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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation WaterLino Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mach.
PIbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post'Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: T) �
Date: La r' TG A.M._P.M. Ent :
Address: _� _ ,(�� SL,%X� 6--l- it
Tenant: _ _. Ste:____ MST: v
BLIP:
Con/Own: _ MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR-
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APPROVED DISAPPROVED/CALL FOR REINSP. CF CO
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PLUMBING PERMIT
DATE T SUED . . . . : PCITY GF TIGARD LM96 -0141
l•?A"fE ISSUED: urC,/1: /9C,
COMMUNITY DEVELOPMENT DEPARTMENT
1317.5 SW Hall Blvd.Tigard,Orsaon 97223.8199 (503)839-4171 PARCEL: 1 S 135AD-0:�5V_I 1
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SITE ADDRESS„ . . : 10969 SW HALL BLVD
SUBDIVISION. . . . : METZGE'R ACRE TRACTS ZONING: R-12
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :E,
-----------------------------
CLASS�OF=MWORK. . : REPA ��JYVGARBAGE UISPOSf:)I..S. : 0 MOBILE HOME SPACES. : 0
TYPE: OF USE. . . . :L`LJF' WASHING MACH. . . . 0 BACKFLOW PRFVN'TRS. . : 0
OCCUPANCY GRP-. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . .. 0
rS ORIFS. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES•—_"---.__-.—___---- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
1 LAVATORIES. . . . . : 0 OTiAER FIXTURE S. . . . : 0
TUB/SHOWERS. . . . : 0 SEWER LINE (ft ) . . . . 0
14AIER CLOSETS'. . : 0 WATER LINE (ft ) . . . : 3t30
9 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Installing 390' of water, servir_-e
Owner: FEES --
LARRY IHOMAa type amoi_rnt 17y date r^ecpt
l.c.'694 SE 1c'`�"fH F'RMT 9� f30. kDO B 06/12/96 96--280` 20
5P'CT $ •4. 00 13 06/1[/96 96—C-80 520
C:L.ACKAMAS OR 97015
Phone #:
Contractor-:
N0141-H' S PLUMBING
1'7120 SW SHAW
BEAVERTON OR 97007
Phone #: $ 84. 00 TOTAL
Req #. . : 000340
-------- REQU I RED INSPECTIONS ----____
this pewit is issued suhject to the regulations contained in the Water- Line Insp
Tigard Municipal Lode, State of (Ire. Specialty Codes and all ether Water Ser-Vice In
applicable laws. All work will be in accordance wittl_ —---` Final Inspection
approved plans. this pewit will _xpire if work i started
within NV days of issuance, or work is pe 0 '�r'vara
than 188 days.
I-'ermittee Siynat�.rr
I s s l-red By :
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Call for- inspection - 639-4175
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City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec.i # •_
Permit #Permt / 4 q(
ti- DIS(
13125 SW Hail Blvd. --r l
1-igard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
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° &109h9 SW Ha11 Elvd. New Sln Ike Family Residences Ont
U 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Job U 3 BATH HOUSE $225.00
Address uwst.. zp Fee includes all plumbing fixtures in the dwelling and the first 100 feet
Tigard, Oregon 97223 of water service, sanitary sewer and storm sewer. See fees below.
H.m.i.,°.m.°1 HU..,„.) FIXTURES QTY PRICE AMT
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Larry Sink 900
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' "^°^• Lavatory 9.00
Tub or Tub/Show, 'omb. 9.00
Owner 126 Sr 125th - -
c.°s,.,. Shower Only - 9.00 -
Clackamas, Oregon 97015 Water Closet - 9.00
Dishwasher 900
Duplex Garbage Disposal 9.00
Occupant M„.ro ti,°„. - �*^• Washing Machine 9.00
Floor Drain 9.00
Water Heater 9.00 _
Laundry Room Trdy 9.00 *
u,.. Urinal 9.00
North's Plumbing Inc. 649-5544Other Fixtu es (Specify) V e 9.00 I
Mon. 9.00
Contractor -
17120 SW Sbaw Street 97007 M 9.00
coy's,n. ..w 9.00
Beaverton, Oregon 00002090 Seppr 1st 100' ?0.00
S1.1.A.g ft-N. cM i_1�'1+ Sewer a�. Addit 100' 25.00
003/0 Water Service 1st 100' 100- 30.00 30.00
I hereby acknowledge that I have read this application. that the Water Service ea. Addit. 200' 100 25.00 4
fi/wn
given is correct, that I am the owner authorized agent of -
hat plans bffii a a pliance w h State laws, thatStorm &Rain Drain 1st 100' 30.00
red with a Constru on ontractor's oard, that the Stone &Rain Drain Addit. 100' 25.00
n is coect. (If exe t fro Sta egistration, please bolo .) Mobile Home Space 25.OU
Back Flow Prevention
11/9 Device or Anti-Pollution Device 900
.o, ^•'• Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new (J addition (D alteration repair (-4 Catch Basin 9.00
to be done residential ® non-residential O Insp of Exist. Plumbing 40 00/hr
Specially Requested Inspections 40 00/hr _
Existing -e of Rain Drain, single family dwelling 30.00
building or property -
Residential backflow prevention
devices 15.00
Proposed us- of same -
building or property ___ _ -
'(Except residential backflow
prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL- (30.00
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF 5% SURCHARGE 4.U0
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED - -
FOR A PERIOD OF 190 DAYS AT AN r TIME AFTER WORK IS
PLAN REVIEW 25°ro OF SUBTOTAL
COMMENCED.
TOTAL B4-00
Special Conditions _
Dale issued by
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NAME- 141; ,''tH PL.I, JYMlN6 INC ;:ri+.M1 I.Wli AINr 641. 00
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