11390 SW 94TH AVENUE-1 ml Ri w
r 11390 SW 94TH AVENUE
I f 1 f
r•'i
i
Ocn
1-4
f+ G
���
G� f{LJ�G�JCI�tal
1 C'7 i i
rtl1 !'
(Ilk
� . ,_I�• X41� .,E s � a� � ! I � , ' i µ,'.;
i
! f
�f-f.tu� 'fi t Elul r .0
tl + 1
Ea
a t ''
!. t'3 lu�l1 �trlll+f {►�IVil�.�,n��;f��i.lY. `F�,!IL; '��1
F 41
. 1
� t
EL4wjLwK!r
�JXW�TLIir Vjmr "AIMMIM
CITY OF TIGARD Plumbing Permit 3
Building Department No.
Residentiri! 2 commercial Ll
Now Installation R Replace 1:1 Addition L1 Alteration El Date
Licensed f t
4:11 10.1 0 A
Plumber GIA-11U 4,4 \;y -za Owner
/,ddress -4112 ,tj4�
Job Address //& :2/) R�&
Phone
Applicant
CITY BUSINESS LICENSE RECUIRED FOR LL CONTRACTORS A I ND SUB-CONTRACTORS
ITEM NO. FE TAL ITEM NO. FEE TOTAL
Fixtures-Traps wer:Fir 1100 ft. 30.00
Dishwasher .50 ch_ dit.100 ft. 15.00
r "' '-
Wchdi
Garbage Disposal Ejec r Pump 1 7.50
Water Heater .50 Water: irst120ft 20.00
Ba_ ckf low PrePrevent0 ft
Ea Adf�,gft. --.15.00
or &R n:Fir 1100 ft. 30.00
ach Ad i .2200 ft ft. 15.00
Mobile Home Space 25.00
Other(Specify): Rain Drain-SingleFam.ID611ing 15.00
PERMIT FEE Comments:
STATE % 00 Issued By.
TOTAL (00 Receipt No. jQ L?l Applicant
For Plumbing Inspection Phone 639-4171
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : "� PERMIT NO.:
DATE: SL1;L DATE ISSUED: .._LI -
OWNERS NAME : —
ADDRESS : —
AME :ADDRESS : _ //3 9t2 �LO 'EVA
CONTRACTOR :.
TEST* Air ❑, Water p , Visuai Cl , Laboratory ❑
RESULT: Approvedg , Disapproved ❑ , Pending ❑
SKETCH:
INSPECTOR DATE
COTE: Attach supplemental test data heret]
PLUMBING PERMIT APPLICATION �
Jurisdiction of v
No. Type of Fixture Fee Permit No.
�« m, 35390
Permit fee uv �,, 0 Q
Water Closets Toilets Permit Issued
Bath Tubs Approved by Nf
Lavatory Wash Basin ,� Building Permit—d2-
ermilk--
Shower Receipt No.
Sinks Dishwas ink
Sin s Kitchen
Si s Ordinary Location of Building
n s._ ar
�Inks, Slop —
�A��uttomma isDishwasher -----— - -
_ LLQ --�-
Launr.iy Trays Name & Address of Owner
_Drains, Flocr _ ---------
brains. Area
Drains, _Re riEerator
Rain Drains -- - -A ----
Automatic Washer Name & Mdress of Plumber 1�.��l�i�c+��✓l
ounta ns r_n ns� „Q
Fountains oda
Hot ater an — a -
Water Service Size -
rinals _ Buildin ld r New Alter. Repai
L) r or
e7-c - asins - ar � a - —
_ Lawn Sprinkler System _ -- `
swimming Pool -` � er �_ -
:�prin
This permit becomes null and void if work or construction authorised is not —'
commenced within 60 days, or if construction or work .is suspended or abandoned
for a period of 120 days at any time after work is commenced,
All plumbing firms must be licensed by the City of Tigard and post a $1,000 bond
I hereby certify that I have read and examined this application and know the semi
to be true and correct. All provisions of laws and ordinances governing this tyj
of work wi?.l be complied with whether specified herein or not, the granting of a
permit doee not presume to give authority to violate or cancel the provisions
of any other state or local law regulating construction or Uie performance of
construction.
-S gnature of Applicant
.__ .._ -_. ....__ ��► t
City of Tigard
INISPECTION REQUEST
for
INSPECTION TIME : PERMIT NO.:
DATE: . !. '� DATE ISSUED:-1-1—
OWNERS NAME : , -
ADDRESS : L2/L(-
CONTRACTOR :_
TEST: AirC] , Water [3 , Visual ❑ , Laboratory ❑
RESULT: Approved Q Disappro. ad ❑ Pending ❑
SKETCH:
I
INSPECTOR DATE
(NOTE : Alloeh •upplamentoI tett data hereto1
Fj Wjj WX 0 f�
I
I
I
City of Tigard
INSPECTION REQUEST
I
for
INSPECTION TIME' PERMIT NO. :--
DATE:
O. :DATE: 1 1'�_.L :' DATE I S SUED :_1_L._.
OIAI N E r'S Pu A M E : .4 IZ A:
COI` TRACTOR : — ------ _- ,
TEST : Air C7, Water ED Visua: p , Laboratory (]
RESULT: Approved , Disapproved C-J , Fending ❑ _ I
SKETCH.'
I ,
I
I
I
INSPECTOR DATE
N07V Attach supplornental test data beret]
` CITY OF TIGARD
12420 S. W. Main Strut
TIGARD, OREGON 47228
APPLICATION FOR BUILDING PERMIT
New Construction Demolish ❑ Addition Rciodel ❑ Move❑
ZONINGrl--_;ZDLTE ISSUED ^' Fel BUILDING PERMIT
--BUILDING FEE $ C! No.
DATE RECEIVED
.—PLAN CHECK $
BY— OTA VALUATION $ •!' ;?yf
P, J k" • `I
TOTAL $ RECEIPT NO.—
�
TWO SETS OF PLAN AN)D PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT # �_— MAP # CENSUS TRACT' _ JOB #
1 :5/- 3.11JN-s
Architect or Engineer __ _
Address _`Phone
Owner /1—,/
Address i!►r, J �5---- Z `'1 _Phone
Builder /—�•? R i+r (c .L••1. � r�..r
L. 1
Address � 4x � � Phone
BUILDING USE Single Res. Multi Res. ❑ Comm. ❑ Industrial❑
OCCUPANCY GROUP No. of Stories_ Total Height__Z,2 r Area of Lot
Type of Construction I II III IV Floor Area 8 _ 1 �•�f rs2 /
I • �
Set Backs: Front7 Backe L.Side L_ R.Side ZF,*1A4'0+r
Private Sewer Pipe Size Sewer Septic Tank ❑
Water Service Pipe Size �f! Storm Sewer ❑ Ditch ❑ Drywe11
Street and Curb Requirements
Driveway Width_i t/_No. of Parking Spaces
SEPARATE PERMITS REQUIRE EJ FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED 1 ' )96 1A)
FIELD CHECK BY _-_______—._-__`DATE
PER14IT APPROVED BY �•
It is understood that all work will conform with applicable c ts and ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the building wil
not be occupied until a Certificate of Occupancy has been issued by the City of
Tigard Building Inspector.
signature �FApplica
Address �`�-- —44A—.__ Permit
Name of Occupant Permit charge
-...._�� Paid
-- -_---- Date connected J
Type of Building cs�'-�4.� _. Inspection fee
Service Rate__ ,��_ Paid by
Contractor Paid
— -- _ Assessment ,�D�
Size of conn-,-tion -