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CITY OF TIGARD BUILDING INSPECTION NOTICE
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Inspection Line: 639.4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
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Foundation Water Line Ceiling - lump
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Post/Beam Mach. Shear/;:heath Framing -Mach.
9 g p `
Pib Und/Fir/Slab Plb To Out Insulation -Elect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg. ��
San. Sewer Gej Line Appr/Sdwlk Reins. ;
Other:
Date: - �1�_ A.M.__ .M. Entt `
Address:
Tenant: te: MST:
Con/Own:- MEC:
--- -- PLM: r
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THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspecto % — Date:.?
PtPROVED -DISAPPROVED/CALL FOR REINSP. CF CO t'.
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PLUMBING PERMIT
- CITY CSF TIGARD PE=RMIT #. . . . . . . . PLM96-0154
DATE: ISSUED: 06/17/96
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 07223.8199 (503)630.4171
PARC[---L: 151 0..;UH-09000
SITE: ADDRESS. . . : 11265 SW MORGEN 2-T
SUBDIVISION. . . . : GENESIS NO. 3 ZONING: R-4. 51
BLOCli. . . . . . . . . . . LOT. . . . . . . . . . . . :85
CLASS OF WORK. . :NEW GARBAGE D I SI'='ORALS. : 0 MOBILE HOME SPACE=S. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . V_I
STORIES. . . . . . . . (%r WATER HEATERS. . . , . : 0 CATCH BASINS. . . . . . . : 0
FI XTURES-•--- --- ----- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE: TRAPS. . . . . . . 0
I_AVATORIE.Si. . . . . : 0 OTHI=1-3 FIXTURES. . . . : 0
TUB/SHOWERS. . . . : 0 SEWER LINE (ft) . . . : 0
WATER CLOSETS. . : 0 WPIER I._ ENE_ (ft ) . . . : Q
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 ?
Remav-14s : Installing residential bacl<flow prevention device V
Ownei : - -_.________.____------.-.-----_._...___.._____._.._._____________- FEES
ROGER ,JOHNSON type amor_rnt by date r,er_pt r'
11265 SW MORGE-N CT PRMT $ 15. 00 B 06/17/96 96-2-80653
5FICT $ 0. '/5 B 06/17/96 96- 8065
TIGARD OR 97223
Phone #:
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Contractor: --------------_----._----_-------_
MATT SANDERS LANDSCAP 1'�+r3 INC
21785 SW TV HWY
ALOHA OR 97006
Phone #: $ 15. 7`-1 TOTAL
Rey #. , . `:;702;
------ _ REUUIRED INSPECTIONS --- --_-
I Thrs permit is issued subjert to the regulatio;is contained in the RF'/Backflow Prev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days.
f'e r,m i t t e e ;3 i y i r a t r_t r e .
I s s i.r e d By:
Call far inspection - 639--4175 t
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Ci Of Tigard PLUMBING PERMIT APPLICATION City 9 ON Planck/Rec. # _
1.3125-SW Hall Blvd. Permit # 0 M
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE+ ST. SURCHARGE
Now Single Famfhr Residences Ontj
JobA.... C11 BATH HOUSE$140.00 C32 BATH HOUSE$195.00
�rt ❑ 3 BATH HOUSE 5225.00
Address arw. a Fee includes all pkanbing fixtures in the dwelling and the first 100 feet
L2/Z 1 Z L3 of water service, sanitary sewer and storm sewer. See fees below.
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Nw»rw nww M 1T•w��i FIXTURES QTY PRICE AMT
Sink 9.00
Me"AdOom Lavatory 9,100
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Owner \ S W O�'(r-�J L I Tub or Tub/Shawer Comb. 9.00 I
""°"" Shower Only 9.00
allf It 1l4 -4) �jrL `j, � 2-�j Water Closet 9.00
"""' •"'""•"'�""' Dishwasher 9.00
Occupant " Garbage Disposal 9,00
M."Ad*— '""" Washing Machine 9.00
_ Floor Drain 9,00
C"FWAM a' Water Henoir 9,00
_ Laundry Room Tray 9,00
Unnal 9.00
O-'YL 1-f�SC r,-/ Othor Fixtures (Specify) 9.00
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Me"AM... ITww -
Contractor 9
I �� 9.00
coosm. ap 9.00
L-z ',/t_._ O--�(- Sewer 1st 100' 30.00
s.w R.0.0.wn w. o.r rv.T.w.
Sewer-ea. Add R. 100' —� 25.00
�1 �(j,r7 Water Service 1st 100' 30.00
1 hereby scixnowledge that I have read this application, that the
Water Service on. Addie. 200' 25.00 ,
information given is correct, that I am the owner or authorized agent of ---
the owner, that plans submitted are in compliance with State laws, that Storm 3 Rain Drain est 100' 30.00
I am registered with the Construction Contractors Board, that the Storm s Rain Drain Addit. 100' 25.00 y
number given is correct (If exempt from State registration, please
give reason below.) Mobile Home Space 25.00
rte- T
ack Flow ention
/Y-7L or AntFPollutfon Device no
00. Any Trap or Waste Not
Connected to a Fixture 9 00
Descn work n addition alteration repair Q Catch Basin
9.00
non-reside
to be ons rest tial ntial O Insp. of Exist. Plumbing 40.00/hr
Specialty Requested Inspections 40.00/hr
Existing use of
Ljilding or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of
building or property V
'(F�ccepr residentlal backflow
prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL r`)
PERMITS BECOME VOID IF iAORK OR CCNSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5%SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD nF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 2595 OF SUBTOTAL
TOTAL
Special Conditions r r
Date issued by
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woo $117u` %tet`' "
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