11175 SW 119TH AVENUE � w is All lwwIi(I< Int
--- 11175 SW 119TH AVENUE --
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INSPECTION NOTICE
City of Tigard building,Department 1
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection �� -�B�•-'t /��-Kim' K/ ;t�1,rX-�� '
Date Requested_��� ,_� 2- Time A.M. Lam`. P.M.
Address _. L i 17 ,< Gc� //% Permit #
7
'
Owner �� f 1 . Lot #
Builder
` The following Builcling Code deficiencies are required to be corrected:
64.
- - -
44
Presented to
Inspector (� — ❑ Disapproved
` Date
CALL FOR REINSPECTION
C�]
YES Ll NO
CITY OF TIGARD Plumbing Permit `
7
Bulling Department No _
Residential [ Commercial ❑
New Installation ❑ Replace ❑ Addition 0 Alteration
Date
Licensed
Plumber — �L'hl 11.f.� 1�i�7r / Owner , r i �^y 's
Address
I/�� �1'�i�
Job Address _
Phone ,.�.��& / �� v 3 Applicant . },r-
CITY BUSINESS LICENSE.REQUIRED FOR ALL CONTRACTORS AND SUB-CONTRACTORS
ITEM NO FEE TOTAL ITEM NO. FEE TOTAL
Fixtures-Traps 7.50 — Sewer:First 100 ft. — _ 30.00
Dishwasher _ 7.50 _ Each Addit.100 ft. 15.00
Garbage Disposal _7.50 _ _ Ejector Pump _ 7.50
Water Heater _ 7.50 Water:First 100 ft._ — 20.00
Backflow Preventer 7.50 Each Addit.200 ft. —__ 15.00 _
Storm&Rain Drain:First 100 ft. 30.00 T
Each Addit.200' 15.00 -
--__ Mobile Home Space 25.00
Other(Specify): Rain Drain-Single Fam_Dwelling - 15.00
PERMIT FEE , Comments:
_ T
STATE 9i6� r , Issued By:
Receipt No. �_ �� Applicant_. ' ' r7
TOTAL �f:t�� Signau re�
For Plumbing Inspection P 4171
PERMIT TO CONNECT
Tigard Sanitary- District o to,.
a�
PERMIT M 966 DATE - --
PER311T IS GIVEN TO ' .a ,l\��y�. Q-,
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT i 1 1 N _� 1 I–- ----- —_ --- -- --.—
THIS ;FRMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION 1S MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLFTED.
PERMIT FEE PAID a_ . .........................TIGARD SANITARY DISTRICT
By
ONCONNECTION INSPECTED AND APPROVED
Date Superintendent
Address 1_41_X_—_,,t4w_/r 44 Permit No. 7`G
Name of Occupant Permit charge
Connection fee
Paid by__ G
Date connected
Type of Building Inspection fee
Service Rate _ Paid by --- Date
Contractor _ _ Assessment Paid
Size of connection