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CITY OF TIGARD BUILDING INSPECTION NOTICE
j Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
I Inspection: rr
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Footing Susp. Ceili g Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech, Rough-in Fireplace }' ti+ •:
Pest/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg. a fi
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
IJndertlr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: y� /�-~0y(y% Time: AAM PM fi"
Address:
Builder: Permit
THE FOLI.OWING CORRECTIONS ARE REQUIRED:
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Ins ector: Gate: 1 ��
OVED —DISAPPROVED -APPROVED SUBJECT TO ABOVE
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—Call For Reinsp. t
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
PLUMBING PERMIT
PERMIT' #h. . . . . . . : P1_149 550(113e
639-4171 DATE ISSUED: 02/21/95
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PARCEL: c'L-1 10BA--@fa 100
ITE ADDRESS_ :: 14565 SW MC F'=ARLAND E+l_VD
SHADOW HILLS ZONING: R-
. . . . . . . . . . . LOT. . . . . . . . . . . . . r 14
CLASS OF WORK. . :ALT GARBAGE. DISPOSALS. . : MOBILE HOMES %PACES.
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . s BACKFLOW PREVN'TRS. . : 1
OCCUPANCY GSRI R3 F'LODR DRAINS. . . . . . . : TRAPS. . . . . . . . . . . . . . .
STORIES. . . . . . . . : 1 WATER HEATERS. . . . . . : CATCH BASINS. . . . . . . s
1 IXTUREt3-._...__._.._._.....---_....__.._ LAUNDRY TRAY.:. . . . . . : S1= RAIN DRAI.NS. . . . . :
SINKS. . . . . . . . . URINALS. . . . . . . . : GREASE T'RAPS. . . . . . . s
LAVATORIES. . . . . : OTHER FIXTURES. . . . . :
J1 / 'FICJWE FiE:i. . . . :
SEWER LINE ( ft) . . . . :
WATER CLOGETS. . : WN T LR LINE
DISHWASHERS . . . : RAIN DRAIN (ft ) . . . .
Remi-arkFi : BACKFLOW DEVICE
Owner:
KEN DICKEY type am0I.tnt: tly date re(:F)t
14'-.,65 SW MC FARL.AND BLVD F'RMT $ 15. 00 KS 02/17/95 -
5PCT f 0. '15 K`:i 02z'/17/95
11GAND UR
i,orle ##:
t- ON BOND LANDSCAPE MAINTENANCE
11i'4.10 SW I,:-.'6TH AVE
TIGARD OR 97223PI-10r;F1 #: 590--6885 $ 15. 75 TOTAL.
Flet' #. . 117cLf
RE UUI RED I NSPE C"r IONS -----
Th;s peysit is issued subje,:t to the regulations contained in th. RF'/Backf.luw Prev
Tigard Municipal Code, State of Ore. Specialty Codes and all otner Final lnR;ppr7ticm
applicable laws. All work will be done in accordance with
approved plane. Chis persit will expire it work is not started �_ _•_•,_,._���___.�. _ _,__..__ ._V _�
within 160 days of issuance, or if work is suspended for sure
than 180 days.
et-mittee
:.,i nat .�r•N : ..
i s;I-t a d U y `
Cal for- inspert; ion - 639 417`",
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City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # _
13125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
N.-.0 D-WM.." I Now Single Fami- IY_Residences Only
aaw ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Job -s' s'b /A 404 ❑ 3 BATH HOUSE$225.00 w►
Address CAWSh" w Fee includes all plumbing fixtures in the dwelling and the first 100 feet
Tr,a6trl O l q TU of water service, sanitary sewer and storm sewer. Sce fees below.
wm.( www...) hh FIXTURES CITY PRICE AMT
ketAP& U" 01 7 Sink 9.00 r
ma"A"«. Q eh. Lavatory 9.00
Owner J IlQ' % ILL Tub or Tub/Shower Comb__ 9.00
W9100 - Shover Only 9.00
l t,t e" C r, "Tc Water Closet 9.00
N_la e of ) Dishwasher 9.00
LL?Vllt Ahux Garbage Disposal - 9.00
Occupant ,,)„e, M*M Washing Machine 9.00
4 f e Se Id SII, F4 Floor Drain 9.00
CW91ft ,�,�L,)�-- _► Water Heater 9.00
Ti 7JLLaundry Room Tray 9.00
rtnr. Urinal 9.00
46 Other Fixtures (Specify)- 9.00
w•N Aran nom. 9.00
Contractor 1//() 5-1A)5-1A)l,��/� �ol p `/1 VK.� lc t 77W 9.00
ctwstw. tre 9.00
Sewer 1 st 100' 30.00
s....R.wn.n..n. uw a..Ta N. Sewer-ea. Addit. 100' 25.00
Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm R Rain Drain 1st 100' 30.00
I am registered with the Const)uction Contractor's Board, that the Storm &Rain Drain Addit. 100'
number given is correct. (If exempt from State registration, please
give reeon below.) Mobile Home Space
ffBack Flow Prevention
/Qjyl L ru�I-In Device or Anti-Pollution Device 9.uo
(WMW o"e Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work newV addition (D alteration U repair O Catch Basin 9.00
to be done residential V) non-residential Q Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.001hr
Existing use of Rain Drain, single family dwelling 30.00
building or property
Residential backflow prevention
devices 15.00
Proposed use of,
buildi- of property
�=--J-n---�- '(Except residential backflow
7o by / A�rr prevention devices)
NOTICE ■ 'Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME 1OID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5%SURCHARGE I S
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED - -- - -"
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 26%OF SUBTOTAL
TOTAL S
Special Conditions _ M
- _ _ Date issued by
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