12230-12232 SW 106TH DRIVE 3AI80 4190T DSS Z£ZZT-0£ZZT �`�'
CITY OF AR ®
DEVELOPMENT SERVICES PLUMBING F-'ERMI7
13115 SW Hall Blvd,, Tigard, OR 91.e23 (503)639.4171 1=1=RM I"l" #. . . . . . . : 17'L.M96-O381
DATE ISSUED: 12/19x96
S 1:TE ADDRL:SS. . . : 122-32 SW I VIGTH DR PARCEL .
SUBD I V I S I ON. . . . : CLYDESDALE
BLOCK. . • LOT
%ClNING: R-•4. 0 I
CLASS OF WORK. . :AIT (:�ARIIAGF� DISF='OSAL.-S. : 0
TYF''F OF USE. . . . MOBILE HOME: spACE_-S. : 0
:R WASE-TING MACH. . . . . . : 0 BP,CKF'I_OW F'REVNTRS. . : 0
(JC;CUF'ANCY (;r2f>, ,
FLOOR DRAINS. . . . . .
STORIES. . . . . . . . : 0 TRAF'c . . . . . . . . „ . . . . .
FIXTURES---_ -----. WATER HEATERS. . . . . : 1 CATCH BASI.. . . . . . . . : 0
SINK.r LAIJNDrtY TRAY'i„ , , „ . - �I car- RAIN DRAIINV-3. . . . .
%S. . . . . . . . . . 0 URINALS. . . . . . . . . . . 0 ,
I_.AV("iTORI.E'S. . . . . : 0 GREASE TRAFS. . . . . . . : 0
1�T11F-R r-rxTIJRrG. . , . : ,l,
TUB/SHOWERS. . . . 0 SEWER LINE (ft ) . . . : Q1
140TER CLOSETS. . : 0 WATER I._INE' t t`t ) . . .
DISHWASHERS. . . . : 0 0
RAIN DRAIN (ft ) . . . : 0
Remark., :
Owner-:
JOHN KESTER 8 .JAN KEETER .._._.._._
FEE;'.
29475 DAVID LANE tY1te amo .int by sate rer-pt-
F'RMT $ :5. 00 JSD 12/19/96 96-288009
iVLWBEFtr, OR 9713;7: 1,x1. $ l.. 2!J ,JSD 12*/19/96 96--288170-
.011t'ractat-: -----.--
'PEORGE: MORUIN PLUMB I O
529 sE FrisTER FAD
F'ORTL_AND OR 97206
7'71--1 1 4"i ..
Rag #. . : 0: 734 $ 26. 25 TOTAL.
This pet-sit is issued subject to the regulations contained i-1 the Misc. YIrspeclt i Girl INSRFf'TIQNS
Tigard Municipal Code, State of Ore, Specialty Codes and all other Final I n sliec:t i nn
applir.able laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started —���—
within 180 days of issuance, or• if work is suspended for more "
than 180 days.
rm i.t t e e �r ix�n:�lr i.irr y —�/����•, t; _' -- ----- --- _____ ---
suAc!
Call for• inspection
12,16is6 09: 11 %�503 6841 7297 CITY/ 1( A OF TI/GARD 10003/004
r'iTY CF 11. ARD Plumbin A V -'�
13/25 SW HALL BLVD. C 9 PPlicatioll Rec0By �^
commercial and Residential °J1e ReIa
TIGARD, OR 97223
(503) 639-4171 Cate to OST
i or Type Permit 0
Incomplete or illegiblE applications will not bo accPpted cxuea trasr t_
iNamgorCeveloon+gnNP,�tqu� -`-- RE S71 -
Job sant - _L PRICE AMT
Address Street�eur�i:' -` Suite 9.Oo
Lavatory
�!)(D qt 9.00
Tub ar TuWl T,, er C omp `_
8Id9 0Citymate LP
Shower On 9.00
�,•d 6R l 7��+- " - _ 9.00
Water Uosgt
Narna -ti. 9.00
9.00
I Q111R1er Mttvknq Address rude Garoaye Ohposal-�-
)'r C i�Gl✓l�r�a�(r' I 9.00
W2Vtrflq Machine __
ZIP Phoma -` 9.00
qkW) Floor Dram r 9.00
--
Occupant W+'1v__ww! �� ; s------oo • 900
n elate Heater --
13:zc.ti /�
'fC0 -- I 9.t 7
C.TWSup Phon1'.ncry Room Trac -
9.0
iA 4P-* J2 `=1 7i1,43 t- 3 ung 9.00
Naltse( OvY'G r]thgr Fufturea(Spac.hl _ 9.00
Contractor McO+o Address suite 9.00
1. sw A4,4,, Nov - 9.00
PmaGtprrStats -
4
7,A;a <v2n-1-73S'( -- 9.00
9.00
Ad"Co"of
J76gon ComoPont_Board Ur 11 Exp.Date 9.00
P _
-- t9 Uc t _ 9.00
L►csr��e y..T✓�� Exp'.Dal! ' x�+er-1st 100' � -` I
_ 30.00
COT Bualnasa Ta:or Me_tro a - * corn aaeroy a1 too' I
Exp.Dote Z3 00 I i
wnwr _ _� wat@r st 100
x rvtrn• t 30 ao j
)tee Servtoa-cavi addAlonar 200 25.00
Archkect Stour;A R,,n or-w- st 100 30.00
--i-^ -�
Or H4Wtp.iA0rE33 JL to Storm&Rout Drab[-"CP ad"Orvu 100' Z5.00
41ob11e Home Space
Engintor t=:hrsw: `r�n P1lone- _--_� :5.00
C.4rt1R"M1311 33CX Flow I r%j antrort Drraae of AAd. I 23.30
_ Pothloon Cevtoe
O+aot w cert Mw O Addition O Ateranon O Rendu C) Ras+nenoat 64-Wow arevenuon
dorsi' 7rsr0er•bal O Von-respeeneal O Oev�cll ----7---r 1 .00
s.04Mket•0escrrpaon of wort[ -' AM Trap or WZ1?Not CannncTed Io a�um,re 9,00
Ga1rr c3as,n 9-00
10,00 •
Wirle
Arg se at oravarty So Reduested Ir%Specaona e0 00
Rau,kraut.Sutgie fam h dwedinq - 30.60
P1000eea Lmof
[holding r*„r rpnty__-^
- Gntase rr>ip.>t 9.00
Arw Va' �pP�9 a
OUANTTry TOTAL
rrptayt -`
9 a<►y riuuref 7 YRS U Nn❑ laorneeta s riser 1AW"12 r"Wil"M f Cwwmy Ttm;. >9
Iters see back of forml
I helmb�acAnawlr•tfge Nat I hive read mil app4GtlOn that the/,)frit[at on 'SUBTOTAL.
_ LS
yroen s cnrtla:rat I am the creel or autlu•rtt:ty aQey,t of pie nemer.7nr1 ---
'"I Olaf's submf"ed arr,n Wmaliancr with p 5% SURCHARGE
rigor Stott tart. S
�lgMlV rs or t?wnM nAgmt - .Into -- -•i PLAN PEVIEW 25X OF SUBTOTAL
antact Pemon Mame -' TOTAL
C.
--- -- Phone
'Mlmmvm pertrrt fin is 525�cy.swrnarpe tsstxpt ahloannai Etar*now •
--_ Aevttntln.Lev cn.wflrt;t,is t Is•SK wrertarye
tea s+ rmap0.CCC RM