10460 SW 66TH AVENUE-1 - RLIN3AK H191) MS 09VOT -
I
1K W W N
C11YOFT117ARD PLUMBING PL.RNIT
`MYOFTt6AfdD I E:RIVII:T tt. . ., » . » . : P1 M90-0065
COM54UNITY DEVELOPMENT DEPARTMENT �. ORFOON rJRIM. PERMIT 0 . : PL..M90•-0065
13+25 SWHali9lvd. P.O.Box 23197,Tipnd.O,epon 97eiik93�►s�91�15 �� - 1)A'TE ISSUED. (tai
/l6190
S:1 T'L ODDRE SS. . » : 10460 SW 66TH AV F•'faR(:;E:L: 1S; :::f.,AD-•00400
CUDDIV1SIUhd. . . .. : VII...I...0 RIDGE NO.. 2 t.'JNING: Fi._4. 5
BLC'C.'K. . . . . . .. . . . : LOT. . . . . . . . . . . . . 92
CLNSS OF WORN.. . :ALT GARBAGE DISPOSALS— :: M0141LE HOME:. SPACES. :
TYPE:. OF LISL. . . » :SF' WASHING 11ACH. . . _ » . .. - BACN.F'I_.OW PREVNTRS. . :
OCC,UPONCY GRP. . :R3 FLOOR DkAINS. . . .. ,. „ » .. TRAP"S. . . . . . . . . . . . . . .
STORIEyS. . . . . . . . . WATER HE'A fl'--RS. „ ,. ,. .. » ., CATCH BASING. . . . . . . »
F IXTURE S--_.....__._._..__ ....___. LAUNDRY TRAYS. . .. .. . ,. SF RAIN DRAINS. . . . .
SINKS. . . . . . . . . . .. URINAL":)'. » » . . . , . ,. „ . ., GREASE TRAP!--")» .. . » . . . .
I...AVA'TORIvE:S. . . . . . OTHER FIXTURES. .
I U1•:+/SHOWE:RS. » . » : SEWER L ILII:::
WATER (,LOSETS. . : WATE R LINE. ('ft) . . . . : 100
DISHWASHERS. . . . : RA 1.N 1)KAlhl ( ft) . . . . ..
kemalrk!a
— F k. .._...._............_.
HOWARD STRINGER type aniMtnt by date rec.�pt:
1.0460 SW 66TH AVE PAYM $ 26. 25 JL..H 014/16/130
T'1:(,API) OR 97223 ":PGT + 1. 25 /
Pharie Tt:
C;car►t rac:to r..
OREGON C1TY PLUMD & HEATING
(.,11. 7TH ST
OREGON CITY OR 97045
1-''•i c)rie M: 503 656-8558 58 t 26. 2'5 TOTAL
Rp.1 11— c 2132
_— - RE.OUIRED 10SPECTIONS
This permit is issued subject to t:ie regulations con. road in the Top 0i.it: :T.risp
Tigard Municipal Code, State of Ore. Specialty Codes and ail other F'irial Inspeetiori
applicable laws. All wo-k will be done in accordance with
approved plans. This permit will eipire if wort is not started
within 188 days of issuance, or if work is suspended for more
than 188 days.
___.__...-_........_._...__._M........._
P e r ni i.t:t e e S i g ri to t cl r e:
1 s s i.i e d H y: _.._....__...._._.__.....____.. ____..___.__..........._._....._.___.. .__. _ ___._..._ .. _...___.._...
Cell f0•r iris;pecticiri - 639••-4175
CITY OF TIG)ARD REGIFIF"i" OF PAY110,41 Fl-CEIF'r r-io. s 91')-2M
CHECK 0MOLINT
OREGON Cll ,r PLUMPING CAEM AMOUNT r 0.00
AD D E -!yll 7TH EJ PAYMENT DATE 0t/1(a)' il
SLIP.I)I V I S I ON
OREGON CITY. OR 9704.5— 10;60 CW 661H
PUPPOSE or- PAYME1,17 AMOUNT FAIL) PURP09E OF' POYMENT AMOUNT F441 V
PI-LIMBINE) PEf;441i'" 91-111. D PE'RHIT TAX 5%
TOTAL AMOUNT PAID
CITY OF rl!C',-ARD
PLUM 131 NG PFIRMIT 6) 6-116C 13125 SW HALT, BLVD.
' P. O. BOX 23397
Applicants must hokJ Oregon Registration to conduct a plumbing P- 0.D, OR 97223
Ixrsiness or mint be property towner/operator not hiring outside help.
Name of —knxnonf — (503)639-4175
Plumbing I ermtl No. �—
Address Descrtp000
[Ad
--- i_a v— _—..— Map.No. _ ORS 814-21-610 DUAN. PRICE AMT.
Tax
roaa
-- -- FIXTURES
Lot Buck SutdMslon ----- —
Sink 7,50
ams—Tar na—r►>A o isuw9s �— Lavatory - 7.50--_- ----
Tub orTub/SfgwerComb
�Tarrng res$ — -- — _
<' (i lv Shower Only 7.50
Owner CRY/;.tato ZIP Water Closet _ 7.50
-- Dishwasher 7.50
Phone Garbage Disposal—_ ---- - - 7.50 - - _---
Nam Washing Machine -- — — - 7.50
J�tvAk\,A S-T—Vt—y\ tij ey—_) Y�S y( or Drain 7.50
+ ess r Phom Walty Heater
Occupant ZIP Laundry Room Tray 7.50
Urinal -, 7.50
COther Fixhlres(Specify) 7.50—— - -
tt .50
L rsss�{ n C i'hone -- --- -250 750
Contractor Clly/
to ZID `� — 7.50
MISCELLANEOUS
7 City Bus T No. Sewer 1$1100' 30.00
Sewer-ea.Addit.100' - --- ;S.pp
tate 010
r o. tete s s. _
Rxlential) Wate•_Service 1st 100' - 20�00
I hef"W acknowledge thvt I have read this appRcatbn,that thevinformation WaW Swvioeea.AdditXD' 15.00
wven r:torted.that I P n registered with the State Buildols Board.and also Sbntt b Rain[rain 1 at.100' 30.00
have u Strife Pltuttblhg license the e nurrhed
om given are oorr ,that aft —-- —
pkombrng work will be done in accordance with applicable proyWo hs of Ore Sorm i3 P Jn Drain Addit.100' _ 15.00
Von Fievisnd Stshntes Chapters 447 and 693 and amAicabie codes and that MotMe Home Spens 25.00
rxo help will be omphhyed unless licensed undo(ORS 663 IH exempt from — — .00
State registration,please give reason below). Back Flow Prevention
1`10MECTWNERS-I hereby cetily that 1 am the owner of the propoerty(to Dery ceor Mb-Pollution Do-me 7.50
scribed above.N which location I propme to make a plX'**vj lraaNatlon kx
Any Trap or WaaN Not
my own use and this property is being constructed to sale.lease or roti CpnrleGNd b a Fixhxe 7.50
_Catch Basin 7.50
It".of Exist.P%Knthing 40.00 Per Hr.
--- -- Spedally Regtwled inspersions - 40.00 Per Hr.
- Rain Drain,
- Single tram. Dwlg.- 15.00 -
A• D PIA E
[M work new❑ addition l7 operation❑ repelr ---
119 be dome rfesidenti non-residential
Lxtstln0 use of MINIMUM PE. ---.T 1►a3 25.00
SUB-TOTAL �J
u!a M 5% SURCHARGE -
P1opa✓,Y- --- --- ---
-__-- .____ __-- __-----.. ___. _._._..__-- 25% PLAK REVIEW
NG"10E _
Ttrs,hentdt Ovoornee nutf arxl wild o worst or oon.truollon&Ut rAUed is"corn
manned hMthkh te0 rleya�or M oenior XIM(N otork4s elnipertdeI or abandoned ler
a pent of ISO nay$b any ion"sttr wort Is oxrwnwved
tItMCuu.000tiUQTKk1s
Date Issued ,._ - by --- - - ----- -