11770 SW NORTH DAKOTA STREET �v
111770 SW WRTH DAKOTA STRFE:1'
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PLUMFUNG PERMIT
PEPM]''T A0. : PL-891.5P-6
C11Y OF T'FA RDCla°`°°n�ARD
COMMUNITY DEVELOPMENT DEPARTMENT /I DA"IE 15SUEZ: '7/J.•41/89
13125 S.W.Hall Blvd..PA.Box 23397,Tigard.Oregon 97223.(503)6394175041M . - .NO , 891526
PM1-
JOB AIN)FIF$5 : 11.7*70 !*.-i W NOWTH [)AKOT ii. 5T
TAX MAF /lAYT HK :
I AND USE :
L.071, `61ZE. :
ITEM: N(3:
WORK CRASS : A-001TVIN W A,I'r-.,:P (AJ35I:::*T
USEE TYPE : 5:11WA 1_:-: FAMT L.Y IP*-41NAI— HKFLOW VirWNTR
CON51' . LAVOPA'TOWY 'I I it*-)p PRIMER
WX11I R, T1110 151-101AIC:11:4 C-114EAGE 'rPAPS
D151-11WASHEN
I ON T FS WA!;lH.,[N(*,'- MAGMTNE:
1'.)W I-"I L. ON'T"Y"J i AUNI)PY TPAY 1A.-DG . I)PAIN (L)ILA
1-•1-00P D11AIN
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WATEP IAA ATE.P
(31'HET4
0 r1.1%1, I.t Iti t)r,lit cI I PIESIMIT
W :1.1'!'70 yaw i 11.7 r,t,I- clakat4a st
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E t:1.9 01,1"d 01., 971323 FJX,I1JPF-.5
604-4838 SiTATU. TAX
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This permit is issuel subject to the regulations contained in Title 14 ........... ..........
of the TMC. State of Oreg—i SpeciVy Codes,zoning regulation3 PICAAUTREA) 3:NL-*,PrXT10NS
and all other applicable codes and ordinances, and it Is hereby FTNAI
agreed that the work will te done In accordance with the plans and
specifications and in compliance with All applicable codes and
orJinnnces The Issuance of this permit does not waive restrictive
covetiar,ts. Contractor find subcontractors shall have current city
bulintiss,tax permits.This permit will expire and become null and
void it work is lot started within 180 days or It work Is suspenOrld or
abancloorid for a period of 180 days any time after work tins
rommonciRo. It shall be the responsibility of the permittee to Assure
ati required Inspections are requested and approved.
Permittee Signature
Issued By 1
SEPARATE PERMITS RECUIRErs FOR WORK OTHER 'THAN DESCRIBED ABOVE
P.O.6bx 23397
CITY OF TiGAR D PLUMBING 13125 sa tau Mvd-
Apph-lits must hold Oregon Registration to conduct a plumbingPE;R M I T 1iqWJ CR 97223
business,-x must toe property owner/operator not hiring 001SOc help. I 6334175
fA*ame of Dmiksprnenl ----y
PI Jmb,nK Permit No.
s,•nl�titxnJob --- - ---_. _ ORS 814-21-610 QUAN. PRICE AMT.
ax Lot Map.No.
Address
ssk�ck - --- FIXT1IRES
Subdivis►a, ---------- -
_ Sion _ 7.50
eme nm`e1v�business /nom �✓L Lavatory 7.50
L 1 `u551�1 I Tub a►ub/ShowerComb. -
1 l of IlddFuss _7.50
�d7j
Shower Only __ 7.50
Owner C,/ate Waie►Closet7.50
_/' LCi/' Dishwasher-- 7.50
&3Garbage Disposal - 7.50
Name _Washing Machine _ 750
Floor Drain 7.50ailmg rocs PtnWater Heater 7.50
Dcupartt City/State t laundryHoom tray 7.50
Urinal750
ame Other Fixtures(Specify) --- 7.50 -
igAddress Pfnone -----�...._._- --- 7.50
7.50
Contractor City/State - ---- 23P7.50
MISCEt_LAWEOUS
City Hce Tez No -
Sewer 1 at 100' 30.00
into s��tot+rdTTn: Mate s gus�l7o. Sewer•ea,Addd.100' 15.00
(Retrdential) Water Service 1st 100'
_ _ _ _20.00_
I hereby acknuwledipe that I have read N,is appWAtion Lt•al the Information Nater Service ea.AWit.2r 15.00
given is cored,that I am reQisfwed with the Stale Huikle%s Board.and also Storm rl qac Drain 1st.100• _
have a State Plumbing keens that the raxnbers ghmn wr oorrvo.ftt ail 30.00
pfumb1V wvtk will be done in aocordance with applicatAo provisions of Ore- Storm 6 A!-in D,ain Addh.100' 15.00 -
go n Revised Slatutes Chaptert 447 and 693 and appfk:ahie oMes and that -_--- --- ----no help will be employed unbss Iloensed under ORS 683.(If exemO frtvr. Mobile HoTw Spatz _ 25.00
State registration.r4sase Give,eason below) Bart Flow Prevention --- -�`
FKWEOWNERS --I hereby certify that I am the owner of the property de- Devioe ar Aft-Pollution DevwA 7.50
sa bed above.of~location I propose to rrwhe a pkxrA*V ww"Netio n for Ary T'ep cr Waefo Not
my own use arxt thio property Knot bskq Cy"Anx'fed for safe,leaee rx r" Ccuxsectau to a Fixture
-_`.�---------- --- --- _..-.7.50
- JCalch Basin_ _ _ 7.50 -
Insp.d Exist.Pkarnbir,p 10.00 Per Nr.
- -- -4 - -
'_ `apediaalty Requested Inspeco" - 40.00 Per Nr --
After.of Pkxr b'kV wits in
Au
p an Exledrl�BWQ 15.00 min
p �� T7i / J fq OatsNew Bldg.or Build.Addition 25.00 min. �-
aeecribe Wort( new -L' ! fX�lin a family
[ addition( ) atteration,] repair n
tO be done residential non•ror<xlertrial �1i�---- _ -
Exteiry use o1 ---_-- - _
taUlkWV or property -- -- ""
-- ----- - - SiWTOTAL
uAe of _.�._-. - -. Gd
or Pl'OS)"
TOTAL
ThN parrnM bwtxxr»s r,uN and void M work Of otanarr,Wticn arXlnc>.irnd f7 re Som
""noel W A 1�0 daya,sr M oorsmrtR born a wvrlt++1 aingarnds l a aba►►d mad for
a ParW Of'ISO days al any fir»eflsr work Is rx>rnrr+arwVd
*MCIAL.000KNTKWO
Dat" feeued ��' � by
Address 11770 S.W. N. Dakota Permit No. 1524
Permit charge
OwnerAl t, �i,L j� r,►��„_.�� t.. Connection fee 40J.00
Paid by Dale Const. _
Type of building Res. Date connected 10-,22-71
Service rate Inspection fee 25.00
Contractor Dale Constructi n _ .?aid by_ same Date
Size of connection 4" Assessment Pa►.d
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PERMIT TO CONNECT4�
Tigard Sanitary District y 7-11
PERMIT N? 1524 DATE
PERMIT IS GIVEN TO7'
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON Till DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID !..".' ........................TIGARD SANITARY DISTRI..T �
..f By
CONNECTION INSPEVTFD AND APPROVED
Date Superintendent
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