15675 SW 88TH AVENUE jSF
ADDRESS.
'lira
.15G75 SW WPM
AYEN
r.
CITY OF TIGARD BUILDING INSPECTION DIVISION T
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 4 ; —
Date Requested_ AM _PM I 1 Il_X� BLD _
Location Suite ' M C) —
Conta^t person _ Ph _ PLM
Contract r
C r Ph _�/,�-y� �(e. SWR
BUIL DING Tenan O:er , ' 1.^�� �, u i ELC _
Retaining Wall -` ELR
Footing A ----
Foundatior. NOT REQUESTED !i � ��✓ FPS
Ftg Drain -
Crawl Drain Ir FOUND DURING RESEARCH SGN _
Slab NO INSPECTIONS) !N FILE SIT
Bost& Beam --
Ext Sl-eath/Shear
Int Sheath/Shear
Framing �—
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler -_
Fire Alarm -- -�---- ---�-- ----`-- —
Susp'd Ceiling -�
Roof - --
Misc: ---- - ----- _�— ---
Final _.--�--------__�
PAS PART FAIL
MBARG
Pos Beam ------ — — _ - - - — --
Under Slab
TopOut ---- - --- ._..--- - - ------ -- - �. _ - —
Water Servicra
Sanitaiy Se wer
it
-ai s
1PART FAIL
%NICA!_ --__-----
�,ost S Beam - ---- ---- --—
Rough In ----
Gas Line
Smoke Dampers -
Final - - - - T-— �--- —
PASS PART FAIL
ELECTRICAL --
3ervice
Roug),In
V) UGiSlab
� low Voltage
Fire Alarm
�. Final
PASS PART FAIL
SITE
Backfill/Gradino - - - --- -- -- -- -
Sanitary Sewer
�Str,.n Cowin i I Reinspec!ion fee of$ required before nert inspection. Pay?t City Hall, 13125 SW Hall Blvd
Catch Basin Please call for reinspection PE:
Fire Supply Line I I p _- _. ( I Unable to inspect-no access
ADA
Approach/Sidewai'< t C
_ Inspector
Other Date L L J Ext'
Final
PASS PART FAIL I DO NOT REMOVE this Inspection record from 1 he job site.
ONEMWAIP WEIwo
PILUMBINO' PERMIT
CITY OF T I GARD DATIM
I'!I T S#. .UED: Q'. . . . . .. P L M')6—lzi 16
_ IS6/08/9(,
COAMUPITY DEVELOPhENT DEPARTMENT
1312E SW Hall Blvd.Tigard,r.,regon 9722398199 1503)639.4171 PIORCEL: j'S111DD--041Z100
SITE ADDREG':3. . ia,75 :3W st.',T H iA V E
SURD I V 15 1 ON. . . . : SIRATFORD 70NING: R--4. 5
BLOCK. . . . . . . . . . : 1-0"i. . .
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
IYVIE OF USE. . . . :SF WASHING MACH. . . . . . . 0 BACKFLOW PREVNTRS. 0
OCCUPANCY GRP. . :R3 FLOOR DRAIN6. . . . . . . 0 TRAPS. . . . . . . . . . . . . 0
LI—OR IES. . . . . . . . : 0 WATER HEtJERS. . . . . : I CATCH BASINS. . . . . . . . 0
F 3 LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
.-.I NKS. . . . . . . . . . : IT URJNALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . 0
LnVATORIES. . . . . : 0 01'HER FIXTURES. . . . : 0
1*UB/SHOWERS. . . . : 0 SEWER LINE ( ft ) . . . : 0
WATER CLOSETS. . : 0 WATIER L I NE (f t ) , . . : 1p.
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . :
Remarks : REI-11—ACE ELECTRIC WATER HEATER WITH GAS WATER HEATER AND INSPECT
NEW GAS LINE* PIPING TC, WATER HEATER.
Owner-: FEES ----------
BARBARA T. SQUIRES t'ipe amount by elate r-eept
15075 !-31W 88TH PRMT $ .2t-j-. 00 J*H 06/20/96 I)C280B34
5PCT' $ 1. 25 J*H �?iib/20/96 96—.280834
T1GHRD OR 97224
Phone #:
Contr-actor-:
KODIAK PLUMBING
6604 SE WOODSTOCV
PORTLAND OR 97206
1-'hone it: 318-9096 MBL 26. 25 TOTAL
Req #. . .- 72465 REG).UIRED INSPEC"TILINS
This permit is issued subject to the regulation, contained in the Misc. Inspection
Tigard Municipal Code. State of Ore. Specialty Codes aid all other Gas Linz...
applicable laws. All work 4ill be done in aCCL-dance with Final Jitspection ..............
approved plans. This perbit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
Than 180 days.
I er,m j t t e e G i qriRt 1.tv-e
Call for inspection —__6'3q' -4175
trt�
City of Tigard PLUMBING PERMIT APPLICATION P,anck/Rec. # F�M��'- 0(to
13125 SW Hall Blvd. P r v .l Iate, /c�' Permit #
Tigara,''OR 9722.3 �``' ww"L �` s `�6
(503) 639-4171
MINIMUM! 425.00 PERMIT FEE + ST. SURCHARGE
N.-of D..Wpmenr F- New Single Family Residences Only
aye.: 0 1 BATH HOUSE$140.00 O 2 BATH HOUSE$195.00 )I
.lob Jlo/S S tG! 1 ❑ 3 BATH HOUSE$225.00
Address c5ur. m Fee includes all p:umbing fixtures in. the dwelling and the first 100 feet
er water service, sanitary sewer and storm sewer. See fees below.
1 ! N.me,an.mi p FIXTURES QTY PRICE AMT
Sink 9 f 0
Lavatory 9.00
��ner ciJ�� ? �- 2'�'T SCU i3�r/Cy Tub or Tub/Shower Comb. 9.00
cxps+.0 rp Shower Only 9.00
.ve-C� �. Water Closet 9.00
N.me,or n.lne nl bnnewl Dishwasher 9.00
- -;" t 4 Garbage Disposal 9.00
!occupant M,O,p,1td,,, „nne Washing Machine 9.00
Floor Drain 9.00
ceysur. z>o Water Heater 9.00 U L
Laundry Room Tray 9.00
Urinat 9.00
�[' �/ /Lc•/i/�//(�j Other Fixtures (Sperify) 9.00
M.Ifn°Mdn. r Phone 9.00
Contractor ��' .�' ��� ' 9.00
9.00
1(�'`n)` �a,, �i'�f�C:�� •.,,+ /9p�, ,�2��, Sewer 1st 100' 30.00
VJ /, .,■,.r.ep.n■unn
N. -tom- Q r eu• T.. S9wer -ea. Addit. 100' 25.00
77-ti S d-4' 5*,:- Water Service 1st 100' 30.00
I hereby acknowledge that I have read this ap lication, that the 77 Water Service ea. Addit 200' 25.00
information given is correct, that I am the owner or authorized agent of Storm 8 Rain Drain 1st 100' 30.00
the owner, that plans submitted are in compliancy with State laws, that
I am registered with the Construction Contractor's Boal.! that the Storm &Rain Drain Addit, 100' 25.00
nu,nber 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
spn.wre a.ner n .°er,u D.le Any Trap or Waste Not
Connected !o a Fixture 9.00
Describe work new (_ addition 0 alteration repair 0 Catch Basin r 9.00
to he done residential 0 non-residential O :Insp. of Exist. Plumbing _ 40001h
Specially P,eclucsted Inspections 40.00/hr
Existing _lie of (, Qa Rain Drain, single family dwellinq 30.00
building or property _.V/L�? ct/�- C`rG� It /�/ cC 9 Y
Residential backflow prevention
G fid�� CG devices 15.00
f-
Proposed use of
r budding or property '(Except residential bacwfl-O
prevention devices)
c� >
NOTICE 'Minimum Fee (25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5%SURCHARGE /'
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUG� ON OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25% OF SUBTOTAL S
COMMENCED.
TOTAL
Special Conditicns
Date issued by