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9115 SW EDGEWOOD STREET
iCITY OF TIGARD
Building Department Plumbing Perm'-T-
NO - --- i
Commercial [-]
Residential
New Installation ❑ Replace
p Addition x Alteration pate l ��
I Licensed /
Plumber „`�6 Owner &JA aS e_,,Address��o1 d �;, 7�/ -//—,,✓ --
�``� 1`�_ Job Address
' Phone y�' />o�- _
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS AND SUB-CONTRACTORS
IITEM NO. FEE TOTAL ITEM NO. FEE TOTAL
Fixlure3-Traps 7.50 Sewer:First 100 h.
Dishwasher 7.50 _ Each Addit.100 R 30.00. 15.00
IGarbage Disposal 7.50 Ejector Pump 7.5U
Water Heater 7.50 Water:First 100 ft. —
_ 7.0.00
Backflow Preventer 7.50 Each Addit.200 ft. `
— i S.OG
Storm&Rain Drain:First 100 ft. 30.00
Each Addil.200 ft. 15.00
Mobile Home Space 25.00
Other(Specify): Rain Drain-Single Fam Dwell
(ng 15 00
t
PERomm
MIT FEE %S C� Cents:
STATE Issued By:
TOTAL �jr �,r� Receipt No — _ Applicant _ 4�f __�C�cFor Puimbin9; P3ns Ilion Ph 68ro —
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