13398 SW BENCHVIEW TERRACE ADDRESS :
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City of Tigartl Building Dnpartment
13125 SII Ball blvd. Tigard, Oregon 97223
Inspection Line (Rec Phones 639-4175 Buaineae Phones 639-4171
Inapectiont_ ---
rooting Plbg. Underalab / Meeh. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas tine
Poet/Beam Struct• Ban. Anwar Framing -Bldg.
POst/naam Mech. Rain Drain Inrilation
Plbg. Underfloor Nater Lilo Gyp. Bd. _Hoch.
Date Requentedt _Timet
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Bu,ildor: - �.►�
THE POLLOWINC CORRECTIONS ARE REQUIRED:
Inspectors'--'A%
Dates -�
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE r
_Call For Reincp.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13126 8W Hell Blvd.Tigard,Oregon 97223.6199 (603)639.4171
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)Sp;iC��ie 1a.Ys', All work witi ac done in accordanct pith
pprovig Aims, x is perwit will trretrt t' work ii r.rt s.arttzl
nithll�'1W am Oj :LsuBrt:R, or if no is 50ptR0e0 rtr' oar£
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CITY OF TICARD
PLUMBING Pc- RM[T _ 13125 SW HAIL BLVD.
P. O. BOX 23397
Applicants must hold Oregon Reglsf ,,ti,rx to t mhdt" a pluml„ng T I GARD, OR 97223
businessrxm„stbeproperty owner/rperr;ar outside help.
�– None of 0 imkspmont
Plumbing i arm%t No. _
Adcke (� Ooscrip"on — --
_ �I Q—? „j1 /. �.".,�✓ ' % ons 814-21-610 t]UAN. PRICE AMT.
Job T L,d ts:.r,do.
Addreas
_ F:wTURES
,tblivislon _
Sink 7.50
--- W”--1 a �j
... j-- ` to
t Lavary 7.50—
„" � /J Tub orTub/Stwv--r Comb_ 7.50
W"--1
_�ss _
Shower only 7.50
Ownert%tY/Ste'e Water Closet _ 7.50
----�—
Dishwasher 7.50
r PfhQne ,/ Garbage Disposal -- ---7.50
Name !� Washing Machine y 7.50
Floor Drain 7.50
1 Address Phone -- Water Heater 7.50
Occupant City/State –— LAmu*y Room Tray —– – 7.50_
Urinal 7.So
— frame Other noes(SPedty) 7.50
7.50
3 JOHNSON CREEK BOL RD ---� — 7'50
Contractor cny/stat AMD;t?RE9�Ff�Y94 f2t�— — 7.50
MISCELLANEOUS _
City 134je.Tax Ne. Sews(1 st 100' 30.00
5z 1612
Sewer-ea.Addit.100' – —15.00
State o. tate --
(Resdential) Water Service 1st IDD* 20.00_
I hereby acro ovRiedgo Mrd 1 have read tis application.trot the kiiorm Pion Water Servios ea.Addit.200' 15.00
given is oomect,that 1 am regWw*dVhth the State Builder's Board.and also Storm R Rain Drain 1 st.100' 30.00
have a State Pknmsbing li eme that the numbers given are corned,that atl
D> sit work wig be dorm In eocordonne vnth applicable pro%'wions of Ore- Skim 6 Pcin Drain Add t.100' 15.00
gon Reviser'OAA les Clsaptars 447 wW 693 whd applicable ales and tsar Montle Honse Spwv 25.00
no help w►,bm employed twAo"tk*need twhdw ORS G (t exempt fern --- --
State regasuation,please give reason below). Back Flow Prevention
Devioe
1KMIFOow*–1 hereby o *that 1 am the owner a the property do- or Arsti 1'olhntion Device 7.50
scribed above.wt which Iocaton I propose to maks a pkwnbing Installation for Any Trap or Waste Not
mry own tno and tis rxaperty In not bekq constructed kr.sale,bane or rens Connected to a Rxwm 7.50
Catch Baskh 7.50
kw.of FJdet.Ptum,tsing e0.00 Per Hr, -
_ ----'—– --- Specialty Requested Inspections 40.00 Per Hr.
Rain Drain, –
single Pam. Dwlq.
4A
Describe
Describe work rtew() addit4❑ allerstiorh❑ tapalr[]
be duns tersldential Pil, non•rebident;+111__ _ — - --
6dstkw use of MINIMUM PERMIT FEE 25.00
bt"V or prope'ty_ — - _-- -- _- SUB-TOTAL t"
weed U"of _-- 5% SURCHARGE
t orwr4-ty_ --- -- - 25% PLAN REVIEW
NOTICE _._.._.. — ----
This
- -TMs p*nT*taoornee nut and Vold rl work or mortaeuction suthontted It nal corm TOTAL
Merwied vrtftin 180 daym xw K co>atnnrJ on or week M slai"nded or stwwkxhed to
a period al 190 days M any On"stun Uork to oom re-q er t.
vftc kL 0ONOR101t8
0 „r klsued L —._......_.- -
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CITY OF TIGARD — RECEIPT OF PAYMENT RECEIPT NO. o93-243031
CHECK AMOUNT x 26. 25
AME DENNIS' SEVEN DEES CASH AMOUNT x 0. 00
DDRESS '7355 SE JOHNSON CREEK BLVD PAYMENT DATE 08/06/93
SUBDIVISION :
PORTI-AND, OR 9-7208—
OPPOSE OF PAYMENT PAID PURPOSE OF PAYMENT AMOUNT PAID
LUMBlNQ PERM ------------25. 00 ST. BUILD PER— ----' ----- |---
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13398 SW BENCHVIBW TERP
TOTAL AMOUNT PAID — — — —> 26. 25