Permit CITYOFTIQARD •
• CITYOF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. P.O. Baa 23397, Tigard, Oregon 97223 (503) 639 -4175 //
PLUMBING PERMIT
PERMIT # ° PLM93 -0011
639 -4171 DATE ISSUED: 01/15/93
SITE ADDRESS...„ 12435 SW 121ST AVE PARCEL: 2S1O3BB- 06900
SUBDIVISION....: ZONING: R -4.5
BLOCK ° LOT °
CLASS OF WORK.. :ADD GARBAGE DISPOSALS..: MOBILE HOME SPACES.: .
TYPE OF USE °OTR WASHING MACH.......: BACKFLOW PREVNTRS..:
OCCUPANCY GRP.. :SR3 FLOOR'DRAINS ° TRAPS ° •
STORIES °1 WATER HEATERS °1 CATCH BASINS.......:
FIXTURES LAUNDRY TRAYS SF RAIN DRAINS °1
SINKS...........: URINALS ° GREASE TRAPS
LAVATORIES °2 OTHER FIXTURES °
TUB /SHOWERS....: SEWER LINE (ft)...
WATER CLOSETS.. :2 WATER LINE (ft) °
DISHWASHERS ° RAIN DRAIN (ft)
Remarks: Add 4 bedrooms to care home.
• Owner: • -- FEES -- -_
J & K LORI NC type amount by date recpt
12435 SW 121ST AVE PRMM1T $ 52.50 JH 01/15/93 —
PLCK $ 13.13 JH 01/15/93 —
TIGARD OR 97223 SPCT $ 2.63 JH 01/15/93 —
Phone #: •
Contractor:
OWNER
Phone #: $ 68.26 TOTAL
Reg #..: 00000
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Rough —in Insp
Tigard 0unicipal Code, State of Ore. Specialty Codes and all other PLM /Underfloor
applicable laws. All work will be done in accordance with Top —out Insp
approved plans. This permit will expire if work is not started Rain Drain Ins p
within 180 days of issuance, or if work is suspended for more Gas Line
than 180 days. Final Inspection
•
Permittee Signature:
Issued By:
Call for inspection — 639 -4175
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•
INSPECTION NOTICE -
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec- O- Phone): 639 -4175 �Bussiness Phone: 639 -4171
Inspection: ,�. l r ia / `.- _ice -
Footing P1..� Underslab Mech. Rough -in Appr /Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post /Beam Struct. San. Sewer Framing -Bldg.
Post /Beam Mech. Rain Drain Insulation - Plumb.
Plbg. Underfloor Water Lin Gyp. Bd. -Mech.
Date Requested: . �3 Time: AM PM 61-
Address: '7 31 Permit #:
Builder: 7)� gal? - 2O //
THE FOLLOWING CORRECTIONS ARE REQUIRED:
•
s r/�sd 7
Inspector: 7 �- Date:
, APPROVED�� DISAPPROVED APPROVED SUBJECT TO ABOVE
� VV7 °°° Call For Reinsp.