Permit -
- COMMUNITY • DEVELOPMENT• DEPARTME - • ' • r '
.■ 13125 SW H 1I Blvd. Tigard, Oregon 97223°8199 (503), 639 =41,71 • �-
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Ems.. ._7i ISSUED Eil�/
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,aUB� 4.15I0IV'a- v a o . _ ZONING-I' .
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' �`BL.OU4 < , ' . . e - , L.OT . " .e - . ,
LLf S_ : 131: UO,R3-'.', . ° REP'' , GRRBA ,E D T SPOSWLS. `e iriOB LE - HOME SPACES/ .. e , ' • TYPE, -.OF USE .C,,Oi "i •WASR INC MlACH. h e B.ACI {i="L OW PREVNTRS,o
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4 .322 -c I'.- �PtICY GRP g,B2. . ' t LOO 'DRA `I fiaS' . o o _ ' o a.o %' - - - '
ST,OR'IES; `,,.➢ o _ .. r, 1 , 'WATER HEATER'S; . e e . - t Cf T.CH ' ZASINS' , - 'c.'' I - T. -- _- __._.._ LAUNDRY TRAYS: o 0 0 o SF RfliN' DRAINS g
:,F.) INKS. a e o. o o 'URINAL �5., ;.' n GREASE TRAPS '''
' _LA VA :PO'RI�ES.. o . o - , ,.3-,: OTHER RI'XT'U'RES� .ri ;, : ,•,
T'UB/SHOWERSG . 4 . o -SEWE - R 'LINE ' ( f{:) e g -
1.JATER .''CLOSETS„ ' ' , , ' i•JATF i_`1NI= ('ft )''.'0 1'l @ -. ` • - '
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D- I'r54,;IAWASHCRS° r . • _ ; RAIN -'DRi: I ( ft) - o .. � . • , J � ,i
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, i Rem•arr:i;s ; o:.P.epnir ti+ater 1ine.. 'NOTE; :ANY .WORi»C DONE iN •RIGHT OF W(- v:"', t
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. S'FREE,T OPENING PERMIT FROM TIGAFRL) EENGINL ERING DEPT.
i
- ( +�sr *' -- — - - - FEES -- - - -- •
L 'SME1 CCt r.oRP,TION - ' , . - Jvpe ,I a'mo +_(rat ,by. - date •r'ec - -pt ..
- '6550 Ne ' INTESTATE ' • ' P HMI ',' - - •25. bOlu Ji-i 061
•
5PC1 -`$ 15 JH 06/15/93 -' ,
,POR'VLPND OR 9/217
r'hone #' �,. •� �,� '
G'ontr•• act or: -- . = - - - .__...- _...�__ r
DE 'TEMPLE co- '; -. •' . . +• - -
" 1951. ' NW,.O'VERTO !` ST � . :' , .
POf i'L ;ND- O '9.72L' . - „ -„ .. . ,
-Phone ;_ _ ` + - '� ,' -' - 28.'25 `T•O raL . ' , _ , - ; -r:
Reg •k. rZiE_'�1� =
- ' ' `• ' , ' - - - REQUIRED .' I I ONS - -• -- - -- . •
This pernit -i s • i sued subpect, t,c; the t ;ei? tlations 'contained in the- '; Wat e µ L. i p
n e- In s ' - ' _ ' , - •
Tigth-S•Iii it ipa,} Lode': State or Ore'.-. Specialty Codes - and- all- - ether r e' - . ,
'• ,
I"lrra'E .'Insp Ct'lan .
applicahieL laws. Ali Work till ;he, done. in-'aCCOraaiCE with ., • , _ - '
. plans.'•'Tnis'pernit,•will expire.' if;rinr' is not start d ' ,`• ' _ -� 1
iiith'n i8c� d 'of _ isi nce {' is usn?nded or,,aore . h• �� - ' .. - - .
;roan -,180 days. , _' " - • ' ..., ', - .
' Per- Ar it t e e S.i ::,.nat ur^e 1i •_ �_ _ __ - ,1• . _ _
r• • , Ca!1 for^ ins,per_tia an - 639 -4175
/ 0 LM 93' coo $'ir CITY OF TIGARD
PLUMBING PERMIT _ 13125 SW HALL BLVD.
P. 0. BOX 23397
Applicants must hold Oregon Registration to conduct a plumbing TIGARD, OR 97223
business or must be property owner /operator not hiring outside help.
- or p (503) 639 -4175
• o everopmen
G A f77 Plumbing Permit No.
Address • Doscripton
Job /i7 y 7 "i/ei� ORS 814 - 21 - 810 QUAN. PRICE AMT. •
Tax Lot Map. No.
Address FIXTURES
Lot Block Subdivision
Sink 7.50
2 , - ., name . • =chess) Lavatory 7.50
/Kr / ./.., ( _;) Tub or Tub /Shower Comb. 7.50
ing Address / Shower Only 730
� Water Closet r 7.50
Ownery V Q \ ! G 73, / 7 Dishwasher. 7.50
Phone Garbage Disposal — 730
9 Washing Machine . - •750
Floor Drain 730
• Mailing Address Plane Water Heater _ 750
laundry Room Tray . . 7.50 • Occupant (;ity /State Urinal 7.50
.. Phone Other Fixtures (Spealy) - 7.50 •
i -4-.../.61.Yi !a 69 , -7 -)65V/ 730
• • 1:. : f Phone 7.50
/957 N cv d .3,7) - y/
Contractor /State y� �Q ZIP 7.50
6 9 76-0 9 MISCELLANEOUS
City Bus. Tax No. Sewer 1st 100' 30.00
• State BIdps. Board No. �1 State P lumbers Bus. tic. No. Sower -ca Addrt 100 ,� f , 15.00 i ;
(Residential) A5 0 6 , 7 6 a 576 3 Water Service 1st 100 p{ e. r o !/ 20.00 076.00
I hereby 'acknowledge that I have read this application. that the irdomlation Water Servioe ea. Addlt , 15.00 -
given is correct that lam regisieredSvith the State Buadees Board. and also - Stone & Rein Orain 1st. 100' 30.00 -
have a State Plumbing ioehse that the numbers given are correct that all
plumbing worts will be done in accordance with applicable provisions of Ore- Storm & Part Drain Add& 100" 15.00
port Revised Statrrte3'Chapters 447- end 693 and applicable codes and that :Mobile Home Speoe 25.00
no help will be employed unless licensed under ORS 693. (t exempt from - -
State registration. please give reason below). Back Flow Prevention
HOMEOWNERS —1 hereby certify that tam the owner of the property de- Device or And-Pollution Device 7.50 .
ecnbed above. at which location I propose to make *plumbing installation for Any Trap or Waste Not .
my own use and this properly Is not being aorastnuted for sale. lessee( rent Connected to • Fixture 730
Catch Basin 7.50
•
- Insp. or Exist. Ptumbing 40.00 Per Hr. . —
Specialty Requested Inspsdioru - 40.00 Per Hr.
Rain Drain,
- S ingle Famig. 15.00
. Du r
..1v< o r / Date
C� �._AL , / L , / -/ -9j
•
Describe /� new O addition Q elterntiort ❑ repair IX • .
• be done residential / non - residential
Eicistina pse MINIMUM PERMIT FEE 25.00 X CV
balding aprolierty • SUB — TOTAL 2,540
of 5% SURCHARGE
' rPfoperty 25% PLAN REVIEW
NODCE
This permit becomes cull and void M work or construction authorized Is not corm . TOTAL p6 .
maned *thin 190 darker W oor>enuctlon or work 4 a&rperdad or abandoned for
• period of 18o days at any r s1ter'work Is oomm noad.
sraaAL oo.ttxrlotS - •
0 ate issued by ____ ___ -.. - --