11970 SW 95TH AVENUE-1 11970 SW 95TH AVENUE _
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INSPECTION NOTICE
City of Tigard Building Department
12.420 S.W. Main St.
Tigard,Oregon 97223
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Phone: 639-4171
� Type of Inspection
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Date. Requested_____Z c Time_.-- A.M. P.M. 1
! Address ZZZ�?j__-Q _ / s � _ Permit #—Ia'
Owner------------_--- •----- Lot
iBuilder �r ,,�.�t._ ,G-f'�=J=
The following Building Code deficiencies are required to be corrected:
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Presented to _ — proved
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Inspector �., [� Disapproved
Date
CALL FOR R :INSPECTION
❑ YES U NO
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CITY OF TIGARD Plumbing Permit
B�jilding Department 3 j9 1
Residential P1 Commercial
New Installation Replace Addition El Alteration F-1
Licensed Date X
Plumber C'-
Owner
Address uIT
Iditess
Job A
'Phone
Applicant
CITY ROSINESS LICENSE REQUIRED FOR ALL 30NTRAC,rORSA4 SUB-CONTRACTORS
.
ITEM NOEE_ TOTAL ITEM NO. �O'
!�J_xLuns_Traps FEE TOTAL
7.50 Sewer:First 100 ft. 00
Dishwasher 30.00
7.50 EAchAddit. 100 ft. .00
Garbage Disposal 15.00
7.50 Ejector Pump
Water Heater 7.50
7.50 Water:First 100 ft. 20.00
Backflow Preventer —
7.50 h Addi
Eact,200ft.. 15.00
Storm&Rain Drain:First 100—ft —
Each Addit.200 ft, 15.00
Mobile Home Space 25.00
Other(Specify)
Rain Drain-Single Fam Dwelling
15.00
PERMIT FEE djL., Comments:
STATE % Issued By:,'
TOTAL Receipt No Applicant
For Plumbing Inst:vc1ion Phone 639-4171 Signature
Addreee /l �J^(rf� C Permit No.
Name of Occupant Permit,charge
';.fteti
Paid by
--- -- ---- — Date connected
Type of Building
Inspection fee
Service Rate__ Paid by Date
Contractor Assessment , _Paid
Size of connection