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BUILDING DEPARTMENT, TIGARD �n
PLUMBING PERMIT
_ &12 - 2o,P; "AP014ke .4" _._, hulder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted t�., be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are rea.ly for inspecticn. City of Tigard Business License required
for all contractors and sub-contractors.
Job
Owner/_? r'Bf�_ ??�sr`_. _ Address S l✓L?� M
NUMBER OF TOTAL
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT
RESI.pE.t`1.IIA1.
r
-Single Farn11 -1 both--each _ 25.00
Dulex.-Ear_h 1 bath unit 28.00
Additional iothrooms each _..---_ � _ ,/ _ 10.00_
M�.!:i1N Horn•,''•-('',cf, 15.00 __ ._.._____ .___-� ---__•__- -.
INnIVIVUAL FIXTLR!j9 QQ1I lEFiCT 1
_ 1 to �50 Fixtur€�in 1 1 rn -oath 3.00
_ qui d' -. _........._ '�
_ E1 to 1_00 Fixtures in 1 yuild_ing cath
101 to 200 Fixtures in 1 building-each — 2.00
-201 or more Fixtures in 1 building-each 1_5.0_ -
r1ISC[ r.LANEOus w
~Sewer -each additional 100 ft. _ 10.00 y_ I
Mlat_ar Survicu to building _ 1' C.00 _ Y
Other (Speclfj): -._.... _ -.._-__._..--- -•- .�_� _ .-. f
PEHM11 Ve, on For Plumbing lnspocCon Phone 639.4 171 n` I
At�State - .LYe-A?—_ _ Plumbing Contractor By _!t !►r�V
'roTAL e�/,�. p RFCFIPT NO. Issued 9y ,
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BUILDING PERMIT APPLICATION TIGARD DATE _ T9 '�� 3250
1 HF UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN Tr1E ACCOMPAhIYING PLANS ANC)SPECIFICATIONS. OWNER PHONE
LOT1410 _40 rklTlBlrt -SE.Ilfltf!Or
OWNER ', j JgMaj-k I-JuM�_---JOBADDRESS - 1281 i S,U. G•j C��I I�llj(�C ZC1B __._ Sk®----
ARCHITECT
ENGINEEBUILDER �7$t�H ADDRESS718(i S•W• Ssndburg `at DESIGNER
STRUCTURE [](NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL O FIRE DAMAGE LJ DEMOLITION
FJ RESIDENCE ❑ COMM ❑ EDUCATIONAL Cl GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE fU SLAB❑ FENCE
OCCUPANCY �'i,� LAND USE ZONC h7_PJaLDG.TYPE —��_ FIRE ZONE_ 1__.PLAN CHECK BY —b�F� HEAT
----- - CaEnsk,ruct Finyle Family (Awelling u/atLa;,;Ted Garage
3 bedrooms
Mudel Mark 1160 2 bathe
SEWERPERMIT# 21944 47n-1 anjj — _-
OCC.LOAD FLOOR LOAD 40 HEIG,IT 16' N0.STORIES 1 _ AREA 19:39 NO.BEDROOMS VALUE 7 k
BUILDING DEPARTMENT SET BACKS FRONT 201 REAR aia I f-r, SIDE F � RIGHT SIDE
Permit 237,01) THIS PERMIT IS ISSUED SU.JJECT TO THE REGULATION'S CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS ANO ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THE
Plan Check 1.18,SO 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
ub•total _ 3 ;, J RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 9,46LICENSE.SEPARATE PERMITS REOU14ED FOR SEWER,PLUMBING AND HEATING.
98 SDC- ;; 00.00 gmarti Lin-al-wi Ghaige - ;, ,:St"0*0(s
Total 364.
_ :" : .t`/
PDC# T— 1.00.n APPLICANT OR AdEN1
By L3CR
——— Rer.eipl No. � _
Al proved ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
�--r�,r;•� ��^�- - `- Contractor
!�f0 S' Permit No. �d�o �0 7- 11P -,l�.
ctwl t"� , d it Rough-in
L - • 1ell ------ -._- Fixture --- -- -
Final
HEATING
Contractor
-- --- -- -� Permit No.
Gas or Oil
-- -- �� Rough-in ---
--- ---. Final
-- - — SEWER
--_ __ --- Finrl f O -
—DRIVEWAY
Final ------ -
Storm Drainage.
(Rein Drain)Final
Sidewalk
Curb&Street Final
Approach
EILOG. DEPT.FINAL TEMPORARY CERTIFICATE OC ANCY '
CERTIFICATE OCCUPANCY �inpl
O 6 Landscaping
`- Toning Final