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CITY' OF TIGARD �'ERPI`T1LUMBINCj PERMIT
T #. . . . . . . .. PLM96 -01'9O6
COMMWITY DEVELOPMENT DEPAPTMENT DATE ISSUED: 07/OL/96
13125 SW Hall Blvd,Tigard,Oregon 97223.0199 (503)639-4171
PARCEL: 2'S10')BA--HS01-7
SI"fL ADDRESS. . : 1�Lcj,,3 H161-1 Wil 1,11i
SUBD I V I S I i.,N. . . : : HILLSH'IRE SUMMI'f ZONING: R-7 POD
.. . . . . . . . . . LUT. . . . . . . . . . . . :017
CLASS OF WORK. . :NEW GARBAGE DIGPO9ALS. li) 110r,11—E HOMm- SPACFS. : 0
TYPE OF USE. -16F WASHING MACH. . . . . . a 0 BACKFLOW PIREVNTRS. . : I
OL CUPANCY GRP. . -.R3 1=LOOR DRAM."), . . . . . It. TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEPTERS. . . . . 0 CATCH BASINS. . . . . . : 0
LAUNDRY rRPYS. . . . . 0 SF R;'41N DRAINS. . . . . : 0
SINKS. . . . . . „ . . . : 0 URINALS. . . . . . . . . . . 0 GREASE_ TRAPS. . . . . . . 0,
L A V 0'4 1'0 R I L5. . . . . .. (i) OTHF14 (_IXTURES. . . . lzi
TUB/SHOWERS. . . . .. 0 '-�EWER LINE. (f t ) . . . . LA
WATER CLUSEIS. . : 0 WATL.R L I iNIL. (f t ) . . . , 141
DT"'.33HWASHERS. . . . : 0 RAiN 11')RAIN (ft ) . 0
R f?m a Y-�k S
FEES
ROBERT WHITE type Amoi_mt by u n t P Y. (*Cpt
IbW HIGH TOR DR PRMT s 15. 00 CJS 07/QA&../9b 96-261268
SPICT $ (A. 7tj G J S 0I OCE' 36 96 Ic 6 A
I IGARD OR '37223
LL) r)'e
$ 15. 75 TOTAL
Reg MO. . :
REQLJ I kED INSP2-UTIONS -------
This permit is issued subject to the regulations contained in the RP/Backfl.ow Prev
!igard Municipal Code, of Ore, Specialty Codes and all o0er Final Iiispertion
appocabiriaws. Aii -4or will be done in accordance with
approved plans, This permit will expi.d if work is not started
within I&I days of Ossuince, or if work is suspended for sore
than 18@ days.
f_lerj by :
Li..Il for irispec-tion 639-417'6
City of Tigard PLUMBING PERMIT APPLICATION Planc!-j'Rec. #
13'125 SW Hall Blvd. Permit # ?6/'" �� . D/fir
Tigard, OR 97 X23
(593) 6394171
MINIMUM $25.00 PERMIT FEE * ST. SURCHARGE
N.—.,N.W.°mrnl New Single Family Residences Only
A".. C 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195 07
Job !^':? j _ � , � ra^ � L-I 3 BATH HOUSE$225.00
Address carfsrare Zk Fee includes all plumbing fixtures in the dwelling and the first 100 feet
i b A of water service, sanityry sewer and storm sewer. See fees below.
N.me ra name H BwMeeer FIXTURES QTY PRICE AMT
Sink 9.00
McB°y Aea,ee. °h.. Lavatory 9.00 ---
UWf r / :�L---' HJr f/`/ 7-0 W_ (A Tub or tub/Shower Comb. 9.00
C"°fBl"' Zip Showe. .)nly — 9.00
IV6 Water Closet 9.00
Name Ia..m.of b.mals) Dishwasher 9.00
t1.1 Garbage Disposal -- 9 UJ
Occupant Maeho ram.ee N,... Washing Machine _ 9.00
Floor Drain 900
cxyrn.,. zip Water Heater 900
Laundry Room Tray M�_ 900
FFF N.ma Urinal 9.70
an si�.SQOther Fixtures (Specify) 9.00
Y1
M. °Nlheea '�_—••� Vhw�. 9.00
Contractor _
9.00
zq 9.00
i
Sewer 1st 00' 3000
s.,.n.,p.b.°m,N. Ua,Me r..N. Sewer -ea. Addit. 100' � 25.00 �J
Water Servic«; 1st 100' 30.00
I hereby acknu,vledge that I have read this application, that the Water Service ea. Addit. 200' 2500
information given is correct, that I am the owner or authorized agent of — —
tho owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30.00
I aro registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit 100' 25.00
number given is correct. (If exempt from State registration, pl4ase
give reason below) Mobile Home Space 2.5.00
Back Flow Prevention
Device or Anti-Pollution Device 9.00
�W.h e ° '°"a'"l) J r'"° Any Trap or Waste Not —
,1,� Conne^ted to a Fixture 900
�: 0 scribe work ;9w,0 addition O11teratioi, C repair G3tch Basin 9.00
to be done residential 39 non-residential Q Insp of Exist Plumbing 40.00/hr
Specially Requested Inspectirns 40.00ihr
Exisw-q use of — —
building or property _ Rain Drain, single family dwelling— 30 C0
Residential backflow prevention _
devices 15.00
Proposed use of
building or property ----- (Except residential backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL
PERMITS BErOMiE VOID IF WORT' OR CONSTRUCTION —
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAY`;, OP IF 5°h SURCHARGE
7�
CONSTRUCTION OR WORK IS SUSPENDED OR ABAf,nC'wED —
FOR A PERIOD 01 180 DAYS AT ANY TIME AFTER'.1JORK IS
COMMENCED. PLAN Kt-VIEW 2501,OF SUBTOTAL
TOTAL ��•
Special Conditions _ —_— — —'
Date issued `� / by
CITY OF TIGARD BUILDING INSPECTION NOTICE
.1spection_iLine: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
i
Foundation Water Line Ceiling r`iumb.
I I
P0st/Beam Mech, Shear/Sh-ath Framing -Meeh.
P1bg.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��L ' ---
Date: i / - A,M. --P.M. _ Entry:
Address:
Tenant:���� .._C ..�f? ��' 4@�°. �� T: —~ r�
Con/Own: 9 BUP;
ME
ELC.
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspector. Date: &FO
APPROVEDDISAPPROVED/CALL FOR REINSP.