12354 SW 131ST AVENUE 1
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12354 SW 131st Ave•
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PERMIT N
CITY OF TIOMRD MITN . : PERMIT
PLUMBING��r/� O. : PL892106
C11F TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
P)TE ISSUED: 10/10/89
13125 S W Hall Blvd.,P.O Box 23397,Tigard.Oregon 97223.15031639-4175 n' PMT N0. 89210S
JOB ADDRESS: 12354 SW 131ST
TAX MAP/LOT SUB: LT: BK:
LAND USE:
LO*I SIZE:
ITEM: NO: NO:
WORK CLASS: NEW WATER CLOSET TRAP'
USE TYPE: SINULE FAMILY URINAL BKFLO6 PRVNTR i
CONST.TYPE: LAVORATORY TRAP PPIMF..R
OCCUP.GRP. : TUB SHOWER GREASE TRAPS
DISHWASHER
GARBAGE DISPOSAL
NO.STORIES: WASHING MACHINE
DWELL.UNITS: LAUNDRY TRAY BLDG.DRAIN (DIA
FLOOR DRAIN
SINK SEWER (FT)
WATER BEATER STORM/RAIN (FT
OTHER
REMARKS:
FEES:
dom7.alsl i i :,b PERMIT 415.00
ry 12354 sw .131st
Es tigard or 97223 FIXTURES
PKONE (503) 639-7754 STATE TAX $.75
OTHER
C
O
T LYNN HATCH I.-ANDSCAPING
R 14135SW 1111TH
C tigard or 97224
T PHONE (503) 620-5660
R REGISTRATIEN NO. E18 TOTALS $115.75
1',Is permit Is Issued subject to the regulations conta.ned In Title 14 _________ RECEIPT NO. /0
of the TMC, State of Oregon Specialty Codes.toning ,-pi-.aouns
and all other applicable codes and ordinances, and it Is hereby
agreed that the work will be done in accordance with the plans and
specifications and in compliance with all applicable codes and
,)nlinnnces The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
husiness tax permits This permit will cxpire and become nul and
void it work is hot started withir ib-1 days.or it work is suspended or
,lhandoned for a period of 180 lays an,+ time. after work has FINAL
commenced It shall be the responsibility of the permittee to assure
Fill required inspections are re nested a ld approved.
e "it mil
�ft� t`tc�r�1 1+T7�1�� LIQ—`, C
Issm-d By _. ._..r-QW—lN6P9C-T 4l/�F--SOT—`T175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection (� C
Date Requested Ti AIVQ
CP.'M.
Address �O1 3 y /��/ 4- Permit #
Owner — Lot #
Builder
The following Building Code deficiencies are required to be corrected:
- --- ----- -
i
Presented to —Approved
Inspector _
Disapproved
Date --- C � --
CALL FOR REINSPECTION
❑ YEi 0 NO
w w w w w w w w w
INSPECTION NOTICE '237
City of Tigard Building Department 73P�
PC Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested 13 31 Time A.M. ' P.M.
Address /,--2 3 �tJ1_.� � �' ^-( Permit
Owner _ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
�E'�..---�L�-LCC_---�• �� �L�_.._ ✓:,
00
� ►�a� ��ti--^ vy c� t w••� 5fc�t
Presented to
❑ Approved
Inspector
�se
� pproved
Date
2:5
CALL
CALL ,�F�O,,..R,,��R$INSPECTION
UPOVEs ❑ NO
I
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested/ Timo _A.M. P.M.
Address _�_L� ,!Z_� Z 3Z �t _` Permit # �
Owner Lot #
i
Builder
The following Building Code ueficiencies are required to be corrected-
Presented to _
nl
,/ Approved
Inspector ,,�� -'✓
--- �] Disapproved
Date
CALL FOR REINSPECTION
❑ YE8 NO
i
III
I
INSPECTION NOTICE
. �1c� City of Tigaro Building Department
' P.U. box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection ,''u! �iJ>(; ��l�•� �_
Date Requested— - ly - Time A.M._Yb, P.M.
Address f, 3.5-y Z �t Permit # $
Owner _ _. Lot #,
Builder_
The following 9uiiding Code deficiencies are required to be corrected: .
rpt'
ti
Presented to _ Approved
Inspector ✓ _ ❑ Disapproved
Date
CALL FOR REINSPECTION
0 YES D NO
i
i
INSPECTION NOTICE
City of Tigard Building Department
P.G. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of I nspe,tion
Date Requested=�',( _ Time_—_ A.M. P.M.
Address —L y _._ / s` Permiiiz
Owner Lot #
Builder
The following Building Code deficiencies are required to be corrected:
G
Presented to
-yam---- F] Approved
Inspector _ I I Disapproved
Date %h - 55 >
CALL FOR REIA'SP CT1ON
C1 YEa O No
■w t J� iL' � ® f 1! !1
INSPECTION NOTICE
City of Tigard Building Department Cl/I
P.O. Box 23397 /f
Tigard, Oregon 97223 �G
Phone: 639-4175
Type of Inspection /�' —��
i
Date Requested ,.Z "/�/���� 7 Time_ A.M{�-� P.M.
Address
_�_� 7 �c�/ �'"/`. Penni 5 t/
Owner Lot #
Builder zL,)
The following Building Code deficiencies are required to be corrected:
Presented to _ - _ �� Approved
Inspector -- _ --. _-- _-- ❑ Disapproved
Date
CALL FOR REINSPECTION
❑ YES 0 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397 ll.•
Tigard, Oregon 972231_
Phone: X639-41755
Type of Inspection
Date 4equested_ — Time
_ r
Addrass /•..�'�L�� Permit #
Owner Lot #
Builder The following Building Code deficiencies are
requiredto be corrected:
f�..�/R.-.� tel. Lf? G- �C ,� LX_.
! F .l*!-( .1
?1-k'G
Presented to [Approved
Inspector _ _ —_ �� Disapproved
Date
CALL FOR REINSPECTION
[] YE5 0 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397 �-
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested_'l - f Time A�l{ _P.
Address ,z�r�. �� Permit
Owner_ Lot #
Builder ill 2-
LE:::-The following Building Code deficiencies are required to be corrected:
ii.
Presented to
�, El Approved
Inspector
❑ Disapproved
Date
CALL FOR RhINSPECTION
0 YES LINO
t ■
l INSPECTION NOTICE
City of Tigard building Department
P.O. Box 23397
Tigetd, Oregon 97223
Phone: 639-4175
7
Type of Inspection 4< w u
Date Requested L ��L_—/ Time A.
Address =Z% [ Permit # ,
Owner 1._ Lot #
Builder_ ' 2&2
The following Building Code deficiencies are required to be c Z
rrected:
? � _
g2 --_
11-len j r •_
J
P , j-w,,,
_ ,=
Presented to r (� Approved
Inspector Disapproved
Date ----_---
CALL FOR REINSPECTION
F-1 YES Cl NO
i
i
i
i
I
i
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested Time A.M.__P.M.
Address
-- ... Permit
Owner_ _ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
7
n.'Y
1
F
i
Presented to
—� F1 APPceved
Inspector -11
IDate Disapproved
CALL FO"EINSPNC'TION
YE! ❑ N8
I
I
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175 011
roc
Type of Inspection `� � ��E2
Date Requested Z-61 4 1 Time A M ( P.M.
Address ^ / _ ��_ / —�—
Permit
Owner Lot #_
Euilder
The following Building Code deficiencies are required to be corrected:
1�
Presented to
Approved
Inspector
❑ Disapproved
Date LZ ______�
CALI, FOR REINSPECTION
C7 YES ❑ NO
i
INSPECTION NOTICE
City of Tigard Building Department nay,
P.O. Box 23397
Tigard, Oregon 97223 I
Phone: 8,49-4175
i
Type of Inspection ?;
Date Requested__ �� ;-;1 -�(C] Time A M r l�--
P.M.
Addreis �t f /
Permit #_'`C�
Owner
Builder Lot #
`- l✓YY ' �.. ,>S" ��_ ( �—
The following Building Code defin-encles are required to be corrected:
.r.-.�_ T.r �_���— tom✓ i
r�
Presented to y �
'P_I Approved
Inspector
U Disapprov-d
Date Jv
CALL FOR REINSPECTION
L� YES ❑ NO
PEKIPiMIT
CITYOFT167ARD 17'EnM:I:*T* NO .
CITYOFTIGARD
COMMUNITY DEVELOPMENT DEPARTMENT 0111160100
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard,Oregon 97223,(503)6394175 ci, DATE-' ISSUED : -1/25/09
WU W W Q 15 15
ADI)PEESS : 1.2331 SW 1 AVi*-:.
IAX M('NI:*A/L..C)'T' AIALJ
I i')NU USE: SUE[: MOVMING, F11I.A.. 6 1
I I J'I SIZE : VAI U671*1014: 1111 1.36 SEA'"ACKS
FI-IONT : 20 RE.!:AP: 5
WOPK C;I ASG : NEM DWEl.l...IJN*11'13 : I 1' : !15 PVAIT : 20
USE. TYVIEK . !4:1'.NGL'E FAM11 N, NO . 6"1: 01-40OMS : 3 1:.:X V . WAI t CONS"!
C,'ONST . T'YI:)1:.: ; VN N(J. EIATI-11ii : 3 N
W
PPOT . OPEWINGS :
(A:XUP�I OAD N E
'I(JIT61. ,3:1.85
N0 . 5T0N:I:E::ti . 2 SiT: J-'e482 ROOF GUNST : C" FXPE PVJ'?
20 N 1) 923 A 1:4 V:'A SE PA r 4'? i 4 Al 1'-:'D
9AF1EMI;i.NT'? I.XX"Up. 5E.PAIT?
760
5.30 FIM.-K W6.11:11<11.1,11,? Al AI:1147
F L'C)W c 61 P M DE:1+1"'T"?
I Ita:A T, 1A
t-"I AN
OF NO.
0
W 1101,12.AI15 1<1, 5o
IV I /105 !3W :1.P.8'111.1 A V 11.
Ia .1. A 1:4 D 061
1150'311 6,39 7 J.Itsel I 1 1. 11'IX
C
0
N f 1111m) Ir.?5 0 0 0
TDC I I� I 1!1,F I
R 5 $600 . 00
A (V.300 4!iw HAHNIJI-1 01 VI:) ["[W
C P I'l AND
14
F..:1:5 AT 1) < $100 Oo
Q
'101 9 0 1. W!I
This Permit 18 Issued subject to the regulations contained in Title 14 PECElPT' NO
of the TMC. State of Oregon Specialty Codes, zoning regulations .......
and all other applicable codes and ordinances, and !t is hereby PF1411 11 V4:1) 1 NSI:li:I; I I OW-5
agreed that the work will be done in acco,dance with the plans and t 00*1-I.N(.','
specifications and in compliance with ull applicable codes and
F(JUNDATT(IN WAI. L. PAIN J:)"'A:Ir.NS
ordinances The issuance of this vermit does not waive restrictive
covenants Contractor and subcontractors shall have currogrii city PUS I & B[.A11 L. VNE
business tax permits This permit will expire and become null and PI I I-INDEPSI-AH C.1 Fy (IPPIA"l-I !:iw
void if work Is not started within 180 days.or It work Is suspended or !:;I f F :1.NAL
abandoned for a period of 180 days any time after work has r,l .1:'l rt: r,c)(i*r
commenced. It shall be the responsibility of the permittee to Fissure
all required Inspections are requested and approved. I-*PAW(11A.",
F,1611':.6'1..ACE
1N(31.11..AT I(I N
'YP
Permittee lgnst(re G 00APE)
C--,
Issued By —
IF4,11•'ril PIP 7.
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
SEMEP PL."AM3:*Y*
CITY OFTIGARD (Cjm��4111100 r.:1EAKUT NO. ! SE- 8907'39
COMMUNITY DEVELOPMENT DEPARTMENT 0210WDN
13125 S.W.Hall Blvd.,P.O.Sum 23397.Tigard,Oregon 97223,(503)6394175 UWTE: V4SUE.�.IJ . 4/25/89
I;1'lUTIYl DIVII-1, bifl i4QI!ilr'RA
1.23.51 171W 1,315T, AVE'. USA NUMUER: 037,190
lg')X MAP/1-01' '251. 1A8 9200 SUB: M(')1:4N:I*N(',) M11:1...1... 6 1_1* : 1221 EIK :
1. (.11IND USE :
III SIZE:
',I ("TJ ON: A:I TWP : R th [M(., : 1.w
WONK Nr:::W
FAKILY
I,i,i cminj;)1y w:Ltl-i w1l liki-ICI I`eqI-IJ-flLLJ-CIh91 Of 1.1-leU11:1.4lieid
")ol"Init i. ;10 dayla -Ill.,uln (Jlvil clattv.) J.Iulsl.led . TI-le w:)-t,40.
r.)oid will be) (Jr)"m I-10t
J
J.(
.(.?JJL t,:L f:)ILI to-1: t V)r.*.) "I j.CI w, ill rulwre I" 'I'a t I*?1-1.4.J.% f 0.10. illi
alt .0-le ttlo illmULT.A.C.)r. javc)%11)et:t 3 4?(,.?et -ill
I.,vc-,ti Ll I-)% -F r-m in t,1.1 lyi., d-I.Ili t.ut 4*1 cvl? J.V 0.I'l J:f 11131, vi 13 3.(J C.!i&t to cI . 't,1.1 co J.11 Is t,ill 1.1.M.)I` Ill,1'1.;1
1,,-;e a "THLIJ iarld !:liclo.r., r)r,!v,n:i i. mi.ici Aqe)tic) wJ .1 1 114.ill'"13. In 3.0itto1'-Ift'.1
OING 1:M1:1-: 4V)(.11 1!:i AREA;
V. t INX I ia I:KNAN1 IiiI.'lPI:JVE'M1:KN'T :
UI 111. 1:1 .1
6L SKI PCHUJI'T J '11!111 C
N
SW 120TI-I AVE. 411. , 100 . 00
OP 97('112,3 L.U4l:..* TAP IWITALA.. .
I H001 6 fV5/I
!-)W "APSUP
AND UP (isIPI.9
1503) k*.19*,3-.- 1,'1I1:1F)
ra l ." IFIATTON NO . 51159, TOTAL, 40. 1.;3:5 . 00
H '
This permit is Issued subject to the regulations contained n Title 14 WEXAJ:1::"Tt 1,
of the TMC, State of Oregon Specialty Codes. zoning regulations ....... .......
and all other applicable codes and ordinanr,es, and it Is hereby INSPECTTONS
agreed that the work will be done In accordar ce with the plans and a l+-JN
specifications and in compliance with all applicable codes and
ordinances. The Issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and
void It work Is not started within 180 days,or If work is sucoended or
abandoned for a period of 180 days any fume after work has
commenced. It shall be the responsibility of the permittee to assure
all required In9jections are requested and approved
Permittee Si slur
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
C'TYOFT167ARD EXAAANTJ:AL PFAM11 i.
cr � M
AWD PEAKUT N(7.
COMMUNITY DEVELOPMENT DEPARTMENT 001100N
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard.Oregon 97223,(5031639-4175 DATE'. 15SR)EM: I/C?5/89
l.ArJ-I-td InIM-1. ?J(3 ]WRO
)(38 AIMPE:GS - :I.a35A1 SW on VI;;.
IAX MAP/l 0-1- MOPINITNG 1111..A... 6 L'T : J,PJ. OK :
I AND USE: :
I OT !i:I:ZE*. :
NO
W(:)Pl( C'11-101155 : OF.W F'URNAGE: <100K ATP HANDI R <.1.0
FAM11 Y I"-*kJPNAG'E 1.001<+ 1. Al A IAANDI 1:1 101<
(:'(:)NG1* .TYr--1r : VN FL 00P E:VAP. (:.1C)(AA::P
(:)(:',CLJP.GPP. HEATE.,N Vk:*N'T' FAN
BI R/(::0MI::' <31AP HOOD
NCI . 5'T R IE'S' Ell-PICOMI.:1 3 TN(:1Nr..:P1r•1T(:)I-'4 MUM
J .5
DWIZ,L L UN I TS t Ell 1.1/(:"(:)m I:-1 J.".5 ":301"11:, -I:NC'-1NI;-:PA-TOP((:,(:)M
UEA.. Tyl:.11!',: GA5 Fill RMAMP, 30--t"301-.1p, r-4I:PATI1 LIN1115
MAX . TNI:'AUT 50-HAP (:l THEA rf
I TPIr.- I.)MPPG"? C.-A5 UATTLEJ5
Pl-wss'?
0
w DOMZALSOCI: rKH.4E.'ITY 4.1
N
W t�2(:
E ITIA AVE: I ON 1;41:. -' 1 E.::w ER)
R I VUAPO UP 97RP3 1 X f U NL:.!;) 3 15 0
1:11-40191%. ( 503) 639 -77FM ')TF. TAX
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1_"I TOTAI f1i 15 FI 5 Cl
This permit Is Issued subject to the regulations contained In Title 14 NO. 16 3 5;?o
of the TMC, State of Oregon Specialty Codes. zoning regulations ........... """"'•'•. ...........
and all other applicable codes and ordinances, and It is hereby
agreed that the work will be done in accordance with the plans and UAS L.
specifications and In compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive 1-415,11 REAM
rovenants Contractor and subcontractors shall have Current city HOLKA-1 'CN
business tax permits. This permit will expire and become null and
void if work is not started within 180 days•or if work Is suspended or
abandoned for a period of 180 days any time after work has
commenced.It shall be the responslbllity of the permittee to assure
I
all requiredions are requested and approved
Permittee SignaluAl
Issued By
.1.N S PF,I, I IN 639 "11. i
SEPARATE PI RMITS AEOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
1 1 MIr
CITY OF TOGA RD
CIiyOF ND
101111'
111' N: 140O. 151-890737
TWW'A
COMMUNITY DEVELOPMENT DEPARTMENT 01100"
13125 S.W.Hall Blvd..P.O.Box 23397.Tigard,Oregon 97223.(503)639-4175 1:55L)EA). Ali.!;:,/(Jig
Will gs?ii
.III ADDII 123.5/1 15W AVE.
f(.iX MAPI/L.O'T V:0. IIAD 9200 Fit.ffil : M(31:41SIINIG 11111 6 L.T: 1.P-1. B l<
11 ,I1ND USIE, :
1 .11I 151ZlI
M: NO :
W01I CLASS : Nf.-::W WA-11:11 CLAISEA, 3 TPA P
11SIK: TYPE : FANTI.-Y LIPTNAL. Eil<I-`L,0W 1:41VNI'll'I
CONS1 . l'Yl.*Ir-.:: VN I 61,10PATORY <I 'TPAVI
1:43 T'I.A.4 SIAOWENI 2 GRE-ASE. 'r PAPS
DISHWASHII I
CIAHBAGE
NO %TOP11I P MALIHI.N11 I
1 TS : 1. LAUNURY 144AY E"41-1I DAMI IIII
FA 001I DRAIN
til N l< 1511
-VTORM/PAIN II
10- Mol:41<5
F-
W 1)(1M7(-')I I.il<:r. A01I ..1 1. RMI'T Q1 I AJ() 0
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R IXT1.11I
'111::: TAX *7 . OO
(503)
C
0
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0
R I I i I I : 11 1 ell . 00
This permit Is Issued subject to the regulations contained in Title 14 1 NO
of the TIII State of Oregon Specialty Codes. zoning regulations "•"......
and all other applicable codes and ordinances, and It is hereby V11EQUIPEE)
agreed that the work will be done In accordance with the plans and PILAI .1.1NrA.l4!:IL.A1I
specifications and In compliance with all applicable codes and Ia(�13 T' di Iafi:FaM
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city WA1144 L.T.NK:.
business tax permits. This permit will expire and became null and 1:111-H., rar.c.)w
void if work Is not started within 180 days.or if work Is suspended or PAIN DPAINS'
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
sill required inspections are requested and approved.
Permittee Signa r
IssuedSy
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
'ea � s ae ■r � �
C11YOFTIGARD, �4 PLAN CHECK( APPLICATION�� - -
�4' cm'oFn�i+Rn PLAN Ci+ECK
COMMUNITY DEVELOPMENT DEPARTMENT ti) PERMIT H
1»zss.w.xanenra P.o.BOX Z7�97.TIp.ra o�eyon97213.(503)6'�4+� tiDATE ISSUED n G
JOB ADDRESS: �Z,�� rD W MAP/L�T
ut; �iRN: P
1\� \ �j_ � Qo LOT: _ 1-� LAND USE: — -
VALUATION: ` --
T SPECIAL NOTES
OWNER Z REISSUC OF: _ --
NAME: E LAST REISSUE:
ADDRESS: Z r `�UJ• \Z`bT 1� —
r '�ARG FLOOD PLAIN/
_-- SENSITIVE LAND: _
PHONE:
TIMAv I G
APPROVALS REQUIRED
PLANNING: —
CONTRACTOR ENGINEERING: —
NAME--UE�E.L�F'I��NZ PI�P�•CNWE��� c� — --
� �.UJ• �F��Ps�G `c `�Z. 11 FIRE DEPT
ADURESS:
Ve)VnL-N%�1G OTHER: -- --
PHONE U�� ��`�' ITEMS REQUIRED
LIST/SUBCONTRACTORS:
ARCH/ENGINEER BUS TAX: _.
NAME: 4 1+'\� � 1�E CALCULATIONS:
AGGRESS: M KS TRUSS DETAILS: I.
PARKING PLAN: _.
LANDSCAPE PLAN:
PHONE: OTHCR: — —
COMMENTS: �—
PERMIT H ACCT H DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
,�' (�
10-432 00 Building Permit Fees ----
10-431 00 Plumbing Permit Fees �
10-431 01 Mechanical Permit Fees —-- -
10-230 01 Stata Building Tax (5X) —
Building —
Plumbing _
Mech —
10--433 00 Plans Check Fee
Building
Plumbing
Mech
30-202 00 Sewer Connection _ -
30-444 00 Sewer Inspection
51-446 00 Street System Dev Charge (SDC)
52-449 00 Parks System Dev Charge (PDC) --
31-450 00 Storm Drainage Syst Dev Chrg (SSDC) _ -----
10-230 09 TRFD --- -
10-230 06 Washington County Fire H1 (95X) -
10-220 00 Amart/Wedgewood
101-At
— - REC H
APPLICANT ATURE
pv( pived Fly - }Zil- / Date Received: —
cn/3')H1P/1HP
PLUMBING [�[�[�M ��[ 13125 SW HALL BLVD.
P. O. BOX 23397
Applicants must hold Oregon Registration t) conduct a plumbing T I GARD, OR 97223
business or must be property owner/operator n(x hiring outside help. (503)639-4175
Named[)evebprnecnt Plumbing Permit No. to
Address tkoscription
I
ons 614-21-e10 t]UAN. PRICE AMT.
Jot) Tax Lot Map.No.
Address _ FIXTURES
Lot Block Subdivision �k ----___-__ -- 7.50 -
- arr►e or name ss Lavatory --- 7.50
Tub or Tub/Shower Comb — 7.50 --
ar xq ass Shower Only -_ - ^_ 7.50
Water Closet 7.50
Owner CNy/ to ZIP -
L Dishwasher _ 7.5 p0
Phone Garbage Disposal -.. 7.50
_-- _ Washing Machine -— _---7.50
Name ------ -
Floor Drain _ 7.50
Thar irg ries Phone Wale(Heater _— _ _. _ _. 7.50
Laundry Room Tray - 7.50
Occupant City/state ZIP Urinal 7.50
---- - Other Fnctures(Specify) `- 7.50
ami
��' -- — ---- 7.57.50
ass 0
j U,if` — -- -- -- 750 —
Contractor Ctty/State ZIP —
L `• �. ) )�/ MISCELLANEOUS
City las.Tex No Sewer 1 si 100' 50.00
State s
Sewer-ea.Addit.100' 15.00
�-TTo. -
(RettdenGan Water Service 1 st 100'_ 22—.00 - -
Water Service ea.Addit )c 15.00
1 hereby acknuModge that I have real this application.that the kpkxmalion ---. - ---
given is orxreet.OW l am rcostered wide the State Buil def s Board.and also Storm 6 Rain Drain t st.100 -- — 3000 _- -
he"a State Pkenbkq kcense that the raxrthers given are o0owl.that ell 1�i.U0
ltknrtbinp work wig be dorm in accordance with apprtcable Ixvv:sicxss d Ore- Stomi b Prin Drain Addd.100_ _ _
pan Revised StnMes Q%Wert 4I7 and 693 and applicable codes and that Male Home space -- -25.00---
-o
0--o hep wM be am pk"d w*M,iieneed urder ORS 683 (It axe",(hom -
State rtration, se ason below). Back Flow Prevention
°�sPk'a give.
aDevice a Mb-PdFutan Uewce / 7.50 --
IKXvt[OWNI I t",--1 hereby certify that I am the owner of the property de - - ----- _--
ar-tdped surra.of wtnldi lor,atkm 1 propose to nu"a pkirribirT. trttallatlon Iot Any Ttap or Waste Not
mY own trio and this proper w to nal bekV eonstrucled lot sale,base Of rent Cotrnected lo a Fxb" -- 7.50
Catch PAskt 7.50
kap of E-I M.Pkinbing 40.00 Per Hr.
- SpedsMYirlaquested lo%P-cti 'u 40.00 Per Hr.
__-- Aker.of Plumbing wM-An _ -
-- - Bkf
an Exielkppp
15.00 min.
— --------- ---- ---- -
AUT►IORlXEO SI(3NATTJP('�
-- - -— ---- -- Date New Bldg.or&M.Addition 25.00 mkt.
azin a fanil _
Cewir be wort clow O addition( ) alteration f� ---reisalr O d 11 ing 15.00
tq be dom resklentiall)-- non-reside letjj- -- -
F pdstlrtp use 01
txfudk>q cx Ixt>,+ttr,y sU8-•ro�r�I.
I,rc ioe�d ufte 5% SURCHARGE 7�.
25$ PLAN REVIEW
TOTAL -
1 IgM parr>,Il hanarpoa tvrfl and void w wvrtt a oonstrWkon authtortaad r rcpt uom i
rnarxpsd wkNn 1 tlh dM pr M rrpnatnx'1ldt d tlWDtk w MAparrlad a atparxkxptd for
a(Wi vi M 1nr)days of..,Y&1.*aflec woi4 Is arrrrnarrwi
P
el'a.YAI cxklUtT1c7N9_ --- --- - ?
Hate lesued - __.__— by ---- --- --- --- -
••-