14920 SW 83RD AVENUE f
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CITY ZF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water I.i,e Ceiling -Plumb.
Post/Beam n' .ch. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct, Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins
Other: Q ' 3(—) — 1 � C) C�
Date: - 9 A.M. D.M.__. Ent
Address: Q
Tenant: Ste:_ _ MST:
BUP:
Con/Own: MEC:
PLM: L
THE FOLLOWING CORRECTIONS ARE REQUIRED ELR:
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Ina @ctor: _y Date:
LPPROVED _DISAPPROVED/CA r CF—�
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
PERMIT #. . . . . . . .. PLM97-0051
131259W Hall BlVd.,Tigard,OR P7223 (503)6394171 DATE ISSUrD: 02,'20/97
PARCEL: 2SIlEEC-05200
SITE ill)DRESS. . . . 14920 SW 83RD AVE
SUBDTVSION- . . . : LA MANCHA ESTATES ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :5
---------------------------------------------------------------------------------
CL.nSS OF WORK. . :REP GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPF C'•7 USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUP,-,"!CY GRP. R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . .. 0 CATCH 0
FIXTURES----- --------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
S 1 IP,KS. . . . . . . . . . s (A URINALS. . . . . . . . . . . : 0 CREASE TRAPS. . . . . . . : 0
LAV(-iTORIES. . . . . : I OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . .: 0 SEWER LINE (ft) . . . : 0
WATER CLOSETS. . : 0 WnTER LINE 'ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN 13
Remarks : Replace lavatory
Owners --------------------------------------------------- FEES --------------
C SNYDER type amo�_tnt by date -,-.,ecpt
14920 SW 83RD r-RMT $ 25. 00 DRA 02/20/97 97—r-,90693
SPCT $ 1. 23 DRA 02/20/97 97--290693
TICARD OR 97224
Phone #:
Contractor: ----------- -------------------
CHRISTIAN PL(!MBING
23172 SW STAFFORD RD.
TUALATIN OR 97062 ------------------- -------- -----------
Phone #-. 50:14=3f,'-6671 is 26. PS TOrAL
Reg #. . c 42671
------- REQUIRED INSPECTIONS --------
This pimit ij issued subject to the relkilmtions contained in the Water line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Set-vice In
applicable Ims. All work will be done in accordance with Rough—in Insp
approved plau. This persit will expire if work it not started PLM/Under-floor
within IN days of issuance, or if work is suspended for wore Top—out Insp
than IN days. Final Inspection
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Permittee
qlq-4 1,f? -
cc Issued
Uj Cal '. f n r i ri s-i r�c t i a o 639-4175
CITY OF TIGARID Plumbing Application RecJBy�—
1312.- SW HALL BLVD. Commercial and Residential Date Recd a
TIGARlJ, OR 97223 Date to P E.Date to DST
1503) 639-4171 Permit 0 �q7��—
Print or Type Related SWR 9�
Incomplete or illegible applications will not be accepted Called
Name of Development/Project FIXTURES (Individual) QTY PRICE AMT
Job G Sink 9.00
P1 L4 J Lavatory 900 c�
Address Sweet Address Suite --
Tub or rub/Shower Comb 900
Bldg 9 City/Slate Zipr� Shower Only 9.00
a'Vater Closet 9.00 JI
Name - Dishwasher
9.00
Owner Mailing Address Suite Garbage Disposal 9.00
Washing Machine 9.00
City/State Zip Phon. Floor Drain 2' 9.00
3" 9.00
i Name 4" 9.00
Occupant Mailing Address Suite Water Neater qm
_ laundry Room Tray 900
CitylState Zip Ph,,ne Urinal 9.00
i
Name — Other Fixtures(Specify) 9.00
f< n 'TiLu _ 9.00
Contractor Mailing Address Suite 9.00
3 ?`ice 5�9L I ) 9.00
(Pnor to issuance City/St'le Z:p hgp
apr licanl must 11 /t�- 3 � ___ - 9.00
r,rovide all Or-gon Const.Cont. pard I.ic.0 Exp Date 900
contractors 2—L7-1--1 -_ 9.00
license Pit bin0jn Exp.Date Sewer-1st 100' —3U 00
rnformation �( _ Sewer-each additional 100' 25.00
for CUT COT Business Tax or Metro>Y i Exp.Date^
database) Water Service•1st 100' 30.00
Nam, Water Sennce-iach additional 200' 1 2500 I
Architect Storm 8,Rain Drain- 1st 100" 30.00 --I
or Mailing Address Sude Slorm&Rain Dram each additional 100' 25.00
Mobile Home Space 25.00
Engineer City/State 71—p
Phone Commercial Back Flow Prevention Device or Anti- 2500
Pollution.Device
Descnbe work New 0 Addition O Alteration O Rebar Residentia Backflow Prevention Device' 1500
to be done Pesidenlial I?( Non-residential O e Anv Trap or Waste Not Connected to a Fixture 9.OU
Additional dddescn;,uon of work^ - -
�� catch Basin goo
Insp of Eustmg Plumbing 40.00
/hr
tSpecially Requested Inspections 40.00
Existing use of
building or property __ per/hr
Rain Dram,single family dwelling 3000
Proposed use of Grease Traps 900
m building or property
Z� QUANTITY TOTAL
Are you capping. moving or replauny ariy rixtures� Yes fPl No❑ Isomeinc or user d agram o renwreo d Ouanity Total Is >9
IIf es see back of form) T' 'SUBTOTAL
I hereby acknowledge that I have read this,pplicabon,that the information _
given is correct.ttiol I am the owner or aulhoi zed agent of the owner and 5% SURCHARGE
that plans submitted are in compliance with 0'e on Slate Laws
Siprature of Owner/7
wners lent bate PLAN REVIEW 25% OF SUBI OTAL
I I1 °etiuired or -f Ixture_ty total,s>9
III AItt�,i
TOTAL
ntact Person a Phone
-Minimum pennit fees S25 - 5%surchargu.except Residential Backflow
Prevention Device,which is S15+5%surcharge
I:`plmapp.doc 12/96 (dst)
PLEASE -OMPLET—I AS APPRQPRIAI-E-7 O PROJECT:
Fixtures to be capped, moved or replaced Qty
Sink
Lavat
_ ry
Taub or Tub/Shower Combination
Shower Only
Water_Closet
Dishwasher _
Garbage Disposal � e
Washing Machine
Floor Drzin 2"
E 4"
Water Heater
Laundry Room Tray
Urinal _
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
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r: plmapp.doc 12,96 (dct)