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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested Time A.M. PAI
Address __ Permit #
Owner—,, Lot #
Builder
The following Building Code deficiencies are r4cd to be corrected:
re�
Presented to -*p
41A proved
Inspector h Disapproved
Date
CALL FOR REINSPECTION
F-1 YES E] NO
i
i
CITY OF TIGARD Plumbing Permit 3 , 91
Building Department Ne.
Rbsidential 0 Commercial ❑
New Installation ❑ Replace ❑ Addition ❑ Alteration E Date
Licensed N caner �� f ,l < v
Plumber ~" .� — _
Address ._- �� =r +� �� -' b Ad ress , _ ---
Phone —
�1 li
� ------ APP� -
CITY BUSINESS LICENSE REQUIRED F _� C' TRACTORS AND SUB-CONTRAC1 ORS
ITEM NO. FEE TOTAL ITEM NO. FcE TOTAL
FixtuteE-Traps 7.50 Sew :First 100 ft.- -_ 30_00
Dishwasher _ 1 50 ch Addit.100 ft. 15.00
Garbage Disposal 7.50 jector Pump _ ---7.50 _
Water Heater _ 7.50 er:First 100 ft. 20.00_ -
Backflow Preventer 7.50 �\ Each Addit.200 ft. _ _ 15.00
_ f
Storm&Rain Drain:First 100 ft._ 30.00
_ Each \ddit.200ft.
Mobile home Space — _-_ � 25.00.-.------
Other($pecity): _ Rain Drain-Single Fam.Dwelling 15 00 -
--- -- Comments -- ----
PERMIT FEE `� '-- -
_ _: ,
- ----- Issued Sy
STATE
Receipt No. ,-._< Applicant
TOTAL l Signature
For Plumbing Inspection Phone 639-4'71
I
PERMIT TO CONNECT
Tigard Sanitary District I
PERMIT N? 1178 DATE
PERMIT IS GIVEN TO
OF -----
TO CONNXCT A_"'
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT 1
THIS PERMIT MUST bE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID ALX,�-.......TIGARD SANITARY DISTRIgX
-:i---.--� BY
41
CONNECTION INSPECTED AND APPROVED
Superintendent
I
Fm
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Adelress 7,Z //G �,,,� _ Permit No. 7
Permit charge .2
Owner ,�Q %yi p, Connection fee&?J t0
Paid by
Type of Building Date connected_L�_����
Service Rate Inspection fee,Z—p
Contractor Paid by Date
Size of connection Assessment Paid