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INSPECTION NOTICE
City of Tigard Building DepsrtmnC
13125 b.' -all Blvd. Tigard,
Ortisgon 97223 S
Inspection Line (Rec-U-Phone): 639-4175 Business Phones 639-4171Xi
Inspection: -- --- — -- v:.
Footing Plbg. Underslab Rech, Rough-in Appr/Sd•+lk
Found Plbq. Top Out Gab Line FINAL:
Poot/Beam Struct. San. Sewer Framina -Bldg. ,
Poet/Beam !tech. Rain Drain Insulation -plumb.
Plbg. Underfloor j' Water Line Gyp. Bd. -Hoch.
Date Requeettlds_
Timet AH PH
Address: �•�,�-- _ P66oiE )f: �� l)�4-
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Builder:_
TAE FOLLOWING CORRECTIONS ARE REQUIRED:
InspecDate:
tor:_- �- —
-17
/2z'
PPROVED DISAPPROVED AP-ROVED SUBJ CT A
Call For Reinep.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Orogon 97223.8199 (503)839-4171
PLUMBING PERMIT
PERMIT #. . . . . . . : PLM94--0167
639-4171 DATE .ISSUED: 08/05/94
PARCEL : �'S102L�A-02].00
SITE ADDRrW,�.>>. . . : X199,3 SW JOHNSON ST
SUBD I VI S I ON. . , . : NO. T I GARDV I LLE: ADDITION AMEND. ZONING: R-4. 5 �
BLOCK. . . . . . . . , . LOT. . . . . . . . . . . . . :20
—
CLASS OF WORK. AL.T GARBS-)GI-* D I S►IOSALS. . MOBILE DOME: SPACES, :
TYPE: OF' USE. WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : �
OCCUPANCY GRP. . : F'-; FLOOR DRAINS. , . . . . . . TRAPS. . . . . . . . . . . . . . .
STORIE:S. . . . . . . . WATER HEATERS. . . . . . . CATCH LIOSINE;. . . . . . . .
FIX'T'URES- --____ _____.._._.. LAUNDRY TRAYS. . . . . . : SF RAIN DRfaINS. . . . . :
S I NKS. . . . . . . . . . . URI NPL-5. . . . . . . . . . . . . GREASE TRAPS. . . . . . . ,
LAVATORIES. . . . . : OTHER FIXTURES. . . . . .
TUB/SHOWERS., . . . : SEWE=R LINE (ft ) . . . . :
RATER CLOSE:'1:2- - : WATER L INE: (ft ) . . . . : 10171
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . .
Remarks : REF-`LACF WATER LINE
Owner: _.._._______._—__._.______------__._ _____---..__.____._._...___.__-- FEE=S
LUCILL.E BORSCH type amount Icy date recpt
9935 SW JOHNSON ST F'RMT 8 30. 00 JF 08/05/94 -
51"'CT I 1 . 50 JF- 08/05/94 __ 1
TIGARD OR 97223
Phone #:
Contractor:
CRIST 1AN PLUMBIIJG
22919 SW STAFFORD RD
TUALAI 11\1 OR 97062
Phone #: 638-8231 # 31. 50 TOTAL
Reg #. . : 42671
REQUIRED INSPECTIONS _._-.._._. _..._.
This permit is issued subject to the regulations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other F incl Inspection
applicable laws, All work will be done 1n accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
thar 180 days.
—
Issued By :
Call for inspection — 639-4175
.. `Sri,• '.
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Fcity, of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
i3125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
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/ Now Single Famllv Residences Only !
G i L ✓�v,es c
„ftwo ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
-.{-�
Job S- 1 i � 1 f Af S 6 .4j ❑ 3 BATH HOUSE$225.00 I
Address COW& . as Fee Includes all plumbing fixtures in the dwelling and the first 100 feet 1 .
14,o,he d e_ C'72 2_3 of water service, sanitary sewer and storm sewer. See fees below.
FIXTURCS QTY PRICE AMT
sink 9.00
9 Ad*- �^�^• Lavatory 9.00
WM .
Tub or Tub/Shower Comb. 9.00
Owner np Shower Only _ 9.00
Water Closet 9.00
Dishwasher 9•00
i
Garbage Disposal __ 9.00
Occupant MWIng Af- phi• Washing Machin,) 9.00
Floor Drain 9.00 _ II
m 'Nater Heater 9.00
!F Laundry Room Tray 9.00
Urinal 9.00
Other Fixtums (Specify) 9.00
M."um«. Ph«» 9.00
Contractor 2;2c>/� S s/�y���lJ fj� 9.00
9.00
cnTrer.r. _
Sewer 1st 100' 30.00
St..R.041 r ne. err s.T. - Sewm-e•). Addit. 100' 25.00
Water Service 1st 100 30.00
I hereby acknowledge at I '16V6 read this application, that the Water Servlca ea. Addit. 200' 25.00
Information given Is correct, that I am the owner or authorized asant of Storm &Rain Drr,m 1st 100' 30.00
the owner, that plans submitted are in compliance with State laws, that _
I am registered with the Ccnstruction Contractor's Board, that the Storm &Rain Dra n Addit. 100' 25.00
number given Is c,. -ect. (If exempt from State registration, please Mobile Home Spacr: 25.00
give reason below.) _
� Beck Flow Prevention
r BA y/ device or Anti-!ollution Device 9.00
W. Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new 0 addition O alteration 0 repair Q Catch Basin 9.00
to be done residential 0- non-residential Q Insp. of -xist. Plumbing i 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
building or property _. ��-_ *(Except residential bocMiow
prevention devices)
i
r.`TILE 'Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 6% SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS rLAN REVIEW 25% OF SUBTOTAL
COMMENCED. _
TOTAL
Special Conditions
Date issued by
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