12339 SW KING GEORGE DRIVE �•ir
_ 12339 SW King George
King City
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BUILDING DEPARTMENT, 'TIGARD NO. Q55r
1 PLUMBiNIG PERMIT
holder of a valid pltl;nbing contractors license is hereby
e of
authorized to cause plumbing work as herein noted tobe
indCC who shalcl bp noltifiedenoltr less ng (
than four
Tigard. Such mstallptions require inspection by the Ciy p
(4) hours prior to tI,> time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
Address_ Date l ' •�-
Owner-�-`-..----. � --- - TOTAL PERMIT NO.'S
NUMBER OF AMOUNT (Office Use Only)
Ti'PF 01: PERMIT ITEMS FEE ON EACH _
2500 _
S� Fdmlly 1 bett-aech - 25.10
D-plex Each 1 babe unit
10.00 _ --
Additional bathrooms-each -----
Mubile Home Spece-each
INDIVIDUAL FI—XT UP.EFOES — 3.00 -----
1 to 50 Fixtures in 1 buildlnq each -- -
_ 2.60 ---- —
51 to 100 F.xtUref in 1 b�fldin�each _—T _ __- —
101 to 200 Fixtures in 1 bullding-each _
2_00
�.-
201 or more Fixtures in 1 build}neeach _
MISCELLAWEOUS — --- 10.00 _ —
-----
Builc!N_Sewer-tat 50 N. -- 10000
_Sewer-each�dditionel 100 it. — 5.00
' ter Service to build_irt __
•-Na10.00
Privet.1Netei Systems each 100 It _
Oth.r IS ocify) - �I
PERMIT y _ y For Plumbing Inspection Phone 639x191
Plumbing Contractor By
State__ Issued By 'r ---
TOTAL RECEIPT NO.(��'t'xl . .TF=