12750 SW PACIFIC HIGHWAY ADDRESS:
i:\records\microflm\tirgets\building.doc
INSPECTION !G lr F 2!1i�/
City of Tigard Bullding Department
13125 SH Hall Blvd_ Tigard, Oreyo:: 97223
Inspection Line jRec-0-Phone): 639-4175 Rdainess Pt:one: 639-4171
Inspection:
Footing Plbg. Undeisl.ab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FIi1AL:
Poet/Bnam Struct. San. Sewer Framing -Bldg.
p
Post/Deem Meeh. Renin Drain Ineulatloa: C
plumy.
Plbg. Underfloor !y Water Line Gyp. Bd. -Meeh,
Date Requested: 1[_ —j Timet AM pM
I' `7
llddrese: Ali�G �acL1-: pittf
Builder: r
THE FOLLOWIN9 CORRECTIONS ARE RMQDIRF.D:
Inspocto / ---- — - -
� ..�..�------_— Date: -lCa
.APPROVED DJSAPPROVED APPROVED BD&'RCT TO .,BOVE
_Call For Reinap.
CITY OF TIGArRD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223.3199 (503)839-4171 PLUMB INIb PER1y1IT
PLRIII'T #. . . . . . . : PLIY194-016',
G39-4171 DATE ISSUED: 08/06/94
PARCEL: ES1012BD-01503
SITE ADDRESS— : 1-'--'750 SW PACIFIC I-AWY
SUBDIVISION. . . . : FREWINGS ORCHARD TRACTS ZONING: C--G
131–OCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 1
CLASS OF WORK. . ALI" GARBAGE DISPOSALS. 1101AILE HOME Sr-"OCES.
TYPE OF USE. . . - .t-;OM WASHING 1y1ACH. . . . . . . . 1 BACKFLOW PREVN'TRS. .
OCCUPANCY GRP. . FLOOR URO INS. . . . . . . . T R P t--,S. . . . . . . . . . . . . .
STORIES. . . . . . . . : I WATER HEATERS. . . . . . : CATCH DOSING. . . , . . .
FIXTURES–------ LAUNDRY 'TRAYS. . . . . . : SF- RAIN DRAINS. . . . .
SINKS. . . . . . . . . . . URINALq. 1 GREASE TRAPS.
LAVATORIES. . . . . : 11 OTHER F1 �'UR* ' '
E�3 .
TUB/SHOWERS— . : SEWER LINE (ft ) . . . .
WATER CLOSETS. . :2' WATER LINE' t Ft ) . . . .
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . .
Remav,lis : Ct-IP OFF 2 TOILLJ5, I URINAL, 11 LAVATORIES, I CLOTHES WASHER FROM OLD
BEAUTY SCHOOL TENANT
Cojner- ; FEES
ROSE GOSPODINOVIC type amount by date r-ec-pt
12770 SW PACIFIC HWY PRIrT $ C.5. 00 JG 08/08/94
5PCT $ 1. :-'G JG 08/08/94
TIUARD OR 97223
Phorip #-
Con tr-actor--
CONTRACTOR NOT ON FILE
PI-lone 26. 25 TO r(AL
Rpq
RECUIRED INSPECTIONS
This permit is issuod subject to the regulations contained in the F i vi al I n s ppet i o Ti
Tigard Municipal Code, State of Ore. Specialty Codes end all other
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
wiVir 180 days of issuance, or if work is suspended for Pere
thar, 180 days.
P e l-,m J. t t P e Si gnat 1.t r-e
s s 1.t e d by ;,
I I for^ I r)s p e r-,t i o n 639-4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
V 125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-411-1
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
"•"•°'°ivi'°Pm•^' { New Single Family Resldencos Only
Addy- ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Job ) ��jv ��_� � ) 1 fi�L �l E) 3 BATH HOUSE$225.00
Address cnyrpn. zp Fee includes all plumbing fixtures in the dwelling and the first 100 feet
9 2 of water service, sanitary sewer and storm sewer. See fees below.
N.-(&..m•°' rf FIXTURES ary PRICE AMT
11 C7�, ' r-C7S ��11 1c� .S�i - .Sink 9.00
"'•may A"••• V Ph- Lavatory 9.10
Or:ner �!�%�� �, ATL f)( P Tub or Tub/Shower Comb. 9.00
" 'e•'•, t0 Shower Only 9.00
�) `z,V ) > � A- -71) Water Cioset _ 9.00
"•m•Ia ^•°'h°.'"••• Dishwasher 9.00
Garbage Disposal 9.00
Occupant M�..yAa.„; vnPP. Washing Machine 9.00
Floor Orain 9.00
'�•'• Water Heater 9.00
Laundry Room Tray 9.00
Urinal 9.00
Other Fixtures (Specify) 9.00
A".. Ph.. 9.00
Contactor _
9.00
nn
9.00
Sewer 1st 100' 30.00
S,.,.R.yu".iw,,,1� c.v L..• T•1 No Sewer-ea. Addit. 100' 25.00
Water S=rvice 1st 100' 30.00
1 hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given Is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, tnat Storm &Rain Drain 1st 1C0' 30.00
1 am registerea with the Construction Contractor's Board, that the i Storm &Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please -
give reason below.) Mobile Home Space 25.00
Back Flow Prevention
Device or Anti-Pollution Device 9.00
:Yq„uw r.w^er a.y.nq Y �•�" Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new Q addition Q alteration 0 repair 0 Catch Basin 9.00
to be done residential 0 non-residential C Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr -
Existing use of
building or property _ Rein Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of -
building or property --
�'- --- _ resldentiai backflow
prevention devices)
NOl RE 'Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5%SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED --- -FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
Cr`,MMENCED. PLAN REVIEW 25% OF SUIS iuTAL
F_ TOTAL
Special Conditions -
-__ Date Issued _ by-
A" lApp JIAINI I
),)I I )MIA IN I Ii:!1�1
r0 IIW P(It tF I t 1W y If I ILII 1 111 1 1 0 h
I k 1011
PUFtVrCi9 I IF POYMI N 41hUaUN 1 P0.11) 1'ORII(r-11 Ill i
..........
1/10
1;-,/!.,LA iiw U.. MY lot 1 Ilr►1}.I.P$1 1 I. 1
l111 I F•11 "VII it IN I 1.11.1 1.11