10411 SW RIVERWOOD LANE-1 ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 63$A17
Inspection:
Footing Susp. Ceiling 6Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Bean* Mech. San. Sewer Gas Line -Bldr,.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alzrm Water Line Insulation -Mech
Underflr. Insul, Shear Wall Gyp. Bd. -Elect.
Date Requested: ��C?���Time: AM PM
Address:_ ��� y �( ,�C�t�L,�•-1�-�./ T � �
�- L, ({ 71 Permit #�It,) i�jj~
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Date:��� G�
%A2P 10�D DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY CSF TIGARDL'_"7
COMMUNITY DEVELOPMENT DEPAR•fMENT
13125 SW Hall Blvd.Tigard,Oregon 9722.:+8199 (503)839.4171 PLUMBING PERMIT
PERMIT #. . . . . . . : PLM95•-0274
639-4171 DATE ISSUED: 09/22/95
PARCEL: 2S 114BB-1. 000
:SITE-, ADDRLSS. . . 10411 SW RIVERWOOD LN
SUBD IV IS ION. . : SWFNSONS GLEN NCI. 2 ZONING: R l
BLOCI... . . . . . . . . . . LOT. . . . . . . . . . . . . .91
CLASS OF AORK. . :NEW GARBAGE DISPOSALS. . MOBIl-F* HOME SPACES. :
TYPE OF USE:. . . . :SF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS, . : 1
OCCUPANCY GRP. . : Res FI_OOt' DRAINS. . . . . . . TRAPS. . . . . . . . . . . . . . .
c' rORIES. . . . . . . . :00 WATER HEATERS. . . . . . CATCH BASINS. . . . . . . .
X TURES--•---_..__.._..______._..__ LAUNDRY TRAYS. . . . . . : SF RAIN DRAINS. . . . . :
SINKS. . . . . . . . . . . URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . . .
LAVATORIES. . . . . : OTHER FIXTIJRES. . ., . .
TUB/SHOWERS. . . . : SEWER LINE ( ft ) . . . .
WATER CLOSETS— : WATER LINE ( ft ) . . . . :
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . . :
Remarks : Install residential backflow prevention device.
Owner: --------------------------- _.--------------_--------- FEES ------------_
MICHAEL E:VfIVIS AND LAURIE: R tvpe amount by date! recpt
10411 SW ',1UE.RWOOD LN PRMT I 1`_x. 00 JSD 09/22✓95 95--270879
P'f.'T $ 1r. 75 JSD 09/22/95 95--tP7O879
TIGARD OF? 97;='24 00001
Phone #: �-000- 0N01r
Contractor: �-----__----
OWNER
Phone #: . 15. 75 TOTAL
Req #. . : 000000
----- - REQUIRED INSPECTIONS
--This permit is issued subject to the regulations contained in the RP/Backflow Prev _
Tigard Municipal Code, Stace of Ore. Specialty Codes and all other Final Inspection
applicable laws. All worA will be done in accordance with
approved plans. This permit will expire if work is not started
within 1H8 days of issuance, or if work is suspended for more
than 168 days.
-led V
Call for inspection - 639-4175
City of Tigard PLUMBING PERMIT_APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit #
Tigard OR 97223
(503) t339-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
+•^• re»..w•m.^
Now Single Kamm Residences Only
l• I / (� )� hJ 1 BATH HOUSE $140 00 ❑ 2 BATH HOUSE$195 00
Job lJ I �C J -7 3 BATH HOUSE 5225.00
Address zo Fee includes all pl-imbirg fixtures in the dwelling and the first 100 feet
of water service, sanitary_sewer and storm sewer See fees below.
•m•i«nr�raeu.n i FIXTURES QTY PRICE AMT
i/�Z/L •C/1lt�S Sink 9 00
•" q AftM .- 1 �1 // /P^•^• Lavatory 9 CO
Owner �()V,11/ -CJ v,IW dal I-t) 1�)U � / Tub or Tub/Shower Comb 900
tui—wMM• ) q n• Shower Oniv 9 OC
22
`�_--- Water Closet 900
N.— of i Dishwasher 900
At;L .�. Lv /Ll, Garbage Crsposal 900
Occupant Ma",,,,f Ph— Washr ig Machine 900
Jv( /v' tJ S Floor Dram 9 Ot) -�
aiwMr.
to Wat ar Heater 900
U/ .Z y L.'undry Room Tray Y 900
_ +^• U'inal 900
,/-7/_)t)t'� Other Fixtures (Specify) 900
M.In•A4*M Phan. — 9 00
Contractor
900
300 —
Sewer 1 st 100' 3000 _
�•'•N•an"•"^^"^ '" '• `•• " Sewer -ea. Addit 100' ~� 2500
Water Service list 100' —� 3000
1 hereby acknowledge that I have read this application, that the Water Service ea. Ardit 200 2500
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 $ Rain Drain 1st 110' 3000
I am registered with the Construction Contractor's Board- that the Storm 8 Rain Drain Addit '00' 25 00
number given is correct. (If exempt from Stat a reg•,tration, please — --- _ _
give reason below) Mobile Home Space 25^0
Back Flow Prevention
Device or Anti-Pollution Cev ce 900
• • Any Trap or Waste Not
I 2 y Connected to a Fixture 900
gCribe w n v addition aIle ahon repai Q Catch Basin 900
to be done / rdsidential Q non-residential Insp )f Exist. Plumbing 40 00lhr
Sp-cially Requested Inspections 40 0G/hr
Existing use of
building or property _ up��^ _ Rain Drain, single family dwelling 3000
Residential backflow prevention
devices 1500
Proposed use of
building or property __ (Except residential backfPow —
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION —
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5"/0 SURCHARGE
C:ONSTRuc rION OR WORK IS SUSPENDED OR ABANDONED
FOR A PEF IOD OF 180 DAYS AT ANY TIME AFTER VirORK IS
COMMENC ED PLAN REVIEW 25", of SUBTOTAL
TOTAL !j �
Special Conditions
_ Date issued by_
1
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