11870 SW KING GEORGE DRIVE • 1
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BUILDING DEPARTMENT, TIGARV No. 0556
PLUMBING PERMIT
-J1 '!L_:__. G1 u�h holder of a valid ,dumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed *In accordance with the plumbing code of
Tigard. SLIch installations require inspection by the City Inspector who shall be notified not less than four
(4) hours rri- to the time the installations are ready for inspection. City of Tigard Business License required
for all coactor's and sub-contractors.
Owner—,, 1c, k�.i - — Addressl:� 1 Ltr�� Date-- d VU
-NUMBER OF i TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT %Office LISP Only)
-Sirt�le Family-.1 beth--each
Duplex--Each 1 beth unit
Additions% bathrooms-each _ _ 10.00 - -
Mobile Hmnr ^apace_saw. _---- 10.00
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INDIVIDUAL FIXTURE FEES
_1 to 50 Fixtures in 1 building--each - 3.00 M
-51 to 100 Fixtures in 1 building_-each _ ;.50 -� -
101 to 200 Fixtures in 1 buildi -leach - 2.00
201 or morn. Fixtures in.1 bulldir -each_jj _ 1 u0 -- -----� �
_MISCELLANEOUS
_Building S3wer-1st 5U ftV`�- — - —4:::::: 10.00_
Sewe%-each edditianal 100 ft.� -_ _ _-- _ 10.00 -- -_-� - -
Water Service to building ` _ 5.00 - - - -
Priyate_Wetar Systems--each 1(0 ft. -� 10.00 v�' �-
Other (Specify):
PERMIT —� �' tor Plumbing In.V)rtion Phone 6,394191
1% State Z4— Plumbing Contractor By
TOTAL — RECEIPT NO. Issued By ) ----7 —�
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