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10200 SW HIGHLAND DRIVE
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BUILDING DEPARTMLNT, TIGARD
PLUMBING PERMIT ``` U
^�P%l� Ear•+rY ,+, .J __ _, holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in cccordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be ;iotified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
000
for all contractors and sub-contractors.
I Owner _ r � Addre . Dates
---=—
NUMBER OF TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
Single Fe liv-1 bath—each 25.00—-- ----
Duplex--Each 1 beth unit __ 25,00
_Additional bathrooms—each --_--._ _ — — 10.00 --
Mobile Home Space—each — __ 15.00
INDIVIDUAL FIXTURE FEES __V ---
_� 1 to 50 Fixture., in 1 bullding—each,. _ 3.00 — — -------
_51 to 100 Fixturee in 1 building—each 2.50
_101 to 200 Fixture: in 1 building—each 2.00 _- -- --
_201 or more Fixtures in 1 building—each 1_50_
MISCELLANEOUS -- — —
Building Sewer-16t 50 ft._-_ — 10.00
Sewer—each additional 100 ft. _10.00
Water Service to building 5.00 — —
Private Water Systems—each 100 ft. 10.00
Other S ecif :
e'ERMIT c► For Plumbing Inspection Phone 639-4171
3%State Plumbing Contractor By
TOTAL JU RECEIPT NO. Issued By
� P z
City or Tigard
INSPECTION REQUEST
pfzorN-AY for
s --
INSPECTION TIME:, A -n.'-PERMIT 140. _._
BATE : � DATE ISSUED
OWNERS NAME :-
ADDRESS:
AME :_ADDRESS:
CONTRACTOR
TF ;T Air ( j, Water ; , Visual Laboratory p
FeFS1!I.7' nppn,vedl�..� Dismpproved D Pending C7
SKETCH:
�NSPECTQR DATE
City of Tigard
INSPECTION' REQUEST
for
INSPECTION TIME: w�'M PERMIT rJ: . :___.
DATE.' -,';- DATE ISSUED . ,
OWNERS NAME . ���
ADDRESS' --
C 0 N T R A C TO R
DDRESS: _CONTRACTOR
TE ;T : Air rj, Water[] , Visual 0 , Laboratory r
RESiJI_T: Approved' !, Disapproved Fj Pending p
SKETCH:
i
I
r
INS ECTOH DATE
[NOTE" Affaeh Qo!a barptra�
CITY O' u'
BUILDING PERMIT APPLICATION TIGARD DATE ' 19 N- 0540
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS Arj%fPE�FfftTjR .j.-VV'R PHONE
OWNER Tualatin Development C:UA'bDRESS .LU200 !-U. 1-Ughlerid Dr.
BUILDER
ENGINEER
8Ul LDER ARCHITECT DESIGNER
STRUCTURE ONEW ❑REMODEL -- ❑ADDITION ❑REPAIR ❑RENEWAL. ❑FIRE DAMAGC'-1 ❑DEMOLITION
ClRESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGEOSLAB ❑FENCE
l IROND 11 MOVING ❑CONDITIONAL USE ❑D SIGN REVIEW ',OUNCIL APPROVED ❑SIGNS
QCCUPANCY__.__LAND USE ZONE_ —BLDG.TYPE FIRE ZONE-! PLAN CHECK BY tfs HEAT'
.instruct 1425 sq. ft. frame dwelling with attached garagys
no basement
2 bedroom
QCC, 14;7; 27,y0p
C LOAD FLOOR LOAD — HEIGHT NO.STORIES AREA _ VALUE
BUILDING DEPARTMENT 101 —_, 7-•G — 1EI
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit Zd.l.oc -------- - - — --
THIS
ERMIT IS
Plan Check V) �l.! REGUP TIISSUED
ONS AND ALL APPLICABLE CODES SUBJECT TO THE EANDAORDIINAN ORDINANCES, IT IS HEREBY AGREED THATINED IN THE BUILDING CODE, THEWORK 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 393 LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total 134.0
By -
--' APPI..ICA,VT OR AGENT — -
Approved Receipt No.
ADDRESS _,� .,-... _.....w., -O ..
DATE INSP. TYPE INSPECTION REMARKS PLUMBING . onrE
11--� Permit No.
Rough-in
xn� Fixture
.L - _JL, le/ Final
J .Ur ; 04,1 _ HEATING
Contractor
Permit No.
-- Gas or Oil
Rough-in
Final _ _
SEWER/01-3-7.3
Final
DRIVEWAY
—� Final
Storm Drainage
(Rain Drain) Final
--- Sidewalk
Curb&Street Final
Approach L G .2
BLOC.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final