12580 SW 128TH AVENUE jAo
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CITY OFTIGrARD PEA'MIT NO. 111 (391
CITY011"1117AW
oarooM L'.4TE' 155UED 7/1/1 1:.()
COMMUNITY DEVELOPMENT DEPARTMENT r-IQIM. PMT .NO . 091'.389
13125 S.W.14911 Blvd.,P.O.Sam 23397,Tigard.Oregon 97223.(5031639-4175
I.H500
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N VA,XTUPIES $,e.I!-'j 0
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R STATE-— TAX 7;5
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N Oregon Chirritley Repair & Cleaning
T 1318 SE Rhone
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A Portland, OR 97202
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T 231-7704 "I(I]'At $ 7 . -1!:,)
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AFEM-K
This permit Is issued subject to the regulations contair.ed in ride 14
of the TMC, State of Oregon Specialty Codes. zoning regulations PIEQUIPED INSPEC'TIONG
and all other Applicable codes and ordinances, and it is hereby VA'WEA)LACE
agreed that Ilse work will be done in accordance with the plans and SYSTEM
specification3 and in compliance ".4, all anrilicable codes and FT NAI.,
ordinances. The issuance of this per-lit 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 suspended or
abandoned Icr a period of 180 day- any time after work has
commenced It shall he the responsibility of the permittee to Assure
all required inspections of requested and approved
Permittee Signature
IN51'-4A_'I ION 639-417!:;
Issued By
SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
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Address 12580 & 12582 S.W. 128th Permit No. 1454
Fermi t charge ._._.._._
Owner Connection fee 750.00
Paid by_._...�
Type of building Duplex Date connected-7/7/71
Service rate _ Inspection fee35.J0
Contractor �,�,� i ��_] Irurestmant—_..._ Paid by _Date_ ______
Size of connection 4" Assessment Faid
MI wr
PERMIT TO CONNECT � �
Tigard Sanitary District
PERMIT" No 1454 DATE
PERMIT IS GIVEN TO
OF .
TO F70NNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT 7
THIS PERMIT MUST RE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BnEN COM-
PLETED.
PERMIT FEE PAID $..... ......................»...TIGARD SANITARY DISTRICT
. w..w-------- ----- - - -- - - --- - - - - -
J�I(J,FJ<r� f -4 f,",/(^.i9,4 <
CONNECTION INSPECTED AND APPROVED
_.---- bate - --8uperintendent
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