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CITY OF TIGARD BUILDING INSPECTION NOTId&---�
ii Inspection Line (Rec O Phone): 639-4175 Business Phone: 639 4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Pibg, Underslab Mech. Rough-in Fireplace ;
4 Post/Beam Struct. Plbg, Top Out Flec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
I -Plumb.
Plbg. Underfloor Rain Drain Framing
i -Mech.
i Alarm
=Water Insulation
Underflr. Insul. Shear Wall Gyp. Bd. -Elect. r; +
Time: AM PM
Date Requested: ''` ?' ■
Address: E� ,, x.at,�,y(•1 V. ;� ',,
B �7 7Z - 9� � erm
Pit #:
uilder:
I THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Ins ect Date: '-
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_ PROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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PLUMS ING PIF RM_T i
i f : PL1�`CITY OF TIGARD DA ;l-Ail1 ILI:S:iG
1/07/95
COMMUNITY DEVELOPMENT DEPARTMENT d
13126 SW Holl B!vd.Tlperd,Cv7or 97223.8199 (603)639.4171 F(-1(�CI ; s 11. 1 CA--010 10
SITE ADDRESS. . . 09471 '';W LAKESIDE DI? I
SUBDIVISION. . . . : ALDERBROOK FARM ZONING: R-7
lal_OCIJ.. . . . . . . . . . . LOT. . . . . . . . . . . . . . 1
CLASS�OF—WORK. . :REP GARBAGF" DISPOSAL S. : 1Z MOBILE HOME SF'f4ClyS. : 10
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : O BACKFLOW PREVNTRS. . : Il
OCCUPANCY GRP. . :R f-''I._OOP DRAINS. . . . . . e O TRAPS. . . . . . . . . . . . . . : O
STURIE:S. . . . . . . . : 0 MATER HEATERS. . . . . : O CATCH BASINf;. . . . . . . : 0
LAUNDRY TRgYS. . . . . : O SF RAIN DROINS. . . . . : ILS
SINKS. . . . . . . . . . . 0 URINALS. . . . . . . 0 GREASE TRAPS. . . . . . . 0
LAVATORIES. . . . . . O OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . . 0 SEWER I._.INE (ft ) . . . : 0
WATER CI.-OSE,TS. : O WATER LINE (ft ) . . . : 1.1710
DISHWASHERS. , . : 0 RAIN DRAIN (ft ) . . . .' O ■
Ob LLI'J& (I
vie
FEES
LILLIAN OPFERMAN type amoi.lnt by date r-ecpt
9471 SW LAKESIDE DR FIRMT $ 5 0. 00 B 11./07/95 95-272604
5PCT It 1. 7-50 B 1. 1/07/95 95--272604
VIGARD OR 9 7224
Phone #:
Contractor-.-
CHRISTIAN
ontractor:CHRISTIAN PLUMBING
22919 SW STAFFORD RD
TUAL.AT IN OR 97062
Phrrne #: 503-771-9449 $ 31. ` 0 TOTAL
Req #k. . : 42671
REQUIRED INSPECTIONS
This permit is issued subiect to the regulations contained in the Water, Line TrISp
Tigard Municipal Codi, State of (h,e. Specialty Codes and all other Final Insper_tion
applicable laws. All work will be done in accordance w:ih
approved Glans. This permit will er,oire if work is not starteu
within. 100 days of issuance, or if work is suspended For more
than 100 days.
hlermittee Si.yr tU) e :
F 1 5 I a e d fly
Call for inspection — 639-4175
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City of.Tlgard PLUMBING PERMIT APPLICATION Planck/Rec.
13125 SLAV Ha,l Blvd. Permit # V1 01
Tigard, OR 97223 d
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
�, .,,o•.,.,,.,, New Sin le Family Residences Only
,,,.., I ❑ 1 CiATH mOUSE $140.00 ❑ 2 BATH HOUSE$195.00
Job `/'may, X e C] 3 BATH HOUSE$225.00
Address AIw. ZIP includes all plu,nbing fixtures in the dwelling and the first 100 feet
�r ��� "7- of water service, sanitary sewer and storm sewer. See fees below.
N.m. FIXTURES Q1 Y PRICE AMT
Sink 9.00
P^•^• Lavatory 9.00 ■
Owner Tub or Tub/Shower Comb. 9.00
away.• �e Shower Only 9.00
Water Closet 9.00
Dishwasher 9.00 f
Garbage Disposal_ 9.00 f
Occupant M.•n.Aea«. �^^"• Washing Machine 9.00
Floor Drain 9.00
awsn. 7J. Water Heater 9.00
Laundry Room Tray 9.00
r,... Crinal 9.00
64"1 CCS ,,, 4�f^�(rl Other Fixtures (Specify) 9.00
Maw A"- �•7j/ y 9.00
Contractor f�9I-ro/7-
9.00
9.00
4 ti �'/�- � U r; Z Sewer 1st 100' _ 30.00
St...n gial. .,N.. CRY a. t.N. Sewer -ca. Addit. 100' 25.00
,;�(p 7 7 C��76? Water Servire 1st 100' 30.00 �j E
1 hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00 f
information gil,en is correct, that I am the owner or authorized agent of -the owner, that plans submitted are in compliance with State laws, that Stcrm &Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm &Ran Drain Addit. 100' 25.00
J number given is correct. (If exempt frnm State registration, please -
give reason belovr.) Mobile Home Space 25.00
Rack Flow Prevention,
f Device or Anti-Pollution t,,::ce 9.00
....,..�«a.o•"o � • Any Trap or Waste Not
Connected to a Fixture 9.00
Describe wui.. new Q addition Q alteration repair Q Catch Basin 9.00
o be done residential (}l non-residential 0 Irisp, of Exist. Plumbing 40.00/hr
- Specially Requested Inspections 40.00/hr
Existing use of Rain Drain, single family dwelling 30.00
budding or property v
Residential backflow prevention
devices 15.00
Prop-sed use of
building or property
- ---- .(Except residential backflow I
prevention devices)
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NOTICE 'Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUT14ORIZED IS NOT COMMENCED WITHIN 100 DAYS, OR IF 5% SURCHARGE
CONSTRUCTION OR JVORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
PLAN REVIEW 25"/" OF SUBTOTAL
COMMENCED
TOTAL �� �� )U
Special Conditions
Date issued , _ by__
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