Permit CITYOF .�,
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CM/id DEVELOPMENT DEPARTMENT \ oR600r�, '
13125 SW Hall Bbd. P.O. Box 23397, Tigard, Oregon 97223 (503)639 -4175 \
PLUMPING PERMIT
PERMIT # - PLM92 -0169
639 -4171 DATE ISSUED: 11/03/92
SITE ADDRESS...: 12805 SW 77TH PL PARCEL: 2S1O1BD -00103
SUBDIVISION ZONING: I —L
BLOCK LOT -
CLASS OF WORK..:ALT GARBAGE DISPOSALS..: MOBILE HOME SPACES.:
TYPE OF USE -COM WASHING MACH BACKFLOW PREVNTRS..:1
OCCUPANCY GRF!..:B2 FLOOR DRAINS - TRAPS -
STORIES WATER HEATERS CATCH BASINS •
FIXTURES LAUNDRY TRAYS • SF RAIN DRAINS •
SINKS URINALS GREASE TRAPS
LAVATORIES OTHER FIXTURES -
TUB /SHOWERS....: SEWER LINE (ft) -
WATER CLOSETS..: WATER LINE (ft) -70
DISHWASHERS RAIN DRAIN (ft) -
Remarks: REPLACE WATER LINE AND BACKFLOW DEVICE
(8.33' X 16'), 35 feet in height, internal
. illumination, COPY: Utility Equipment,. Inc., MATERIALS: Sheet metal, lexan.
Owner. - - -- FEES
PACIFIC UTILITY EQUIPMENT type amount by date recpt
12805 SW 77TH PLACE PRMT $ 27.50 JH 11/03/92 —
SPCT $ 1.38 JH 11/03/92 —
TIGARD OR 97223
Phone #:
'.5
Contractor: ,
RAYBORN'S PLUMBING •
19990 SW CIPOLE ROAD
TUALATIN OR 97062
Phone #: 692 -4139 $ 28.88 TOTAL •
Reg #..: 44110
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days.
Permittee Signature: 1
Signature
4
Issued By: ---t/
Call for inspection — 639 -4175
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