Correspondence CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
COLUMBIA MECHANICAL INC
1702 DIKE RD
WOODLAND, WA 98674
Plumbing Signature Form
Permit #: PLM2002 -00051
Date issued: 5/2/02
Parcel: 2S114A0 -01500
Site Address: 17005 SW 92ND AVENUE
Subdivision:
Block: Lot:
Jurisdiction: TIG
Zoning: R - 12
Remarks: Restroom with concession - Phase II of Cook Park Master Plan expansion. The
(13) floor drains are 2 ". The other fixtures are (2) drinking fountains, (3) hose
bibs and (1) ice maker.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work .
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
TIGARD, CITY OF COLUMBIA MECHANICAL INC
13a �.�. a AL 1702 ENKE RD
TIGARD, OR 97223 WOODLAND, WA 98674
Phone #: Phone #: 360 225 - 5761
Reg #: LIC 151122
PLM 37-451PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X 7Z,-
Si q rSature of Authorized Plumber
If you have any questions, please call (503) 639 -4171, ext. # 310