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BUILDING DEPARTMENT, TIGArD
PLUMBING PERMIT � •
holder of a valid pl.,mbing contractors license is hereby
au orized to usa plumbing k as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall ba notified not less than four
(4) hours prior to .he time the installations are ready for inspruction. City of Tigard Business License required
for all contractors and subcontractors.
Owned&/, _ Job % `
,��
Address _� = Date, , �I—
NU'.13'cR OF OTAL
TYPE OF PEWAIT ITEtAS FEE ON EACH AMOUNT
AS SM!
Sin h Family-1 bath-eech _ _25.00
Duplex-Each 1 bath unit 25.00
Additional bathrooms-each 10.00 -
Mcbile Home Space-•each -
-------
INDIVIDUAL FIXTURES cOMMERCIAI �V
1 to 50 Fixtures in 1 buildinq-each i 3.00
51 to 100 Fixture:in 1 buildiao-each 2.50 -- —
101 to 200 Fix,tues in 1 building_-each _ 2.00
201 or more Fixtures in 1 buitdineacfi 1.50. ---
MISCELLANF0US
Sewer-each ariditional 100 it._ 10.00_ -
Water Servica to b�;rdina _r 5.00
_--
PERiMIT for Plumbing Inspection Phcne 63:1-4 1 —�
TOTALe \ Plumbinn Contractor By/
�(�. -y Pp FIpT N n tc•isert Rio
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City of Tigard
INSPECTION REQUEST
for I
INSPECTION TIME: PERMIT NO.
DATE: DATE ISSUE;) :-/ Z I
OWNERS NAME .
ADD0$S�
CONTRAC+OR .
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TEST : Air Q, Wot r❑ , Visual Q , Laboratory Q
RESULT. Approve Ja Disapproved ❑ Pending Q
SKETCH.
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IN PECTORA I
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[OTEAttach supplementai test data beret] I
K MEM MIRK
U F
CITY OF TIGARD �C
YI
ORE(,ON
Owner:..TP44l Jn [)evolo ment Company
P.. . ... ....Yermit No. 73r112
Building .Addrpss; . .
1_t).355_ S...W.... �.�pt4.rY. .0ek..
C rrtificat(. i.' hrrehy [riven this., -.29xh..da oi`._Novsmt�s.r
y ..., 19 73.
that said building may he Occupied and
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that it cump)ies with all requirements of
t1w Building Code for the City of 'Tigard,
as approved by thc, l'iggrd City Covneil.
... .............
R111(ling Inspector ......
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. ' .---
D A r E:
O. : --_-DATE: r/ DATE ISSUED'Z-_L_
OWNERS NUMF : 0. e .
ADDRESS : Z of --------- - - --
CONTRACTOR : -_
TEST: A r Ll , WatAr ❑ , VisLtal , Lar ,rotary [1
PESULT.* App;oved2K , Disapproved A , Pending ❑
SKETCH:
PSPECTOR PATE
TE : Attach supplemental test data heret-10
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Gify of Tigard
INSPECTION REOUEST
1
for
INSPECTION TIME PERMIT NO. . .
i DATE : _ ')ATF ISSUED'---� -
OWNERS NAME ' �.r.
ADDRESS : !v ikS �.�• (° - ��,
I C-)N'1 RA CTO R
TES I _i . .k^f e r L] r r
RESULT ApPt' :�iu-pprove,l ^,.a
I SKETCH:
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I INSPECTOR DATE
! DOTE : Attach supplementaeretol
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City of Tigard
INSPECTION REQUEST
i
for
I14SPECTION TIME: ____ PERMIT NO. : — I
DATE: DATE ISSUED
OWNERS NAME : �-
ADDRESS : �_a3� _- 5, w $itilu�✓ GY4✓ BIZ. f
CONTRACTOR - ------ - -- - -- i
"EST : f�:,- 'Nater, V:suai ,�J, I..aboratory i-
RESULT *. Ap-�roved Diiupprwad G , f ending ❑
SKETCH:
L o7T i y
fNSPECTOR D���
NOTE: Attach supplemental test data beret]
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: ��'� _ PERMIT NO. :-------
DATE '.
O. :-_-___DATE : DATE I SSIlED /L_
OWNERS NAME : P -
ADORESS: r i �` Rr�
CON'r R A(; TOR ------
EST : ,*A;r ._� , Water[] , VisualLaboratory [-j
RESULT: Aporored Disapproved G Pending p
SKETCH*
3
INSPECTOR DATE
NOTE: Attach supplemental teat data boreta]
1
PLUMBING PERMIT APPLICATION
Jurisdiction of
No. Type of Fixture Fp(. Permit No. ��
Permit fee
Water Closets Toilets C0 Permit Issued ��,,IL
Bath Tubs _ Approved by1
Lav_ator Was asiri + Building Permm
Shower— Receipt No.
Sins Dishwas :in
SiKitchen
Sinks, Ordinary _ Loc tion of Building ,I
0nk sar_ _.__ - _l� .�
Sinks Slop _ - -.--- ---
Automatic gizis -
_ -Dis osal _
L undry 'fraysName & Address of 'Owner, r$.A 1:y
Drains Floor
-Trains. Area ---- -`
ainsa eT r era or
� _ M
Rain Drains
/ AutomatiT Washer .__9Nar ,e & Address of tP) ber
oun a ns r1in in �1L
Fountains
Hot Water Tank r' Id ---�
Water Service Size
Urinals Buil Old or ew AA ter,, Repair or
a :c - asks -- - Yardn a --
av,n Spr nA er System ._ Z") ._.. ---- ' -
-�� -
Swimming oo1 er �t . c ��' r� ✓ i _,,,,
erystem ___V -
This permit becomes null nd vo d if work or constructicn authDrized is not.
commenced within 60 days, ,)r if construction or work is suspended or abandoned
for q period of 120 days at any time after work is commenced.
All plumbing firms must be licensed by the City of Tigard and post a $1,000 bond.
I hereby certify that. I have read and examined this app-at;ation and know the some
to be true and correct. All provisions of laws and ordinances governing this type
of work will be complied with whether specified herein cr not, the granting of a
permit does nct presume to give authority to violate or cancel the provisions
of any other state or local law regulating construction or the performance of
construction.
Si ture Applican+
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City of Tigard
INSPECTION REQUEST
I for
—
I INSPECTION TIME : �— PERMIT NO. . -
DATE . 6 /26/73 DATE ISSUED'---/--I—
OWNERS NAME :
` ADDRESS : XC - /9 .5�.•,����t�t� -
CONTRACTOR :_ --
TEST .a r ',:i, Water r] , %liscral ❑ , La'* ,ratorl (l
RESULT. Approved, Disapproved 1 Poinding J
I` SKETCH:
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1 IN SPE CTOR DATE
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NOTE : Attach supplemental teat data heret�
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CITY OF TIGARD
12420 S. W. MaIn Sfr*O
TIGARD, OREGON 97223
APPLICATION FOR BUILDING PERMIT
New Construction Demolish ❑ Addition ❑ Remodel ❑ Move❑
ZONING P-D DATE ISSUED %' T BUILDING_F 1,'41T
DATE RECEIVED 4,26-73 BUILDING FEE $ 1010 _ No. 73 11'061
PLAN CHECK $ 50.75
BY sC VAL[JATION $ 29i955•201 `
OTHER $
TOTAL S 152.25 RECEIPT No.
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT # 19 MAP N �G CENSUS TRACT _�„� JOB # _
Architect or Engineer Tualatin Development Co.
Address 15300 S.N. 116th Ave., Phone
Owner
Address
Builder same —
Address Phone
BUILDING USE Single Res. a Multi Res. ❑ Comm. ❑ Industrial❑
OCCUPAN%;Y GROUP I No. of Stories 2 Total height 24' Area of Lot_4j16j
Type of Construction V Floor Area B -- 1400 2 624
Set Backs: Front 10' Back 12' _ L.Side 51_ R.Side_40
Private Sewer Pipe Size 4" Sewer_!j" Septic Tank ❑
Water Service Pipe Size 3/4" Storm Sewer ❑ Ditch ❑ Drywell❑
Street and Curb Requirements Existing
Driveway Width 18' _ No, of Parking Spaces Q
SEPARATE PERMITS REQUIRED FOR SEWER AND PLLTM13ING
SPECIAL INFORMATION
ADDRESS ASSIGNED 10365 $•W'_Century OiLk- Dr' _—
FIELD CHECK BY 9CDA-E�
PLIjAi i APPFOVED BY !{�
It is understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, o«�.qon, and that the building will
not be occupied until a Certificate of Occupancy has been issued by the City of
Tigard Builaing Inspector.
store ,o.t Appp�lliicant