12372 SW KING GEORGE DRIVE-1 4
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BUILDING DEPARTMENT, Tlf,ARD LMU
PLUMBING PERMIT 1� f
holder of a valid plumbing contractors license is hereby
authorized to cause plurri ng work as herain noted to be inst,llled it) w—cordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who sliall be not;fied not less than four
(4) hours prior to the time the installations are recti, for inspection. City of Ti;ard Business License required
ror all contractors and sub-contractor.
Jab i � ��� !,
Owner n _—_ �- Date IsA )
' NU!,10ER OF TOTAL t
TYPE Or PERMIT ^P ITEMS FEF.ON TACH _ A,"110UNT
Sirole Fam;(v25.00
Uupl�tx_Each 1 bath unit
--Additianar bathrooms-each 10.00
I hlab'a HomeSGace-each 15.00
INDIVIDUAL_FIXTURES Ct MMERCIAI --
�1 to 51) Fixtures in_1 building-each r _— _ - __ _3.00
1 51 to 10_0 Fixtures in_1 building-Each _._-.._2750µ -- --•- ----
k --
I 101 to 200 Fixtures in1 building-each _ +_,___�,. __._.....2200__._ .,-.- -----^-------
2tl1 or more Fixtures in 1 buildin -each 1.50_ -_-.._._ ---
IMISCELLAN'EOUS�__` -- _ -- — -
+Sewer-each additional 100 ft. -� 10.00
J_ Water Service to
_ Other I5o,�,:ifyl:
!- PER , For Plun•hing Inspection Phone 5,79-4171
NIT
l _4_;;State vv Plumtliriy Contractor By-/ _
I TO'T'AL "CEIPT NO. Imed BY
...,,w.� .,���_roelr!'�^"-,^..��^mw.aa*.+.o�cso^.+-m,.........,+w+rnezwrr..�nrc»......wr.wuv'*^wm'e*nnw,��xxwuT^r,A'+F.-a.•.v+..5.rypMv..+,e.-,,fin.v..:r• r..t,.,e�,... ... ...,._ ._„Mr,r
BUILDING PERMIT APPLICATION KING CITY D.aTE �_ _, 19
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE-
LOT No .----
OWNER JOU ADDRESS HOME ADDRESS _
ARCHITECT
BUILDER _� GP
ADDRESS ENGINEER
_ t- �?,�Zy _ ���
DESIGNER '
'IICTUFIE_— 01"IEW _ 1:1 R. A.fMO DFI. — ❑ADD TION — C1 REPAIR �RENIt ',AL [:]FIRE DAMAGE ❑__DEMOLITION
.� HE ❑
SIDENCE COMM OEDUCATIONL CJGOV'r GRELICIGUS❑PATIO C]CAH -ORT ❑GARAGE L_JSTORAGEQS AB []FENCE
C180ND 0MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑S,GNS
QCCUPANCY____LAND USE ZONE___-.—.`_BLDG.TYPE—_.FIRE ZONE_.._,._--PLAN CHECK 8Y—.__ HE A7
xl<:; ( tri»mite We is pleuscs �'Jvoe dlxistlni rijofinf4 an v.. inserto reapt.jrP
W-Q._LOAD__ Fl44RJ��D—_ —H�lSx►1t�__—_ Q JL4 1�°e.�.__._._A13EA—. �1S�El k.04Q-M�---SAL __ .-_.._.__'..
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
--` —'” TH— PERMIT IS' ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ?:)MING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED 'HAT THE
—` WOPK WILL BE DONE IN 'iCCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
c I: total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
`-- riE'TRI;'';VE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS :iEOUIRED FOR SEWER, PLUMBING AND HEATING.
Total
�By
��. APPLIC .NT OR AG.'NT — --------- ---- --.._�_��.�
,'approved E Receipt No. 4