16250 SW KING CHARLES AVENUE;+
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CITY OF TIGARD Plumbing Permit
Building De1artmant NO.
Residential cors--.ercial Ej
New!:istallation ❑ Replace Addition ❑ Alteration ❑ Date
Licensed
Plumber Owner
Address "5
Job AAdress.
C
Phone . j Applicant
Cir, BUSINESS LICENSE REQUIRED FOR ALL CGNTRACTORS AND SUB-CONTRAC,rops
ITEM NO. FEE TOTAL ITEM NO. FEE:jTOTAL
, :
3000
Fixtures-Traps /.50 Sewer:First st 100 It. —
Dishwasher 7.50---- Each Addit.100ft.—. 15.00
Garbage Disposal 750 Ejector Pump 7.50
Wate,-Heater 11 7.50 Water-First 100 ft. 20.00
Backtiow Prever. L; 7.50 Each Addis.200 ft, 15.00
Storm Pain Drain:First 106 ft 30.00
Each Addit.200 ft. 15-00
Mobile Home Space 25.00—
Other(Specify): Rain Drain-Single Fam.Dwelling -------- 1-5.00
Comments:
PERMIT FEE --01 Issued By:
STATE %
OTAL No. Applica Signature
For Plumbing Insprfion Phone 639-4171