9760 SW LAKESIDE DRIVE-1 ADDRESS: ,
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CITY OF TIGARD BUILDING INSPECTION NOTICE
rA Inspection Line: 639-4175 Business Phone: 639-4171
^yr 6 Foo'ng Rain Drain Cover/Service FINAL:
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Foundation Water Line Ceiling Plumb.
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Post/Beam Mech. Shear/Sheath Framing � f w
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/SdwlkFlAins „a ,
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Other: JA PTJ�-�- / �� + Sluu,�i.
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Date. P.M.
� Ent ' _. ,�� '�
Adores 4 SU
Tenantl� —LdR�'�Z-R 6 25l_ MST: r .
1. l G�t/.r- P(�u- BLIP:
Con/Own: _t�-►� _"MEC: A 4 ,
7/ 4 qY 9_ Esc: _ j 4`4
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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In actor: / ��- Date: �� -�
_A PROVED DISAPPROVED/CALL FOR REINSP. CF CO t4' yeti „
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CITY OF TIGARD PERM I'LU#FII��IG` Fc
RMIT PLIt196-01':}..r I
COMMUNITY DEVELOPMENT DEPARTMENT DATE .-SUED: 07./08/96 r
13125 SW Hall Blvd.Tigard,Oragon 97223.5199 1503)539-4171
F'ARCE:�_: c:S.I. 11Cf,-r[141Q�0
SITE ADDRESS . . 09760 '5W LAKESIDE: DR
SUBDIVISION. . . . : SUMMERFIELD NO. 12 ZONING.- F-7 a
BLOCK. . LO*l.. . . . . . . . . . . . . :661
C;LASs JF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
r 'TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0 r
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0
jS'fORIE:S. . . . . . . . : 0 WATER HEATERS. . . . . : lit CATCH BASINS. . . . . . . : 0
FX1"11RF3-- - ___.__..____ LAUNDRY TRAYS. . . . . : 171 cif-` RAIN DRAINS. . . . . 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . .1 0 GREASE TRAPS. . . . , . . 0 c
LAVATORIE:S. . . . . : 0 OTHER FIXTURES. . . . : 0
'IUB/SHOWERS. . . . - 1 SEWER LINE (ft ) . . . : 0
WATER C:LOSLIS. . : 2 WATER LINE. (ft ) . . . : 0 4
DISHWASHERS. . . . 1 0 RAIN DRAIN (ft ) . . . : 0
Remarksa Alteration of one shower, end two wat ?r closets.
Owner-: -----_- ---- ______________._.__._____________.-..___._.._________ FEES --___.______.____
ROBERT DOTER type AmoI_tnt by date reacpt
9*760 SW LAK: SIDE DR DRMT $ 27. 00 CJS 07/03/96 96-281254
5PCT $ 1. 35 CJS 01/03/96 96--281254
TIGARD OR 97224
Phone #:
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contractor-:
CHRISTIAN PLUMBING
x,2919 SW c;T'AFFORD RD.
TUALATIN OR 9706E
i
Phone #: ;,5) 1 OTAL
Rey #. . : 42671 f
...._.......__.__ REUUIRED INSPECTIONS ----__._.-
This permit is issued subject to the regrilations contained in the vlater Set—vice In
Tigard Municipal Code, Etate of Ore. Specialty Codes and all other M'. yc. Inspection
applicable laws. All work will be done in acrordancp with M: sr_. Inspection
approved plans. This permit will expire if work is not started i incl Inspection
within 180 days of issuance, ^,r if work is suspended for more
than 180 days.
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in i. t t rinat ure
1 s s u a d By
Gall for inspection - 6;39-4175 �
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City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # (46- a,?la5y I
13125SW Hall Blvd. Permit # PLM'gG - y I i
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
"•m•°'�•�"°^•^'
Nev Single Family Residences Only
A"- / n 0 1 BATH HOUSE$140,00 0 2 BATH HOUSE$195.00
Job
(c;,Q ,(l� . (� e / �/� 0 3 BATH HOUSE $225.00 '
Address caws". ra Fee includes all plumbing fixtures in the dwelling and ;hs first 100 feet
of water service, sanitary sewer and storm sewer. See fees below.
"•"•'° "•^"°'a"'^�^ - FIXTURES QTY PRICE AMT
Sink 9.0'1
Lavatory 9.00 ■
Owner I Tub or Tub/Shower Comb. 9.00
G^'�'•'• Shower Only / 9.00
Vr'ater Closet 9.00
"•-a^•-M b-tail Dishwasher 9.00
Garbage Disposal 9.00
Occupant �,,,,• p"on. Washing Machine 9.00
Floor Drain 9.00
'x'•'• " Water Heater 9.00
Laundry Room Tray 9.00
N.- Urinal 9.00 i
Other Fixtures (Specify) - _ 9.00
M&09 Aft... ph.. 9.00
Contractor
a 317 2- :' 4 f i/G✓Z(4 9.00
zo 9.00
1 Lk 4, fl,/ 2 Sewer 1st 100' - 30.00
`/ Sbie Rnp.Irnl on.b Crty But.Tax 4o Sewer-ea. Addit. 100' =5.00
Water Service 1st 100' j 30.00
I hereby acknowledge that I have read this application. that the Water Service ea. Addit. 200' 25_00
information given is correct, that I a.n the owner or authorized agent of F
the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30.00
1 am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 25.60
number given is correct. llf exempt from State reg stration, alease
live reason below.) Mobile Home Space 25.00
-� Back Flow Prevention
Device or Anti-Pollution Device 9.00
5a•�"'°^""° "0"' Data Any Trap or Waste Not -+
Connected to a Fixture 9.00
Describe work new Q additio, 0 alteration repair Q Catch Basin 9.00
to be done residential &Dr non-residential Q Insp. of Exist. Plumbing 40.00/hr
��- Specially Requested Inspections 40.00/hr
Existing use of
building or property Rain Drain, single family dwelling 30.00
_ _ _ _ _ _
Residential backflow prevention
devices 15.00
Proposed use of
building or property _ - -
---- '(Except resfdential backflow
prevention devices) f
NOTICE "Minimum Fee $25.00 SUBTOTAL � �.�•'
PERfJiI'3 BECOME VOID IF WORK OR CONSTRUCTION
ALyrHURIZED IS NOr COMMENCED WITHIP 180 DAYS, OR IF 50% SURCHARGE 3
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT AN".' TIME AFTER WORK IS - -�
COMMENCED. FLAN PLVIEW 25% OF SUBTOTAL
J2 -- TOTAL
Special Conditions
Date issuer) by _
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