16125 SW 92ND AVENUE 15125 SW 92ND AVENUE ---
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BUILDING DEPARTMENT, TIGARD Nn E
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PLUMBING PERMIT �II
holder or a valid plumbing contractors license is Thereby I
authorized to cause plumbirA work as herein noted to be installed in accordance with the plumbing code of
"i igard. Such installations require inspection by the City Inspactor who shall be notified not less than four w
(4) hours prior to the time the installations are ready for inspect i City f Tigard Business License required
for all contractor and sub-contractors,
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Owner __ _ Add s. _� _ Dat
r --� NUMBER d TOTAL
TYPE OF PERMIT ITEMS JFEE ON EACH AMOUNT
RESIDENTTl.AL .�._._--
S ie Family-1 bath—each 25.00
—__ _ _ � --
Ou I�x—Each 1 bath unit _—_—25.00--
Additional bathroorns—•each
Mobile Home Space—each — _-� 15.09 _ .__— 4 ',
INDIVIDUAL. FIXTURES(COMERCIA
1 to 50 Fixtures in 1 building each 3.00 -- j
— 51 to 100 Fixtures in 1 building each.___ 2.50
101 to 200 Fixtures In 1 building—each _ _ 2.00
201 or or more Fix•vres in 1 building—each
MISCELLAN US —
_ I
Sewer—each additional 100 fr. _-10.00
`Neter Service to building _ y _5.00 -S _ �--
Oth _So�ciFyl:
_ PERMIT —�', Far Plumbing Inspection KiWe 639.4 171
-)4 Se tatPlumbing Contractor By
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BUILDING PERMIT APPLICATION CITYTIGARIDof DATE _`_��;__, 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE.—
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING FLANS AND SPECIFICATIONS. OWNER PHONE/
LOT NO.VIA
5f
OWNER JOB AODRF35 HOME ADDRESS
ARCHIT CT
ENGINEER
BUILDER ADDRESS r� DESIGNER
O
STRUCIURE _NEW REMDEL ❑ADDITION ❑REPAIR ORENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑RESIDENCE I.,JCOMM ❑EOUCATIONAL ❑GOV'T ❑RELIGIOUS CPATIO CCAR PORT [:]GARAGE. ❑STORAGE❑SLAS [FENCE
080NO ❑MOVING ❑CONDITIONAL USE 0DESIGN REVIEW [3COUNCIL. APPROVED OSIGNS
OCCUPANCY_ LAND USE ZONE "'.L ,__BLDG.TYPE FIRE ZONE_% PLAN CHECK BY---L ._____n HEA 11/__._`_._�`
M0112L if? IJUUAw NQ QUIT "',A CY 111 141 HOWL-ij 'moo Public •__�l�'s�-.bra-c�1L�-
Irlx _rust 'FM;JUQc,�IAA jll uii.L, i Moved ie-1 horsno'
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OCC.
UCC.LOAD _�14�81.QAL2. -- HE1Cz1L _ "�st.�.�O�E$ AREA NO.UjPTl,ZQMS _._._VALSJJ_�.
BUILDING DEPARTMENT SET_BACKS FRONT 70 REAR tI* LEFT SIDE RIGHT SIDE
Permit
-- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CCI;."(AINED IN TH'c PUILDING CODE, ZONING
Plan Check REGULATIONS AND AI_L APPLICABLE CODES AND ORDINANCES, AND IT IS 1IFREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANT)SPECIFICATION', AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS P'RIr IT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total SIX., ,0400.01,;
POIC W44 410001)(1
BV
-- – - — !y APPLICANT OR AGENT
Approved RP.ceq.t No
ADDRESS .,. .r. wa.. .,s,,,,�,o:.rw.a..,.,.1'!�Qlw .......,. ........ .....
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DATE INSP. TYPE INSPECTION REMARKS �— PLUMBING _ DATE
Contractor
--- Permit No. 035- - `4-0
46i Q _� p �— Hough-in
--� --
S /car —� Fixture
Final
HEATING
Contractor
Permit No.
-- A--`— —4_ Gas ca Oil
R ough-i n
— � _--�- Final
---- --SEWER
-------- Final
— DRIVEWAY
Final
Stonit Drainage
— (nein Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL T9:MPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY -- —
Landscepiig
Zoning Final
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BUILDING PERIA f hPi -ICATION cOF TIGARD DATE „
.fie 2 g-- 19--7-t 17&G
THF UNDERSIGNED HEREBY APDL ILS FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF103- - '36
OR &r SHOWN AND APPHOVED IN THE ACCOMPANYING PLANS AND SPFCIF ICA TIONS O".NEFtPHONE--
P.
HONE..._.._ —
Pif 'I�0 mph/ >LOT NO.
nWNEA .- ��.�J(�6 _��
C� /� Flaw) -� AHCHITE�
(p �eZ 5 �V�L/I� FNGINE .
BUILOCR '- _ADDRESS / rFr k DF".SIGNE �`�� j '4
STRUCTURE KNEW R MnDEL (_JAUOITION— ❑REPAIR ❑•+tvEWAL ❑FIRE OAMA E ❑DSt.+CC.ITI
ESIL'IENCE ( COMM ❑EDUCATIONAL [7GOVT ❑RELIGIOUSOFIATIO (3(;ARPURT CIGAPAGE C1 STORAGECISLa8
Xv
Cr ,_PA'div 3Lr. /� — ) fti UG TYPE_ L,FIRE 7ONF_ P1 aN L.P46CK BY._ `�-
- _—
- P •��
SEWS, PE F,(`. .. .__ _..._
OCC LpnD I +T . +�Q_yrUT?IES AREA NO BE0R0Q4.S . . VALUE 38oa
--_ 9UILCIN-; ; FRONT 76 REAR I EF i SIDE 3L 9+1GHT SIDE Z
IS ISSUED SUBJECT TO THF. REGULATIONS CONTAINED IN THE SUILD'NG CODE, V,WN
IPPIAM Check :L'L,'i1 WNS ANr ALL APPLICABLE CODES AND ORDIhaNCES, AND IT IS HEPESY A.GRE.ED THAT r1
-- -
.44t\ A''!' I- 6r DONE IN ACCORDANCE WITH THE PLANS AP40 SPEC IFICATIONS :.ND IN Crjw.rLi tN,:.L WIT
sx) total A; L AFPLI(t,FILE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOi WAI`
-- - - STR1CTIvE COVENANTS. CONTRACTOR AND SUB COp:7RACTCRS TU NAVE CURRENT CITY BUST VE
State Tax -_ T V ENSE SEPARATE PERMITS REOUIRED FOR SEWER PLUMBING AND H'.ATING
Total U L C
Oq .4G_EN_ .
- - - �fIG� npPLIC.ANt t
[App a vf-e
. . .. .. - - A111- qF Sc b►IUfV �_.
SDC -
5FI(AH TAI CTION $ 4P 0 G
5EWER INSPECTION
SEWER SURCHARGEOL
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