3ar:cflow prevention
c evices 15.00
Proposed use of
building or property
'(Except residential backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5'/6 SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED -
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN RIEVIEW 25°/. OF SUBTOTAL Fj
TOTAL
Special Conditions -""
Date issued _by