16715 SW QUEEN ANNE AVENUE i
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16715 SW Queen Anne
King City
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BUILDING DEPARTMENT, TIGARD NO. 0568
PLUMBING PERMIT
_ - holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as hereir noted to be installed in accordance with the plumbing code of 1
Tigard. Such installations require inspection Ly the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Busine„s License required
for all contractors and sub-contractors.
Owner-,_--------,,. _ Address__ Date_
NUMBER OF TOTAL PERMIT NO.'S I
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
RESIDENTIAL
SI le Family—l beth—each 25.00
Duplex—Each 1 bath unit 25.00
Additional bathrooms—each 10.00 _
Mobile Home SDece—each _ ' 15.00
INDIVIDUAL FIXTURE FEES _
1 to 50 fixtures in 1 builds —each 3.00
_ 51 to 100 Fixtures in 1 buiWinp—each 2.50
101 to 200 Fixtures In 1 building—each _ 2.00__v — '-
201 or more Fixtures in 1 building—each Q _ _ 1.50
MISCELLANEOUS
Building Sewer—lit 50 ft. �v Y 10.00
Sewer--each additional 100 ft. 10.00_
Water Service to building _ �_ ^— 5.0_0
Private Water Systems—each 100 ft. 10.00
PERMIT For Plumbing Inspection Phone 639.4191
1% state _ T Plumbing Contractor By
TOTAL _ RECEIPT NO. Issued By �� -