11550 SW GREENBURG ROAD-1 1550 SW GREENBURG ROAD
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CITY OF TIGARD Plumbing Permit
(Building Department
No.
Residential ( Commercial
New InstaVation [] Replace Addition ( Alteration ❑ Date
Licensed
Plumber ":,,., n" Y� 1 i �S Owner
Address -'t, Ir.F - - Job Address .� �_ ' t lSt,!( :k.4-�Li
a
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Phone ._.._ r. "f •i a.=_��.:� -.------ Applicant ---____�--------=�-` ' - ---
_
CITYBUSINESS LICENSE REQUIRED FO LL ONTRACTORS AND SUB-CONTRACTORS _
ITEM _ NO. FE---- TAL ITEM - NO FEE TOTAL
Fixtures-'Traps_ — _ Sew_e Firsl100,_ -- _ ;30.00 —_
Dishwasher - _ 7.50 v E a c ddit. 00ft._ -_ u�15.00 __
Garbage Disposal 7.5( -pec o Mp - 7.50
Water Hoater___ _ _7. _ _ W fpr:First 0.0. _ _ 20.00
Hackflow hreventer _ 7.50 _ Eac Ad 00 ft
— form_ l Ir t O ft. --_ 30.00- ---
Each Ad 0 15.00 — -
__ Mobile_fit/gIr
e 2.5.00 _
Other('3pvwlfy): - Y Rain Dram.Dvelling — -- 15.00
If T0412
PERMIT FEE v Comments: ___._--- -----_-----------__— -�___—. -
Issued By:
S1,ATE y-
---- - Receipt No. . ' I Applicant _-
TOTAL /;4 (a�� Signature
--- ---- - For Plumbing Inspo1ion t'none 639-4171
City of Tier?". Mechanical Permit
New Installation �] Replac V Relocation Addition Alteration DATE: ( i"
HEATING � � ++
CONTRACTOR � 1 _. . . OWNER -.'G.-s-L !r1 _.,
ADDPESS_�__.: __. _ 1: +" JUS ADDRESS_
PHONE _ APPLICANT_------ "w+%��=. l._r--. ---- -_— -
Heat Input Ratmq(BTU per Hoo,) Vent Size _ _ Flue Size__
FUEL 01I_C—J GAS [] ELECT OTHEP
_ ITEM— — NO. FEE^ — ITEM NO. - FEE
For issuance of Permit SE _OW Air rid _Unit xr P t ystern 7,50 _
New up to & incl. 100,000 piTU — _--� 0.00 on+ asci H o S si V 7.50____
New 100,000 BUT s & over _ _ 7.50_ ther h A 4.50
WocdburninyStove — 4.50 Tri In cti�_ _ 4.50
1. Well Floor Suy�ended _ _ \ 6.0 - Air un iti Comp - uu to ncl.3 .P. 0.00 _
Vent Sistern w/Fan _— 0 Air io_n CvrnL o!,-r. to , incl. 11.00
fair•Neat Cooling 0.00� _ -- - —�_,.�._� -- --- _.
CITY BUSINESS LICENSE REQUlREO BY ALL CONTRACTORS OR SUB.CONTRA TO !:0.,,_
PERMIT ISSUANCE _-10.00 Comments. —
FECS '
SUBTOTAL____ -
2 STATE Issued Ry-__-_..._...-__..__--
26%PLAN CHECK
TOTAL _ REC.
—� Signature of Applicant
Address Permit No.
Name of Occupant,,,� Permit charge
-- —- __ Paid by -
Date connected
Tvpe of Building !�+J. LJ/Jl�oy,L� _- Inspection fee
Service Rate-___— �` C C� Paid by -- Date
Contractor Assessment -Lad D U paid.
Size of connection