11715 SW 114TH PLACE jw
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11715 SW 114TH PLACE
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BUILDING DEPARTMENT, TIGARD No 2924
ll� ( PLUMBING PERMIT
_ holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified nct less thar, four
(4) hours prior to the time the installations are ready for inspection. City of 'Tigard Business License required
for all contractors and su contractors.
Job
Owner _G ) ' Address//1 r r,.�1 r l't
�__ .:� Date�� � F• -
NUMBER OF TOTAL
TYPE OF PERMIT , ITEMS FEE ON EACH AMOUNT
$J_QENTIAL
SI le Family--t bath—each _— _ 25.00 _
Duplex-=Each 1 bath unit ,— _�— W( I
Additional bath,00ms each-------- -v — ---
Mobile Home Space—each INDIVIDUAL FIXTURE® CO�II�ERCIA1 to 50 Fixtures In 1 building--eoch61 to 100 Fixtures in 1 buildin9_eech101 to 200 Fixtures in 1 building—each —v201 or more Fixtures in 1 buildir,p---each —
MISCELLANEOUS
Sewer--each additional 100 ft. 1000
Watei Service tot5uil�ingv 5.00
Other (specify): —L
PERMIT _ 15for Plumhing Inspection Phone 639-4171
State (c>� Plumbing Contractor By
TOTAL 5 RFCF-1Pi NO. �� / Issued By ` V
(
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone: 634171
Type of Inspection — / _;; -
v�
Date Requested. �*r N Time ._s A.M. P.M.
Address - Z ZS_u( I /tri_ Permit #
Owner _ Lot -0--__— —
Builder
The following Building Code deficiencies are required to be correct!yd:
Presented to ---_� Approved
Inspector U Diapproved
Date
CALL FOR RE NSpi;CTION
❑ YES E7 NO
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CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE , ° 024819—
THE
248THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER r ��of . �i" ADDRESS
-- BUILDER PHONE _
ENGINEER
BUILDER ARCHITECT DESIGNER
S'rRUCTURE ❑NEW ❑REMODEL ADDITION ❑l-REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSUPATIO ❑CAR PORT ❑GARAGE [I STORAGE ❑SLAB [:]FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY---LAND USE ZONE__ __ ___BLDG. TYPE FIRE ZONE, FLAN CHECK BY__. HEAT__._,____
OCC•
LOAD— FLOOR LOAD HEIGHT --
NO.STORIES AREA _— VALUE S _
— ------ --
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Pel mit — ---------- — �_
-- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERFBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
[By
APPLICANT OR AGENT
ved Recellii N(i
�.—. ADDRESS
Address 11715 3.W. 114th t Permi,t No.— 1606
1 Permit charge
Owner Jim Willock Connection fee boo.00
Paid by Jim Willock
Type of building Rge. Date connected
Service rate 3 oo per month Inspection fee Dg_nn
Contractor T._ ,,,,,991% Paid by same Date
Size of connection 4" Assessment Paid
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PERMIT TO CONNECT
Tigard Sanitary District �J
PERMIT No 16 ( 6 DATE '-may 7.2
PERMIT IS GIVEN TO
OF
TO CONNECT A �{
TO THE ;TSTEM OF TIGARD SANITARY DISTRICT
AT j
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION 19 MAA$ AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETFD.
PERMIT FEE PAID $........ LX,I SANITARY DISTRICT
By
a
C6NNECTION INSACTED AND APPROVED
Date
1 0. 8 0 U. 0 0
5 0 0. 0 0
660. 00
11,960. 00 *