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i:\records\mlcrotim\targets\building.doc
CIV OF TIGARD
COMMUNITY" UEVELOPPA ENT DEPARTMENT
13125 SW Hall 8.vd.Tigard,Oregon 1199 (503)1139-4171 PLUMP INCS PERM.TT
PERMIT 1i. . . . . . . . PLM94-iZ11,.5.l.
6 --4 17 1. DATE ISSUED: 07/07/94
PARCEL. 15135Dn.-03,-,00
SITE ADDRESS. . . : 11r".1.0 SW 90TH AVE
SUBDIVISION. . . . . ZONING:
BLOCK— . . . . . . . . .. LOT. . . . . . . . . . . . . .
CLASS OF WORK. . :ADD GARBAGE D I SF.'OSH'L---. 11OBILE IAOMr- SPACES. -
TYPE OF USE. . . . :SF WASHING 11ACH. . . . . . . BACKFLOW PREVNITRS. . : 1
OCCUPANCY GRP. . . R3 F,'-.00R DRAINS. . . . . . . . TRAPS. I . . . . . . . . . . . . :
STORIES. . . . . . . . : 1 WA', ER HEATERS. . . . . . . CATCH BCISI�'S. . . . . . . :
Lf)(J1\1DRY TRAYS. . . . . . : SF RAIN DRAINS. . . . .
SINKS. . . . . . . . . . . UR I NAL9. . . . . . . . . . . . . GREASE TRAPS . . . . . . .
LAVATORIES. . . . . .. OTHER FIXTURE'S. . . . . :
TUB/SHOWE=RS....: SEWER LINE (ft ) . . . . :
WATER CLOSETS. WATER LINE: (ft ) . . . . :
DI'"iWASHERS. . . RAIN DRAIN (ft ) . . . . :
Remar-ks : BACK FLOW DEVICE
Ownei-: FEES
T140MAS DOLL type amoLint by date r-e0pt
tt',"100 F)'OJ 90TH PRMT $ 15. 00 SW 07/07/j4 -
5 PC T $ 0. 75 SW 07/07/54 -
116ARD OR 97LJ23
Phone #.
Cclnty,actolr-.- ----------------------------------
OWNER
------------------------------------------
$ 15. 75 TOTAL
Reg 00000
REQUIRED INSPECTIONS -------
This permit is issued subject to the regulations contained in the RP/Backf1L)w Pt-ev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspecticir,
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 182 eays of issuance, or if work is suspended for more
than 180 days.
v.
Call fat- inspecti,an 639-4175
INSPECTION NOTICE
City of Tigard Building Deparueent:
13125 SW Ball Blvd. Tigard, 7regon 97223
Inspection Line (P.ec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections__-_ G-V)
Footing Pllag. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam McCII. Rain Draln Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mech.
Date Requested: `1 ___Time: �j AM PM
Address: , �.�0� /oP. ermit\�s l`1`-
Builder: "' C -�9
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
Inspectors _�__ Dates !"J
APPROVED `_- DISAPPROVED APPROVED 3UBJ1!s'f TO ABOVE
l _Call For Rainnp.
A
U I I CIF I )(41-WO .-- Rl. (.11 Plf.N I M-1 'k fill MI. 14
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(;41U I I-40h,1l W! 00
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7-6
4: R
I fA I.NV-J EIt� Rfvf Pt.-P194,-01 3 j S. 00 S E111.11 0 1-
101411- AMOUNT PAID 15. P.5
eessss*e�r�s,
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # _
'13125 SW Hall Blvd. Permit # _
Tigard, OR 9722:
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ;..T. SURCHARGE
— N,m,4 Dw.b°menl NPW 5mnle Famll',r Residences Only
�– ❑ 1 BATH HOUSE$141.011 ❑ 2 BATH HOUSE$195.00
,.lob ❑ 3 RA 1i HOUSE$225.00
Address c° s�.. / — n Fee includss all pFinbi-q nxtures in the dwelling and the first 100 feet
of water service, sanitary sewer and storm sewer. See fees below.
_ FIXTURES QTY PRIC,- AMT
rMm•�.r n•m,of 0. r)
Sink _ °.PO
Lavatory
Owner
Y9.00
Owner L i �l C-c' , C l t' Tub or Tub/Shower Comb. 9.00
ZIP Shower Only 9.00
G� --17) )- 5 Water Closet l 9.00
N.m (m.• abwrr) Dishwasher 9.00
Garbage Dispo3al 9.00
Occupant MW"Aftm v°.n. Washing Machine 9.00
Floor Drain 9.00
aweun Water Heater 9.00
Laundry Room Tray 9.00
N•m Urinal 9.00
N Other Fixtures (Specify) 9.00
M..,a w,r,•. Ph" 900
Contractor ———
9.00
Sewer 13t 100' 30.00
Sum•P g ft.°.°W cnr 9• T•'W_ Sewer-ea At:dit. 100' 25.00
Water Service 1st 100' 36.00
I hereby acknowibdge that I have read this application, that the — Water Service .a. Addit. 200' 25.00
information given is correct, that I am the owner or authorized agent of —
the )wner, that plans submitted are in compliance with State laws, that Storm 8 Pain Dra_n 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm &Rain Dra:n Addit. 100' 25.00
number g en is curre A. (If oxen pt from State registration, please
give reason below.) Mobile Home Space 25.00
l y Pack Flow Prevention
Dovice or Anti-Pollution Device 900
so,.n..(e+,«er.o.n+ Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new O addition Q alteration ? repair Q Catch Basin 9.00
to be done residential O non-residential Q ' Insp, of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40 00/hr
Existing use of Rain Drain, single family dwelling 3000
building or property
Residential backfio%v prevention
devices 15.00 7
Proposed use of
building or property
*(Except restrfenUa! backflow
pre rentfon devices)
NOTICE *MI dmum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5%SURCHARGE
CONSTRUCTION OR WORK IS SUSPENnED OR ABANDONED ---
FOR A. PERIOD OF 180 DAYS AI'ANY TIME AFTER WORK IS
PLAN REVIEW 25% OF SUBTOTAL
COMMENCED
TOTAL
Special Conditions
Onto issued by _