11630 SW MANZANITA STREET 11630 SW MANLANITA STREET
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BUILDING DEl" '.I UAI—�li, IIGt\f;C)
PLUMSIigG PERMIT ,
ho or ,a valid plumbing contractors license, is hereby
autho zeal to caUS4 plumbing v r, as herein noted to be instalie:-.1 in accordance with the plumbing code of
Tigard. Such installations raqui;e inspactinn by the City Inspector who shall be notified not less than four i
(4; hours prior to the tinion the installations are reedy for inspection. City of Tigard Business license.required
for oll con rectors and ui -ontractor- y,�
/ //�3d .SCJ /i�
6t
Owr, r_ Addres. - --
NUh13ER OF TOTAL PER,%4i*r NO.'S
TYPE OF PER.MiT ITE`,ts FEE ON EACH AMOUNT (Office U;e Only)
T 1 Wit. --
Single Family-1 ba.h-.?3rh 25.00
Ouolex-Each 1 bJt1 unit _ y� 25.00
Addlciona!h++;hroum;-each _ 10.00
Mobile Home 5 ut-lach __ 15.00
IN61V'1)UAL FIXTURE .-E �_
1 to 50 F;xhjr•tt in 1 build;.;-etch 3.00-`_
51 to 1J0 Fix•wes 1:1 1 builCi'r -each �-_ 2 50_._
101 to 290 Fixtures in 1 b!.r.ldina_h _ 2._00.__._
201 or more Fix_are: in 1 bti lrl nq eic} _�- - 1.50
D,115CELLANE0U5
Build+r;Sa,ver`tst SJ ft. - _ 10.00 _
SewMr-each e,:.:i:;anel 100 ft._ _ 10.00
�V.tti ,U v
pr S�rvick t0 hu [,� 5.00'iCin _- -` � .- -�--,
Priva1e%Vjr:a_5Y3terr -ewh 100 ft.
Other (5a-:;fyl:
- --- - ----- — - t
PFR,mrr For Plumbing 639.4171 �-
b State Yea Plurrtbinn CuntractorY
- TOTAL S �C�v RECEIPT NO.
6 > 37d�
Address
Ac 114aw'e- Permit No.
Name of Occupant__ Permit charge
Connection fee
Paid by
Date connected
Type of Building______ Inspection fee
Service Rate Paid by ---- -. -—Date 11- .2t-6,7
Contractor Assessment
Size of connection
PERMIT TO CONNECT
I Tigard Sanitary District
PERMIT N° 1058 DATE ;>
PFRln;T IS GIVEN TO
r
OF r `
TO CONNECT A + '"
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POF TEO ON THE D1 SCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED,
PERMIT FEE PAID �i_.. ............................TIGARD SANITARY DISTRICT
9 y93 By
CONNECTION INSPECTED AND APPROVED
Date Superintendent