10135 SW HIGHLAND DRIVE 10135 SW HIGHLAND DRIVE
N
v
c
ro
r.
rn
13
cn
a
I
City of Tigard i
INSPECTION REQUEST �
for
IN&PECTION TIME: PERMIT NO. :
DATE: //U DATE ISSUED :__LL_
OWNERS NAME :
ADDRESS: la ✓ f �_ '- A 'CONTRACTOR :
TEST : Air D, Water❑ , Visual �, Laboratory ❑ I
RESULT: Approved D Oisapproved� Pending ❑
I
SKETCH;
tv
t
INSPECT06 DATE
ENOTV Attach supplemental test data berPtal
i'
i
i
i
E
JOHN E. RiIItHnRUI ptUMt11NG, INC. BUILDING DEPARTMENT, TIGARD N0.
P. 0. BOX 129 PLUMBING PERMIT o 5&-3
NEWBERG, OREGON 97132 holder of a valid plumbing contractors license is hercb;
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified riot less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors,) � ;�f /9
Qwne L_ �r�.�t _�__ Addrese/C)/�. 4�CtJ
NUMBER OF TOTAL PERMI r NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT toffice Use Only)
Single Family 1_beth—each 25,00 —Duplex—Each.1 bath unit _— 25.00 --
Additional bathrooms—each �. .�'" ___ 10_00
Mobile Home Space—each r Y 15.00
INDIVIDUAL FIXTURE FEES
1 to 50 Fixtures in 1 building each _ 3.00
51 to 100 Fixtures in 1 building—each _. __ 2.50 — _ --
101 to 200 Fixtures in 1 building-each' 2.00 -
201 or more Fixtures in 1 buildinp-��ach — 1.50
MISCELLANEOUS ---
.�~
Building Sewer-1st 50 ft. 1 U,00_
Sevw�pFleh additional 100 It. 10,00
Water Service to building_ _5y00 —_
I I
Private Water Systems—each 100 ft. _—, 10.00 f
Other (Specify):
PERMIT �� �`. `(� For Plumbing Inspection Phone 6394191 I
X96 State / L y'1 Plumbing Contractor By
TOTAL—` —, RECEIPT NO. Issued Ey
wwww 104—M
d
l
l
I
City of Tigard I
INSPECTION REQUEST
I
for
INSPECTION TIME: PERMIT NO. :.
DATE: j�71,1-Y11E DATE ISSUED ::LL I
OWNERS NAME :-- — I
ADDRESS: _ I
CONTRACTOR :
TEST : Air ❑, Watero, Visual , Laboratory ❑
RESULT: Approved , Disapproved ❑ Pending ❑ I
SKETCH:
e 4e
I
1 I
INSPECTOR DATE
EMOTE Attach luPPlemental t8st dojo hereto] 4
y
99�
ry
•wYS�MA'^'a"•,v?dwrs ^�'`.: +try r�'*'..rs.9"•*1tAlI'M.. yn'.,Y^l.,«.y,f
wV"11 --w
CITY
®F
BUILDING PERMIT APPLICATION fIGARD DATE jJ <Y
° 0944
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
QWNER T*U*Lo _— — ADDRESS 6Aijhj,&110 U1"BUILDERPH NE_ t����
ENGINEER
BUILDER ARCHITECT DESIGNER
STRUCTURE ❑NEW ❑REMODEL C3 ADDITION C3 REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑GAR PORT ❑GARAGE ❑STORA.GE❑SLAB [:]FENCE
❑BOND ❑MOVING 01,0NOITIONAL USE ❑DESIGV REVIEW ❑COUNCIL APPROVED ❑SIGNS
9CCUPANCY LAND USE ZONE __.BLDG.TYPE_ 5—FIRE ZONE-! PLAN CHECK BY ETU HEAT
lob #5199 1222sq.f' . r rams drilling w/attechwd garage* No bssamew -
7 bodroomes 2 be>rthroomell
OCC,_LOAD FLOOR LOAD — HEIGHT - — NO.STORIES AREA VALUE
—BUILDING DEPARTMENT SET BACKS FRONT REAR I LEFT SIDE �M RIGHT SIDE
Permit 1.1`a.UU -
THIS PFnM1T IS ISSUED SUBJECT TO 'THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 111.00 REGULATIONS AND ALL. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State 15.75 LICENSE. SEPARA.E PERMITS REOUIRE:D FOR SEWER, PLUMBING AND HEATING.
Total
>rleetaale�n.
By _ -- ---- -- - — ------------- _.__..
Approved _ 1�1 Receipt No.
--- --' ADDRESS __.__—..� ,......_----PHONE ------------__ .----
i
i
DATE IiNSP, TYP INSPECTION REMARKS PLUMBING DATE
Contractor�.
Permit No
RlAAough"in —
�� 7G --- „tom-- Fixture
Final
L�- ��- /� +- HEATING
Contractor
Permit No.
Gas or Oil —r-
- Rouqh�in
Final —
�_— � ------- SEWER .'G ISf�I S-7 (s
-- -- - --- -'-` Final
DRIVEWAY_
Final
Storm Drainage _J_
_— _ _ ----- —__----- ------ ---_-- — (Rain Drain) Final
R
et Final
BLDG.D PE T.FINAL TEMPORARY CERTIFICATE OCCUPANCYCERTIFICATE OCCUPANCYg
al