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13445 SW ;iARAUM DRIVE
PLUMBING PE:RMIT
CITY OF TIFA Ra.x1if PERMIT' NO. : 1:4.891.9111.4
COMMUNITY DEVELOPMENT DEPARTMENT ONfOCN
DATE. ISSUED� 9/1.1. Us,)
13125 S.W.Hall Blvd.,P.O.Box 23397.Tigard.0,"egon97223,(503)6394175 PAIM. PMT .NO . 1391914
J04 ADORE 9)S . "13,fl-K115 SW BARNUM DR
T'AX MAFI/L.0'r SUB: L'T' : BK :
LAND USF :
l--OT SIZE::
jTrm: NO: NO
WORK CLASS : ALTEMAIJON WA I L W CLC)51;::*T 'TRAP
USE 'T'YP'E: : SINGLE FAMILY UPINAI- 8K1'7LOW PPYNI'A
0,110INS'T . TYPE: LAVOPA'TORY 'TRAP PRIMEn
OCCUP . (."llp. TUB SHOWER GPE:AGE 'TRAPS
DISHWASHE:P
GARBAGE l)1S1:-"OSAl1
NO. STORMS : WASHING MA(:H:I:Nk:.*.
DWELL. .UNITS : LAUNI)PY 'TRAY 141...D(; . DRAIN (DIA
FLUOR DRAIN
SINK SIE-WE'R (F-T)
WATEP Hl:;.A-'I*E.1:4 5143C)M/PAIN (F'Y*
W ta li.i r,Pit n PEPM.T.'( 1111120 . 00
N 13443 MW LMI"Uftills (Ir
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ti.yatrcl n r 9 P 3 FIX1'UPE:S
PP'-4,IE: (303) 624 1.918 I !-','TA*I'F-: TAX 1111t .00
01 HER
0 BAIRD M 1.(11 H A F.L.
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T MYCHAEL CC). PLOG.
1.61.305W '7i NO AVF-"-
tigmrd tir, 91'r.-2F211
T PHONE (30 3) 639-31.89
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R NO. -1159013 J
'TO'TA1 $21 00
PECEIP'T NO.
This permit is issued subject to the regulations contained In Title 14
of the TMC. State of Oregon Specialty Code,,zoning regulations PFQUIA1E`.D INSPECIJONS
and all other applicable codes and ordinancbD. and it Is hereby
agreed that the work will be done in accts,jance with the plans and PPB.UNDE:Pcisl AD
specifications and in compliance with all applicable codes and
ordinances. The issuance of this permit does not waive restrictive WA'YE'.A LINE
covenants. Contractor and subcontractors shall have current city PI H. TOPOIJI,
business tax permits TKIs nern,it will expire and become null and
void if work is not startod-&-thin 180 days.or if work issuspended or PAIN r)RAIN5
abandoned for a of 180 days any time after work has F 3:NAL
commenced. It shell be the responsibility of the permittee to P,.ure
all required inspections are requested and approved
Aee -2nite-
ure
Issued By
f-r"�t t -6-39---y
eFPAP*ATE PERMITC13 REOU114ED FOR WORK OTHER THAN DESCRIBED ABOVE
.............
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City of Tigard
INSPECTION REQUEST
for I
INSPECTION TIME: "66 PERMIT NO.
DATE: 4/'7 DATE ISSUED :— / I
OWNERS NAME ' _ I
ADDRESS: AV!Y_,',5 Z4dRAI4 � I
CONTRACTOR : -"S'_ -EXCd1'j9Tiw�G,- _
TEST : Air ❑, Waterer, Vieval W, Laboratory p
RESULT' Approved Disapproved O , Pending C
SKETCH:
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i le(t9F 77
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INSPEC'i fiR DATE
COTE: Attach supplemental test data beret]
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ADDRESS 1,3�LcfS �,��. �,�� � . PERMIT NO.
__. PERMIT CHARGE none
OWNERCONNECTION FEE
.r.�
PAID P Y
TYPE OF BUILDING �1°.�e� �__ DATE CONNECTED
SERVICE RATE INSPECTION FEE o1S`
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CONTRACTOR PAIrl BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
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