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i.\records\microflm\targets\building.doc
INSPECTION NOTICE
City of Tigard Building Depart—nt
13125 SW Ball Blvd. Tigard, Oregon 97223
Innpection Line Glue-O-�39-4175 Business Phone: 639-4171
Inspect icn:__,__. _ r--- -------
F-)oting Plbg. Underslab h. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can LineFI_�:'
Poet/nea.n st-ruct. San. Sewer Framing -Bldg.
Post/Ream Mach. Raln train Insulation
Pl.bg. Juderfloor Water Lin s/ Gyp. Bd. -Koch.
Date Requestedt_�� r G)/� �,�_Timet /y/11Kc/ PM
Address:1?/�_ U �n Permit
Builder:_�_7 7 _ 1 7 7
TIM FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors 6 f-_ Date:
iAPPROVED DISAPPROVED APPROVED SUBJECT'TO ADM
Call
For Reinsp.
—LU 4E�i N 6
PERMIT
PERMIT #. . . . ,. . . : PLN94-0, ',
CITY OF TIG RIS DATE ISSUED: 09/30/94
COMMUNITY DEVELOPMENT DEPARTMENT r)ARCEL: 1S133DD-024l1e)l/)
13125 SW Hall Blvd.Tigard,Oregon 97223*6199 (503)639-41171
flI)LN,. 4 VII-L-01 PARK LN
c2 ZONING: R-4. 5
SUBD I V I S 1.ON. . . . : VILL-HUE AT SUMMLR LAKL PARK
. . . . . . . . . . . . . .63
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. - : MOBILE HOME SF-,ACFI-,.
TYPE OF USE. . . . :SF' WASHING MACH. . . . . . .
: BACKFLOW PREVNTRS. - : 1
OCCUPANCY GRP'. . :R: FLOOR DRAINS. . . . . . . TRAPS. . . . . . . . . . . . . . .
CATCH BOSINS. . . . . . . :
STORIES. . . . . . . . WATER HEATERS. SF RAIN DRAINS. . . . . :
FIXTURES—----- LAUNDRN TRAYS. . . . . . GREPSF. "TRAP'S. . . . . . . .`
SINKS. . . . . . . . . . :
URINALS. . . . . . . . . . . . ...
F
L.AVATCJRIE�-). . . . . . OTHER F*IXTIJRES. . . . . ..
TUB/SHOWERS. . . . SEWER LINE (ft ) - - - - -
WATER CL.051-ITS. WATER LINE' (ft )
DISHWASHERS— - ' RAIN DRAIN (ft ) . . . .
Remarks : CAr*,KF[.OW DEVICE FEES
Owner-,
MICH(IEL OILOUGIALIN t ype amol.int by date v-ecpt
PRMT $ 15. 00 JF 09/:30/94
I_,-`887 SW VILLAGE PARI, LN 5PG T $ 0. 75 JF 09/30/94
T I r-,)()R1) 0 R
Phone #:
DLNNIS' 7 DEF9
7355 SE JOHNSON CREEr, 9LVD
POR IL-R1,4D OR 9'7206-93C.9 $ 15. 75-TOTAL
PhCIT'q #' *777-777*7
1�pq #. . . 5009 REU.UIHED INSPECTIONS ......
This permit is issued subject to tne requlatlonS contained in the RP/Backflow Prev
Tigard Municipal Code, State of Ore. Specialty Codes and all other F i n,-
_11 Inspection
applicable laws. All work will be done in accordance with
--
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for tore
than 180 days.
,el,_Mit,tee
ISSUed By
11 for- inspection 639-4175
._..u...,,....r.�:en•:.rs.W.W r.wawr..uawrrr+w--�--�... •rutrW�iwpitlf av�a.ww,.rnrr nww.::"+::.r.✓.w ;
CITY OF TIGARD
PERMIT I"1' .�„�. 13125 SW TIALL BLVD.
PWMBINGApplicants must hold Oregon Registration to conduct a plumbing `l'IGARD, OR 97223
business or must be property owner/operator not hiring outside beip.
Name o f Oevf loprn enl (5 0 3) 6 3 9- 4 175
PluniilinK Pcrrnil Flu.
Address n Description - — -
��?� �, l j URS 814.21-910 -- -- cx1Ml. _ wince AMT.
.Doh Tax luN Map.No
Addt 1 FIXTURES
lDl Block Subc1livislOn Sink 7.50
---- ams a name Is Lavatory _ 7.50
i , L
Tub or Tub/Shower Comb. 7.50
MadmV Address Shower Only 7.50
C ' Water Closet _ 7.50
Owner City/State LP7.50
Dishwasher, __
Phone Garbage Disposal - 7.50
-
__ Name Washi-vg Machine _ ..7.50
FkxK Orain 7.S0
Uw_ ug ress Pfha a Water Heater _ __ _ 7,50
_ laundry Room Tray _ 7.50
Occupant City/State --- r'p Urinal 7.50
Other Fhaves(Specify)Name Phone
7.50
NE NIS'SEVEN DEES LANDSCAPING, INC. 7.50'
PhUAWL 50
LAND,OREGON 97206.9329 — -
Contractor Clty/State zo ---- --
MISCkA1ANEOUS
City Bue.Tax, Sower t st 1'10• 10.00
1-a'y
��� �11
� sewer-ea:Addd.100' 15.00
tats -d No. lNo.
(Resdentlal) Water Service 1st 100' - 10.00 -
I hereby acknowledge thel I have read this applit-Ation.Cul the k*xhnatlon Water Servioe ea.Additfflor -- 15w---
given
5w_given is corned,Chat 1 am nsgis{ered`w di the State Iluikws Board.and also Storm&Rein train I s.100' 10 00 - --
have a State F'KM*lg license that the rxxntens Uiven am oared.that all 15.00
f� �ng nwork will be done in accordance with affAc-able proviaio ns of Ore-
gon Revised Statutes Chapters 417 and 693 and gVilcable ad-and that Mobile Horne SIS 25.00
no help will be enKhbyed unless Ik»need under ORS CA3 (it erernlA hom
Stats registration. Devi
please give reason below). Device
Flow Prevention 7.50
HM �)
OEOWNERp
S-1 hereby certify Chid 1 am the owner Of the rolertY df oe a Mtn Pollution Device
scribed above.at which location 1 propose 10 make a pkrrnbing inetagadan kx Any Trap a Weals Not
M own use and Chis property k not tekV mnstrurtecl Ikr aab,lease Of fm” -Connected b a Ruchrs 7.50
Catch Basin 7.50
Insp.d E3drtt.Pkx nbkV 40.00 Per Hr.
Specialty Requested Insp-bons 40.00 Per W.
` !fain Drain, 1500
- Single Fan. DwIg.
AU 0.841]NATURE elf —
Describe work new❑ addition C] alteration L] rttpair❑ Li —
tQ be done residentinil non-residential F
MINIMUH PERMIT FEE 25.00
6d1tklp tna a1
txtlWktp a{xc>{xhrty SUB-TOTAL � --
Med use of 5% SURCHARGE
tx�«p»ot—ty--.- - - --- 25% PLAN REVIEW
WITICE TOTAL
YJA p« work a mit beoomse null and void it wooory auction authorized la nM oon C
mon0ed vAd*i 190 darken K onnahvdbn or work is ellapwx$od or abandoned lot
a ps.tod M Igkj As"of any time eiter%work to cormronood.
tt"C1Al_ ----
Onte i,suod ____�—_ GY