Permit Pt_UMEiINC; Ph`_RMI'T
CITY OF TI GA RD �Ryn6Aac PERh1I'T' NU . PLEif3
■
OREGON
COMMUNITY DEVELOPMENT DEPARTMENT
DATE ISSUED: 6/16/88
13125 S.W. Hall Blvd., P.O. Box 23397, Tigard, Oregon 97223, (503) 639 -4175 - •
PPTM PMT -N(7 RA117P
JOB ADDRESS: 9806 SW TIGARD AVE.
TAX MAP /LOT SUB: LT: BK:
LAND USE:
LOT SIZE:
ITEM: NO: NO:
WORI< CLASS: ALTERATION WATER CLOSET TRAP
USE TYPE:: COMMERCIAL URINAL BKFLOW PRVNTR 1
CONST.TYPE: LAVORATORY TRAP PRIMER
OCCUP.GPP.: TUB SHOWER GREASE TRAPS
DISHWASHER
GARBAGE DISPOSAL
NO.STORIES: WASHING MACHINE
DWELL.UNITS: LAUNDRY TRAY BLDG.DRAIN (DIA
FLOOR DRAIN 1
SINK SEWER (FT)
WATER HEATER STORM /RAIN (FT
OTHER
REMARKS:
FEES:
V O V R. A. Cray - Construction PERMIT $15.00
N 9806 SW Tigard Ave.
Tigard Or 97223 FIXTURES
STATE TAX $.75
OTHER
C
O SCHULTZ CHARLES
T WESTERN PLUMBING
R 9A60 SW TIGARD ST.
C tigard or 97223
T O PHONE (503) 639 -5296
R REGISTRATION NO. 2A39 TOTAL: $15.75
RECEIPT NO. 32089
This permit is issued subject to the regulations contained in Title 14 _ __ --
of the TMC, State of Oregon Specialty Codes, zoning regulations
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done in accordance with the plans and
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and
void if work is not started within 180 days. or if work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
Permittee Signature
Issued By C LALL r'OR 7:NSt I .L l lury 6.5Y /J
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
• 44 FC1/ / 7 Z
P.O. B x 23397
CITY OF TIGARD PLUMBING 1 125 347 Imo„ Blvd must hold Oregon Registration to conduct a plumbing PERMIT Tigard
CR 97223
business or must be property owner /operator not hiring outside help. 639 -4175
Name of Development
q dd ---Crei C Q ( � (S , c �)
C - -H /1,2,<$ Y.,,-114-1_.- Plumbing Permit No.
T (J Description
Job L-2) ` - i^01 , 5A' " Au ORS 814-21 -810 QUAN. PRICE AMT
Tax Lot M
Address
FIXTURES
Lot Block Subdivision
Sink 7.50
•
Name (or name of b usine - . A, Lavatory 7.50
sm � . • __ __ tc� - . fib$ Tub or Tub/Shower Comb. 7.50
' ar C' • r : ress -7- n
Owner 0 6 E- C l ?rx r� .q()_. Shower Closet 7.50 Zrp
l
I ?( - 0J1 5 , a ..").- Dishwasher 7.50
Phone Garbage Disposal 7.50
Name Washing Machine 7.50
. I , v-- �-e Floor Drain � 7.50 7� �'
Maihug Address Phone Water Heater 7.50
Occupant City /State yp Laundry Room Tray _ 7.50
Urinal 7.50
Name 1 Phone Other Fixtures (Specify) 7.50
/
C.C�-:s%yr� (l.l \AA �n \V `Q- 7.50
Mailing Address Phone .
9 �v s- TC( lye - 7.50
Contractor City /State 7.50
(cPk - 0���" MISCELLANEOUS
City Bus. Tax No. Sewer 1st 100' 30 00
•
State Bldgs Board State Plumbers Bus. Lic. No. Sewer ea. Addit. 100' 15.00
(Residential) Water Service 1st 100' 20.00
I hereby acknowledge that I have read this application, that the information Water Service ea. Addit. 203 15.00
given is correct, that 1 am registered with the State Builders Board, and also Storrs & Rain Drain 1st. 100' 30.00 -
have a State Plumbing license that the numbers given are correct, that all
plumbing work wiU be done in accordance with applicable provisions of Ore- Storrs & Pin Drain Addit. 100' 15.00
gon Revised Statutes Chapters 447 and 693 and applicable codes and that Mobile Home Space 25.00
no help will be employed unless licensed under ORS 693. (It exempt from -
State registration, please give reason below). Back Flow Prevention -7 [ 7�
•
HOMEOWNERS - I hereby certify that I am the commit of the property de- Device or Anti-Pollution Device 7.50 L • Ju
scribed above, at which location I propose to make a plumbing installation for Any Trap or Waste Not
my own use and this property is not being constructed for sale, lease or rent. Connected to a Fixture _ 7.50
Catch Basin 7.50
Insp. of Exist. Plumbing 40.00 Per Hr.
Specially Requested Inspections 40.00 Per Hr.
Alter. of Numbing within
an Existing Bldg. 15.00 min.
AUTHORIZED SIGNATURE Date New Bldg. or Build. Addition 25.00 min.
Pain D ain,simile family
Describe work new p addition 0 alteration 0 repair 0 dwelling 15.00
be done residential • non •
Existing use of _
. butiOng or PropertY SUB-TOTAL
0 SURC1411R0E '
sly TOTAL A5/
This punk becomes null and void M wort or oonatruotlon euthan:ed is not cony
fnenOlod wlli* 110 d•yatior I oontttruoNal or worlds suspended or abandoned for
• period of 180 days at any time *tier work Is oomrttinosd.
S PECIAL. 001101T1OWS
Dab issued by