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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639.4171
Footing Rain Drain Cover/Service FINAL:
Foundationater Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Meth.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: G 1.. '�--
Date: L -l (P A.M. --P.M. Entry:
Address: --� (Z -- - _ •
Tenant:- ---- Ste: -- - - MST:
BLIP: —
Con/Own:�— _ MEC:
PLM:
ELC: _
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR- _
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PPROVED DISAPPROVED/CALL FOR REINSP. CF CO
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CITY OF T Pf_RM I TU#. . . . . . . :Ali
PLM96--014
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/12/96
13125 SW Hall Blvd,Tigard,Oropon 07223.8199 (503)639.4171
PARCEL: 1 S 1 35AD--0c502
SITE ADDRESS. . . : 10973 SW HALL BLVD
SUBDIVISION. . . . : METZ.GER ACRE TRACTS ZONING: R-12
DLOCK. . . . . . . .. . . . LOT. . . . . . . . . . . . . ..6
------------------------------------------------
CLASC3 r"'= WORK. . : REP GARBAGE DISPOSALS. : 0 MOBILE:. HOME SPACES. : 0
TYPE f USE. . . . :DUP WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRP. . : 0
OCC UF'� _ Y GRP. . : R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATE=RS. . . . . : 0 CATCH BASINS. . . . . — : 0
FIXT'URES---___.____—..__._ LAUNDRY PRAYS. . . . . : 0 SF RAIN DRAINS. . . . . . rt.)
SINKS. . . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE_ T'RAPS. . . . . . . . 0 •
LAVATORIES. . . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . . : 0 SEWER LINE= (ft ) . . . : 0
WATER CLOSETS. . : 0 WATER LINE:: (ft ) . . . : 100
DISHWASHERS. . . . : 0 RAIN DRAIN (ft) . . . : 0
Remarks . Installing 100' of water service
Owner:
FETES
LARRY THOMAS type amoi.rnt by date recpt
t2b94 SE 1125TH PRMT" $ 30. 00 B 06/12/96 96-280521
5PC1 $ 1. 50 B 06/1.2/96 96 280521
GLACKAMAE! OR 97015
Phone #:
Contractor:
NORTH' S PLUMPING
1
17120 SW SHAW
BEAVERTON OR 97007
Phone #: $ 31. 50 TOTAL
Reg #. . : 000340
—--— REQUIRED I NSF'E:C T I ONS -------
This perpit is issued subject to the regulations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Service In
applicable laws. All work will be d in accordance with Final Inspection
approved plans. This permit. will ire Pwork is notwithin 180 days of issuance, or i work ipendedpre
than 180 days.
1 ermittee i _rre
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Call for inspection — 639•-•4175
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r1City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # _
3125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT PEE + ST. SURCHARGE
Nim•of 0-iop 1 New Single Family Residences Only
k
�e»• Cr 1 BATH HOUSE $140.00 0 2 BATH HOUSE 5195.00
Job SW Hall Blvd. C:1 3 BATH HOUSE 5225.00 u
Address .NiNn. - o Fee includes all plumbing fixtures in the dwelling and the first 100 feet
Tigard, Oregon 97223 of wafer service, sanitary sewer and storm sewer. See fees below.
N. of IN-) FIXTURES OTY PRICE AMT
Larry Thomas Sink w 9.00
M•&,9&"... o '^�^• Lavatory 9.00
1;'694 SE; 125th Tub or Tub/Shower Comb. 9.00
Owner _
c"(s o f3 Shower Only 9.00
�icgZrd, Oregon 97015 Water Closet 9.00
N•m• ^•m•• ^^•••i Dishwasher 9.00
Duplex Garbage Disposal 9.00
Occupant M,& s,,, ---' p,..
aWashing Machoe 9.00
Floor Drain 9.00 l
cuw •• Water Heater 9.00
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Laundry Room Tray 9.00 I
N.- Urinal 9.00
North 18 Blum`)ing Inc. 649-5544 Other Fixtures (Specify)- 9.00
phJ.00
9.00
Contractor 17120 SW Shaw ;street
9.00
x1artkis Beaverton, Or 97007 - -
Sewer 1st 100' 3C'.co
51.1,P"11.1m No Cm Bu..t•.Na Sewer -ea. Addit. 100' 25.00
00340 00002090 Water Service 1st 100' 100 30.00 JO.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 wner or authorized agent of ----
thfjbr
er, that pla in compli nce with State !aws that Storm &Pain Drain 1st 100' 30.00
I tend w h the Con ruc n Contra or's Board, that the Storm 8 Rain Oran Addit. 100' 25.00
niven .s orrect. (If xemp�from to registration, please -
gon belo .) Mobile Home Space 25.00
Back Flow Prevention
0 6 i 1/96 Device or Anti-Pollution Device 9.00
1, •^• »^• r.uM ___ 0.1• Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new Q addition alteration Q repair It_) Catch Basin 900
to be done residential non-residential Q - Insp. of Exist. Plumbing 40 00/hr
Specially Requested Inspections 40.00/hr
Existing use of -
building or property _ I Rain Cain, single family dwelling 30.00
Reside tial backflow prevention
devices 15.00
Proposed use of
building or property _ -
'(Except residential backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL 30.U0
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 1-5(
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE
CONSTRUCTION OR WORK 13 SUSPENDED OR ABANDONED - -
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMME'4CED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL 31 .50
Special Conditions _^-
Date issuel by
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