12161 SW MILLVIEW COURT 19.161 SW MILLVIEIA COURT
1
U
3
a�
ry
i
i y i ��l � _ _ •�fi7iF'^F7RS7RS.C,.!tR7RJF7RylA?..,.. "' ... �—"�77 ',vr�vr. .^^,^7C^•'t:�.7_.7.,.. "�.R•-;�,y' 1�p}�,�' �(,
00
00
r,
l �
4
Olt
Ln o
rA UD
rb
p R w
bo
A;;, �.
('
��° -�1! ! ni.c: a3i„3aeoba�tix� a�:::ani ,•,�:„� ,,
fill1 'f/ l�� ( �•• v���,,.•� ! t +� . hj' "� ; ++�'',.,N1tiw' +���,r.lj1l,/�.,� � w ' 1�
�'!"h. U,�►,'I!� .'"'!,.• r” , ?,
�'1,�'1� � 1 .,M�,� +l',► '"""' ';�1�,���M, t� .,,�A.d�dp,i�,+lj �.�a. ti tl{}s Ap;';.•� •�;. ..j���,�p � a�� ,
'mow ��✓�6�`A�►j'`�hy�f�w.•`:� tli��I'hl.�if�'�4� �k y�'`�� -•`_-`+'r" ^'`i.F hli �"ra
INSPECTION NOTICE
r,ity of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 039-4 175
Type of ln,-i�ertioh� �-- -------
Date '
t R quested T-- Time— A.M.._ P.M.
Address Permit # j
Owner - —, Lot #
Builrtar
The following Building Code deficiencies are required to be corrected:
v-4 U
Presorted to — (l Approved
Inspector _ ❑ Disapproved
Doto
CALL FOR PF7NSPECTION
�— eaassa�
INSPECTION NOTICE
City of Tigard Building Department
P 0 Rox 23397
Tigard, Oregon 97223
Phone: 639-4175
10 I'll-r
Type of Inspection
Date Revuested S Time A.M.-� P.M.
Address e Permit
OwnerLot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector Disapproved
45
Date
CALI, FOR REINSPECTION
❑ yes Z NO
CITY OF MOA RDr.-:WEA Pr-H-TIMIT
pE[.';lM:['J' NO. : SE81130411.1
CITYOF'TICPARD
W311100
COMMUNITY DEVELOPMENT DEPARTMENT SATE Ti ;SIJEJ): '3/J.6:11/BF3
13125S.W Hall Blvd,P.O.Box 23397.Tigard.Oregon 97223,(503%r 639-4175 PM r -No RR(114101--
$41 MILLVIEW CT LIGA NUMBLA ! 34990
TAX MAP/1-0,11, 1[51 34CIR 1.1.4900 ;'AJ8: MILI VT E.-J L. : :i.'9 6K
LANO USE :
I OT sj:zr-: :
Sl-KCTT(')N! "'AA TWIP : 1 PN(.'.: I.W
WOPK CLALsG : NEW
IMF- TYPIFGYNGLE FAMTLY
Ibex utpplic-,tarit ailipil-ralem tcl C.'timply With 10.1 r1.11ein in.ricl c34' 01001-1i 41:1,v(:I
!:iewe,rmge Agent-ly .- 1,ha p"l-*ra:j.t "xj:)jI-qPvs Ir?.O diayiii +r-um th(W Clate J.trimmed . T h w t f:j t 411-1.
akincil.1ril. pal.icl Will b(m if ttia perivilt • (irJoill r10't, �j 1.1 at I
the� inxic.i.tratcy (.1-11 the 10c'uLtion (:)-I' thel isicle mewer. if the sewmi., im
ricst. luc.�gktecl sti, the nt j..jiverl , the 1:)1.4:)%Pect 3 ffeet irl
tall. e13.I^r1(:ti.crnllt -Fr-cim the cliiutial'('-�gym 1AA-Vel-1 . TJ riot wt3 1(:)C-VLte(J , the infritkIlmi" mhROA,
"TIRP flinci 5:1.cla S4wel"' P01"Mit ifkl-1(:j the,? Aclsanray w1.T.T. i.nattatl.l at latte�rwl ,
,I:NS TAL.I TYPE : P(.Ill DJ:N(',, FsEWFM TMPERVIOUS APEA :
UN1:T!5 n.NANT JMr)P0VEMF-.N'7' :
1:)W I I I 1NG UNTTS
NO OF' 1911-AX45
0 FEES
111135 . 00
W 1011,11 M311-EP PERMIT
N 1.44-/'-9 N S1-IE PWOOD U11 VE) CONNF:CTION CHAPULF.: $1 , 100 .00
E
R L.TNE TAP INSTALL
OTHE-W 1111,360 .00
C
0 MILLE.11
N
1 1*('.)M MAJ...EP E41 014 .
F4I. N SHIEPWOOD BLAID
A
C lnhel-wr"ol
T ("503) 6R5-6167
0 't OTAL. /r?5. 0()
NO. 37305
NO
I his permh-iS issued subject to the regulations contained In Title 14
of the TMC. state of Oregon Specialty Codes,zoning regulations
and all omer applicable codes and ordinances, and It is hereby
agreed th it the work will be done in accordance with the plans and 1:1OLIGI-11—I N
specifications and in compliance with all applicable codes and
ordinances The Issuance of this permit does not waive restrictive
covenants. Con-ractor and subcontractors shall have current city
business tax PP mits This permit will expire and become null and
void itwork Is not started within 180 days,or it work is suspended or
abandoned for a period of 180 days any time after work has
commenced.It shall be the responsibility of the permittee to assure
ad equi ad inspections are requ"d�and ap roved.
It e, ignature
Issued By
SEPARATE PERMITS REOU11RED FUR WORK OTHER THAN DE31CRIBED ABOVF
W
MECHANXCOL PV.;'.PM1'1*
JW
F)ERMIT NO. M
: ESBOA09
CITY OF
�I�� CITYOFTKAID DAT�-"i ISSUED : '.3/1.a/06
COMMUNITY DEVELOPMENT DEPARTMENT 1\ 011GON PRIM. PMT.NO. 800407
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,0iogon 97223,150316:)9.4175
J(10 ADI:)PIk;:.'.SS : t2ldil 151W M111 LVIEW C'J'
TAX MAP/1-OT J-51. '34CH 111.900 SUIFI: MILLVIEW L'T 17-92 BK :
LANI) USE:
LOT 51Z ' : I'T'EM: NO: NO
WOW( CLASS : NEW FURNAC.E (1.00K 1. ATP HANDI-P (10
USE TYPE : SINGLE FAHII .Y FORNAGE 100K+ A114 HANDLA 10V
CONST .TYPE: UN F-Li FUPNA(*.'E EVAP .COOU_;:r4
OCCUP . ('RP- : P3 HEATEP Vl:-:'N'I* F'AN
VENT' vE:-*i4'r . sys)'rF.-.*m
(314) HOOD
NO . !'5*T*OP3Jr'-% : 2 01 PICOMP 3----1..5HP 1:NG I Nin:Af)*T'(:)R(DOM
DWT.U.. .UNITS : INC:tN1-":PA"'(JF4(COM
I 1IF-3- TYPE G,A i_3 BLP/COMI) 30-5011-11P W-iVAIII (INTIS
MAX . INPUT 81 P/COM1--' .11504HP UTHEA
GAS P1.1PING OUTI-11-V-5
AP.: OMPOS,
1.
HIGH F-44 E.S
I. Ow
V4 F:M A D K q
'rnM WILLER PE94MI T
0 6*13
W J.'effe IN SHERWI(JOI) 81-VD. PLAN REVTI":W
N n?I.,W t3 1:)(J nr 971,40 FI.X111PES
E 7
r)H()Nr.-:: (t-03) 6P25-6167 S'T'ATE. TAX
C CI ASS A
0 CLASS A HEATIN("
N
T '15"111 !"IFK IAOI K
97030
A
C PI-IONE (50'3) 667 5999
TrOTAL 95
0 REGISTRATION NO , 0116031?
R CC
RECET PT NO
T his permit is issued subject to the regulations contained in I itle 14 - P
of the TMC, State of Oregon Specialty Codes,zoning regulations
and all oth-jr applicable codes and ordinances. and it is hereby
Agreed that the work will be done In accordance with the plans and Fa AJ t 4F."AM
specifications and in compliance with all applicable codes and 1100111's I11-A N
ordinances The issuance of this permit does not waive restrictive FT NAL.
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null ano
void it work is not started within 180 days.or it work is suspended or
abandoned for a period of 180 days Any tir,,e After work has
commenced. It shall be the responsibility of the Pei-rrlitlCe to Mum
1 811 required inspec ons are rLueste a d approved
m ep ignat P
FOR T.NSPEUIJON 639 41 P5
ISSI-led By'
SEPARATE PERMITS REQUIRED FOR WOFIK OTHER THAN DESCRIBED ABOVE
PI-1.11MBINC.-
NO. : PI-SOUX408
C17y,54
CITY OF TIGA RD 1"6ra
Cily
COMMUNITY DEVELOPMENT DEPARTMENT I'WTE
13125 S.W.Hall Blvd..P O.Box 23397,Tippi,ri.Oregon 97223,(103)639-4175 PA I H Pml .�(:1— f4s(),eln
MAiii ADI)PESS : IZA.61 SW 1`111A.-LVIEW C'T
TAX MAP111-0-7- IS1. :34C H 1.1.900 SUES . lwllLV.l.'r-.:W Ll' ; 19 ISK :
1-AND USE :
STZE:
:unF.m: NO : NO
W(:)WK Cl-ASS ' I-i!;:W WA1*I::'R CLOSV--:.y 3 '1 RAP
USE TYPE: SINGLE r1*AMTLY UPINAL 1-3 K F I OW OWN'TR
CON51' . 1-0NE : VN I AVONA-014Y 3 PRTMEP
OCCUPY .GPP : A3 'TUB GPE:A5V-: TPAP9i
01SHWASHER
GARBAGE DISPOS1011. !1.
NO. 51'(11PIES : R WASHINC4 MAC HTNL 1
DWELL.UNJI'S : :1. LAUNDRY 'TRAY UL.DG DPAIN (DIA
FLOOP I. rN
sTNK 111,11,11
WATF.-'.:P1 'ACEATF11 t S,r0r-)MWAT',-4 (FT
C)THEO
HEMAPIKS :
10 E,5
W '1'(:IM MTLI EP 'i e. ::10
N I.A78 N SHF11WOOD BLVD ,
E
FT X111PE.-Iii,
PHONE (30 3) STME, TAX tN 6 . 63
0,11,111:KP
C
0 PF-KAWFIGN 'T'HEIMAS
N
T AT(AOTO PLUMBING
R
A 1--t . 3 BOY IAO(N 1.
C gilk sitmri or 971:1.9
T
W 0 PHONE r50311 357....689 7
R PKIGISI'PATTON NO. 419955
This permit is issued subject to the regulations contained in Titl#314 PLECEIP-T NO
of the TMC, State of Oregon Specialty Codes,zoning regulations
and all ether applicable codes and ordinances, &A If is hereby Pf.i.QUIPED J:N5PEC*TT0NS
t.gro,-,;ii,st the work will be done in accordance with the plans and FILP .UNDEA1.5LAI3
specifications and in compliance with all applicable codes and POST A BEAM
ordinances The issuance of this permit does not waive restrictive WATE:111 I I Nl!-"
covenants Contractor and subcontractors shell have current city
business trAx permits.This permit will expire and become null and P1 V . TOP(:'.U*T
vo,d if work is not started within 180 days or if we it is suspended or PAIN DPAINS
abandonod for a period of 180 days any timo after work has F*1 N AI..
commenced. It shall be the responsibloity of the r3ormitte,?to assure
all required inspections are requested and sppra d
F, ryl ignat
Issued By TkION -- -
SEPARATE PERMITS REQUIRED FOR WOVX OTHER THAN DESCRIBED ABOVE
W N N 1�
6UTI..DING ryr:PMI'T'
P4.11MIT NO . : SUBIF30A0'7
,,�ION CSF TIVA RD
COMMUNITY DEVELOPMENT DEPARTMENT clrv� Alm r.)PI r: ISSUED:'i . ;T/: 0/tafa
F>RIM . T='M'►' .N(�. E�(lUgO'7
13125 S.W.Halt Blvd.,P.O.Box 23397.Tigard,Oregon 97223.(''503)679-4175
,X)b ADUREi'SSr : 3.2163, SW Mxt.I..VIEW GT' 1
IAX 11AP/11-01' 151. :KR(:kb 11,+"►i00 SElE9' Mll..l._VIEW l.1' : 1,'ia FiK
LAND IJSV : 1't'el 5
I..C)T i7:11 VAI.LJA'T 'TON : 11 M.5 ,00C SE:'TOACKS
F'ROtll' : 20 11F'AA i
WORK (::I...A45':i . NEW DWE::I.L. .l-INITSa : 3. I..E.F T : 1.3 6Tffmil-1 ' 1.8
Ei: 1 YI�F: : !ii:I.Nt:JIwE: F'AMII,.Y t+10 . "1'-
US :C)FiC)CIMSi : .S EX T WAI..1, Cc)N51
(::ONS'T' . Tyrs : VN NO DATHS : 3 N. S : E: W
iJC;C:I.II� .G'PP . : P3 PA01 . 0PF:NTN('.y5 :
OCCUP .i. OAD N: ti : E»: W
TOTAL. ARr;:A: 1.9F.
NO . S'rOA TF:5 : 2 1S,T : W- - ROOF" CONST: C F:CRS' PET'?
F•Ik.1 GRY F:0 2NC): 1001 AREA S E.PAP-1 RATED
BASF. 7 X171): C)C'CUP . 4SEPAP7 PATED:
ME:Z7AN)Nk::'7 DASiEW T
L.UAV: A0 GA.PA6E: AV% F T PE SiPFTKl..l77 AI AF1M'7
F'I.CIW►G:I'FI) DFU1'r Yr.S
1-lEi.A'T TYPE: CAS HI)(,P. ACCESS? COPP?
Rki:11ARK 13
.l+t ut1.:l.:l t.y rrla►la►�ln4�rlt, can left. ,"'idra rtE::T'-m JF: OF" NO. 6712
I.A'►'T I'�I 'I551Jk 6FT-7 7
u
'T'1.7M M.l I.,I..E.P PE:RM.T'T I111:38P. 00
VV 1./170 N F.,J4F..PW00Ia Hl..VU . PLAN Pr%VTE'W IIA0 . 00
r� +nhre97'1.A0 F-114K DEPT
i1 F�!ICINF': (,50'3) 6R.5-616'0' SiTA IE. 'TAX #11';' . 10
[I'I'I-IE;1 I
_ 0EVE.1.OPMEN1 C:HAF>!C F.S :
C TIJIM MJI'L ,.EP SDC:(STORM) bk?,50 . 00
0 T(1M MJ:I_.I-KA F31...1117 SDc:(STPEF::1' ) $600 . 00
,T 1 A 7F) N SHE:RWOOD E1I_VD. $230 . 00
R mhoS1r•wuad nr, 971-10 PAti:PA l D < dl 10 00)
A
C PHONE 1 50Z) 625-6167
T PE:(:�I4VTWATION NO . :377,!85 T'OTAL, . f1t1 �.tU.1 . 1.0
lits permit is issr.red subject to the regulations contained in I itle 14
the TMC. State of Oregon Specialty Codes, zoning regulations E7LQUI.RF:D 11451 l C:T C(IN6
-id all other applicable codes and ordinances. and it is hereby 1"C)CJ1':rNC, SF Wf?P
in Lc rdance,withthe plans and FOUNDATION W61..L. PAIN DRAINS
creed that the work will he done a �o A
i ecifications and in compliance with all applicable codes and POST K F IAM WA'Tr-.Ta 1.•.TNE
dinances The iesuar►ce of this permit does riot waive restrictive hI E3 IJNDF:r'SLA1-J CI T'Y APPPCH/:sW
venants. Contractor and subcontractors shall have current ciry
' isiness tax permits Tt'- permit will expire and become null and
!iiL.AF I NAI..
A if work is not started within 180 days,or if work is suspended or PL9. TOP1171.1 f
i,andoned for a period of 180 days any time after work has 1:PAMJ'N('.Y
)mrnenced It shall be the responsibility of the permittee to ass. a F'I C7EPI..I1l::F..
ii required inspections are requested and approved CAS I..J'NF:
T N Si 01..A 1'T ON
1 - 11 11"I"W40i
.11w.
gna reit
C:AI...I.. VIDA INS, PEC I EC)N 639-4115
Issued By
SEPARATE PERMITS REQUIIIED FOR WORK OTHER THAN DESCRIBED ABOVE
�If � N— IN
CITYMJF T1GARD► 11o. 30632
13125 S.W. HALT_ BLVD. �
P.O. BOX 23397 Uat
TIGAARRD,,y0�8 97223
Name 1
i.ot BlockQap�ru�c i i
Permit q's Bldg. u , Cash C c
Ap
Sewer Other� t r`l��� hiAr ReC�Ef�I.�
r'
Acct. No. _ _ Description T Amount
10.432 _'Fullding Permit Fees _^ C
10.431-600 Plumbing Permit Fees_
10.431.601 Mecharical Permit Fees r
10.230-501 State Bldg. Tax _
10.433 Plans Check Fee y Jl
30.443 _Sewer Connection
30-444 Sewer Inspection
51-448 Street Syst. Dev. Charge _
52-449-610 Parks I Syst. Dev. Charge
52-449.520 Parks II Syst. Dev. Charge _
31.450 Storm Drainage Syst. Dev._Charge
10.430 Business Tax _
10.434 Alarm Permit
10.227_ Bail
10.455- Fines--Traffic/M Isd/Parking
10.230- CPTA Traffic/Misd/Vic. Assts _
10.456 Indigent Defense
30.122-401 Sewer Service/U,13A
30.122-402. Sewer Service/City 30% W-
30.123 Sewer Sevlce/City Maint.
30.125 — Unmatched
31-124 Storm Drainage i-
4 -475— Bancroft Prin. Pyrnt.
40-471 ancroft Int. Pymt.
DEPARTMENT COPY
u'
IMf`
r
CITYOFTWARD A4� PLAN CHECK APPLICATION
/
COM 1AUNfT1f DEVELOPMENT DDEPARTMENTCf1YOFTWARD PLAN CHECKoen�ooa c
"M BW P.O.6M2331FI.rgW,(Nv9w orM(cx �eV41 PERMIT -5 U a 0 /
DATE ISSUED
JOB ADDRESS: '..rr_ /I 1 I c_ t ,� C TXK MAP/LOT /.5.'- 3�/C f3 /I fo
' LOT: 'j�—J
SUB: /_ _ / ' LAND USE:
VALUATION: ��iUUL1' _ SETBACKS: FRON :)REAR: LEFT: /L RIGHT:-
WORK CLASS: /ti HEIGHT: TOTAL AREA:UST' TYPE: � FLOOR LOAD: �� "�-
CONSTR TYPE: __ 1ST:
HEAT TYPE: G<< 2ND:
OCCUP GROUP: k'3 DWELL/UNITS:�- 3RD:
OCCUP LOAD: NO BEDROOMS: BASEMENT:
Na STORIES: ,2_ NO BATHS: GARAGE:
LAP SURFACE: 773
APPROVALS REQ'D SPECIALNOTES ITEMS REQUIRED
ENGINEERING: REISSUE QF:� � LIST SU8CONTRACTORS:
LAST REISSUR:64,77 BUS TAX.
FIRE 'DEPT. : FLOOD PIAIN/ CALCUI ATIONS:
OTITER.. SEN LND. : TRUSS DETAILS:
PARKING PLAN:
L —
ILAN CHECK BY s LANDSCAPE PLAN:OTHER:
COMMENTS:- ,5 I��; f'G S •r L 41 S
ACCT
OWNER D ;CRIPTION AMOUNT
10-432 00 Building Permit Fe •e a � .
NAME: 10-431 00 Plumbing Permit Fees aI j 3 2- Sv
ADDRESS: 10-431 01 Mechanical, Permit Fees
10-23001 State Building lax (5%) tf,I041,13#61.1 2 7G
— 10-433 00 Plans Check Fee Vu 4x4&3 S �,
PHONE: 30-443 00 Sewer Connectlon (202) �'
30-202 00 Sewer Connection (802)
COPTTRACTOR 30-444 00 Sewer Iuspection t-`—
NAME: .51-448 00 Street System Dev. Charge (SDC) t 41
ADDRESS: - ,52-449 01 Parks I System Dev. Charge (PDC) $
52-449 02 Parke II System Dev. Charge (PDC) �
_ _ 31-450 0 0 Stora Drainage SyRt Dev Chrg(SSDC)
PHONES 30-230 09 TRFD (95%)
10-435 00 TRFD (5T)
ARQUENGINEER 10-230 OG Washington County Fire /1 (95x)
KAMP: 10-435 OU Washington County Fire /1 (52) �
ADD'RE"S:�^ ]0-220 00 Amar.0/Wedgewood
PHGr?E: TOTAL
�414'A fir-, qo _-- PREPAID
SFw " REC a -
BALANCE DUE
P41.1CANASCNA
Received By: Date Received:
Nuceq►t K _ .
/CITY OF TIGARD MECHANICAL PERMIT
Permit N
Description -
Table�A Mechanical CodeOTY PRIcE AMT
City of Tigard 1) Permit Fee --0:--- `"-Q:-_ 10.00
13125 S.W. Hall Fslvd.
P.O. Box 23397 2) Supplemental Permit 3.00
Tigard, OR 97223 —
639-4175 Furnace to 100,000 BTU 600
1) incl,ducts&vents
2) Furnace 100,000 BTU 4 - 7.50
Incl.ducts&vents -_
Name of Deveiolxnen! 3) Floor Furnace 600
incl,vent _
Job Address — 4 Suspended heater,wall heater
6.00
Address
or floor mounted heater_ _ --- —
Tax Lot Map No. 5) Vent not incl.in 3
.00
Lot Blod Subdivision appliance permit
Name(or name of business) 6) Repair of heating,refr ig., 800
cooling,absorption unit
Mailing Address Phone 7) Boiler or cotnp to 3 HP 600
Owner absorp.unit to 100,000 BTU _
CityiSbale Zip 8) Boiler or comp to 3 HP-15 HP 1100
absorp.unit to 500,000 BTU _
-� NameBoiler or comp 15.30 HP 1500
9) absorp.unit 1/2-1 million _
Mailing Addr iss — Phone 10) Boiler or comp to 30-50 HP — 22 53
absorp.unit 1 -1.75 million
Contractor cnyrslate '- Zip 11) Boiler or comp to 50 HP 31 50
absorp.unit 1,750,000 BTU
Stets Registration No — Clty Bus.Tax No. t 2) Air handling unit to 450
10,000 CFM
Air handling unit 750
1 hereby acknowledge that I have read this rpplrcation that the information given is 13) 10,000CFM +
correct,fhat I am the owner or authorized agent of the owner,that plans submitted are_
mxnpliancs with State laws,that I am registered with the State Builders'Board,that the Non portable 450
munbw given is correct (fl exempt from State registration please rive reason below). 14) evaporate cooler
Vent fan connected 300
15 to a single duct -
--- -- - -- - 16) Ventilation system not 450
included in appliance permit _
- 17) Hood served by - 4.50
mechanical exhaust
Signature(owner or agent) - Date 16) Domestic type 750
Describe work ❑ addition ❑ alteration O repair ❑ incinerator
to be done residential p non-residential L1 1 g) Commercial or industrial 3000
type incinerator
Existing use Other i.e.,woodstove,water J W
building or properly _..._. _- -- — 20) heater,solar,clothes dryers,etc.
Proposed use of ----- -
building or property 121) Gas piping one to four outlets ' =l�1
Type of fuel- oil ❑ natural gas C.) LPG E] electric ❑ Il
22) More than 4•per out'et
N-QTICE -- -- ------ SUB-TOTAL 314 S U
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- ----- Mb SURCHAACiE
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 _�_%O
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SU13-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER i TOTAL IVWORK IS COMMENCED,
Special Conditions
---- �. Data tsstled t
WW
P.O.a3x ':33`.37
( I , , e1 "T !(JARD PLUMBING 1:125 SAIdaURM.
Applicants must hold Oregon Reglstratioe to c(ndtxy a plumbingP1'R M ITTigxr' CR 97223
business or must be prcpi-rty,)weer/operetor not hiring(--aside hell). 639-405
-� Nems of De"Wment —
_ Plumbing Permit
Addesa—--- oescnptlai -
_ ORS 314-21.810 CUAN, PRICE AMT
Job Ta■_Loi __ Map.No. — '—
Address
FIX"1 URES
Ld F3ksck SubdMF n - - ----
£`nk 7.50
TJame or name W b v snnass Lavatory - 3 7.50 ;1 S7
Tub or TubtShower Comb. 2. 7.50
ally esn - -
Shower Only 7.50
Owner City/ late - zip Water Closet - _ 7.50 71,5 of
Dishwasher / 750 I
-�-� -- -- - Phone ---- Garbage Disposal I __ 7.50
-- -
Nerve Washing Machine 7.50
--- - - -
Floor Dram _ 7.50
al ing ress -------- I'horM- Water Neater 7.50 7,i
Occupant Laundry Room Tray - - 7.50
-
/Stale - Zip
Unna/ 7.50
ams -Phone Otftor Fixtures(Specih) 7.50
--- 7.50
rens Phom 7.50
Ccxttractor olfyiState — ZIP --- -- V 7.50
Cit_ MISCELLANEOUS
— ,Bus Tex Pio. Se~t at 100' 30.00
".a as. and tate Plumbers s. r�. Sewer-ea.Addit.100'-- 15.00
(ResndenUal) Water Servios 1st 100' ! 20.00 ?.o'
1 hereby acknvvrledpe that I have read this application,that the Intormalkin _Water Service u.Addil r - 15.00 _
given is oorrect,Ow 1 am reVaiwed with the Stale Buildoes Board,and also Storm 6 Rain Drain 1 at.1--0' 30.00
have a Stale PkgnbkV koensa ever the number*given are cwred.that all — R -
Pknnbw%i work will be dr"In accordanon with sperlk able provia"U of Ore Storm 6 Pyn Drain Addh.100 - 15.00
gon Revised Statutes C',h"sim 417 and 693 and applicable codes and that Mobile Hey"Spam 2500
no help W11 be anpioyed unims RDerwed under ORS 603 (11 exempt from --- -- - - -
State regkaation,please give reqs--,n below). Back Flow Prevention
HOMEOWNERS -I hereby owllfy Graf I am the omw of the property de- Devioe or And-Pokilion Devroe 7.s0
sortie f above,at whk-A locadon 1 propose to maks a pkxri*v Installation for Any Trap or We@%Nel
my own use ww1*%W property is not bwkV oon siruded for oak lease or rent Can noclsd loa f ixtwe Y so
Cadeh Barin �------- _'- 7.50
------ -__ �`-.---------------- ----- Insp.of Exist.Pkrtrbfr+g---- 40.00 Pe Hr. -_
Specialty Requested!lnspeoliorq 40.00 Per sir.
Also.d PkaTtW T wflhk
an F-KIS"Bldg. 15.00 min.
AUTHORIZED SIUPLATURE —- - --- -- - -f�+►w Now BWg,or Build.Add*m ISM min
-bilikl11311Ta1r_frxldl - --
Describe work rtew U addition[] alteration❑ r"palr ( ] cl'eu ing 15.00
los done residential fl recti-reskderttiel
Fxhtklp use of
IxMdkly or praaerty-----___-- ---___.__ 9UWTOTAL
Fd u~ —T- atm
ol
+�Iwl+c�urwie _�
taAawg of praP«ty TOUL _3
NOTICE l__
Th`s Poo, be=, rvA and wiid N work of oonstrucaont euthortgar3 is not oom
rresntftxl wldih 100 rfeyeasr M oerisb r*m i r wok M efupsrded or absndaii k>,
a pe0od of 100 days at any dnta arise wm*is oor ww•.oed
Oslo leauwcl ny,
r