12396 SW KING GEORGE DRIVE 12396 S. W. King George Dr. King Cty+
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CITY OF TIGARD Plumbing Permit
Building Department
Residential commercial
New InstallationReplace Addition ❑ Alteration ❑ Date
Licensed
Plumber -----. Owner�e
Address
Phone Applicant
19
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS,:ND S T ACTORS
ITEM NO. FEE TOTAL ITEM NO. FEE TOTAL
Fixtures-Traps 7.50 Sewer:First 100 ft. 30.OU
Dishwasher 1.50 Each Addlt.100 ft. 15.00
Garbage Disposal 7.50 Elector Pump 7.50
Water Heater 7.50 Water:First 100 ft. 0
Backflow Pre(enter 7.50 Each Addit.200 ft. 15.00
Storm&Rain Drain:First 100 ft. 30:00
Each Addit.200 ft. 15.00
0 8 Home Space 25.00
Other(Specify) Rain Drain-Sim,le Fam.Dwelling 15.00
PERMIT FEE Comments:
Issued By:
STATE ' %
Receipt No. Applicant
TOTAL ftnature
Fo, Plumbing Inapmfion Phone 639-4171