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CITY OFTIGrARD
CRYOi11FARD
COMMUNITY DEVELOPMENT DEPARTMENT PL.LJ P1 D I N(3 PER I'l I T
13125 SIN HWI Blvd. P.O.Boz 23397,Tigard.Oregon 97223(603)639-4175 FILI'190-Cil 15-i
(.1:3`:)•-•1+1.71. DATE1S'SUIZE.D. 08/31/90
SITE ()D 1)R E G!,; 2 S 10 3 Ff C`0 IJ 0 C1)
13 W 1 P.I S T 0 V PARCEL:
U D D I V I'S 10 N. R-4-- tJ
LCYT . .
........... ........1--.-.-...-.............
1,3_ASS 01:- WORK. -.ADD GARBAOE DISPOSALS. 110DILE" HOME SPACES.
7 W()S j.J�1'H(.'.� ITI()C I-1.. . " -V 11*T'R S..
7'Y 1-1 1: 0 F' U G L., S F P(,-: KFL.0W PRI
1)C C U 11 A N C,Y GRP ,, F-';3 FLOOR DRAINS. T'RAP'S. . . . . . . . . . ..
5TOR IES. . . . .. — :; WATER IA I:-A TE I--i S. (
,nTCA-4 BOSTNS. . .
-
FIXTURES.................- LAUNDRY TRAYS. .. . SF RAMDR1211W3.
S11,IKS. . .. . . .. -, - U R I'll(l)L.S. .. (3)REASE' TRO 'S„ -
LAV0'T*0F%`lES,- .. . D*T 1-4 E R F I X'T U R E F.,
T'UP/SHOWERS. , 5F.WER I-JI,IE (ft:)
Wo 'Y*F.---R ('LOSETS. . W WTER I l 14E (ft) : 100
DIAGIAW)GIAERS. R AT 111 1)R 01 Iq ft)
R(..-?III a.1,k
Owvieri FEES
1,111 T' F-Y R E t Y 1-,)e a 111(3 t.k)I t 13Y (I to -r e c.,I:)
PR I'l 7' 1, R5. 00
PAYIYl $ 26. 25 J L 1-1 08 31/90
I Lt ca rt c It:
RAYBORNIS F)LUMBING
1764',5 SW JUR(JEA%1L3 RD
TUOL.0111sl C)R 9*7062
Plhc)rit? 0.- 503-69fP-43.39 2 2 5 TOTAL
REAUIRED IISI SPECT:TONS
This permit is issued subject to the regulations contained in the T 0 0—a t.t t 111 S r.) ...............................
Tigard Municipal Code, State of Ore. Specialty Codas and all other Final
applicable laws. All toorle will be done in ;-.cordanee with ......
approved plans. This permit will expire if work is not started .. .............. ------
within 160 days of issuance, or :f work. is suspended for more
than 180 days.
.................. ..................
01 ...............
.. ......... .......
4L4/w/Xa;t
Tsst.te(:l LAX.- .................. ........... ............... .......................
ic Call, ff:)-r irilisr)er-tiaii 639-•4175
CITY OP TIGARD
C 13125 SW HALL BLVD.
PLUMBING PERMIT �� I P. 0. BOX 23397
► Applicants must hold Oregon Registra-ion to conduct a plumbing
TIGARD, OR 97223
business or mu-.t he property owner/open 11or not hiring outside help.
Name of Development (503)639-4175
Plumbing Permit No.
Address ( —
_nom'Ji // i � '/dl l�HS81i-2
� ORS 814-?1-810 OUAN. PRICE AMT.
Job Tax Lot Map.No.
Address
�IKTURES
Lot Block Subdivision
,Mink 7.50
Name or name ss Lavatory - 7.50
�ub or Tub/Shower Comb. 7.50
MailiN Address
Shower Only 7.50
Owner City/State -- zip Water Closet — — 7.50
_ Dishwasher 7.50
Phone Garbage Disposal _ — 7.50
Name Washing Machine, _ - -_- 7.50
Floor Drain _ 7.50
Mailing Addrons Phone Water Heater 7.50
Occupant City/State Laundry Room Tray - 7.50
Urinal 7.50
Name Phone Other Fixtures(Specify) 7.50
Phon
!rLCC- � —_ -__. 7.50
Contractor ! all 7.50
`? CSG 4_ MISCELLANEOUS
City/Butt.Tex No Sewor 1st 100' --- r - 30.00 --` -
Stat eBoard1No tate riders taus.Li o Sower-ea.Addit.100 15.00
(Residenti:aq water Service 1st 100' 20.00
!horeby acknowlodgA that 1 have read this applicatkM.Lha!tho information Water Service ea.Addit.2W t 15.00
given is correct.that l am registered with the Stain fkWdw's Board,and also Storm 8 Rain Drain 1 st 100' 30.00
have a State Plumbing license that the numbers given are oonect.that all -
Oumbwg work will be dorm in siocordence with applicable provisions of Ore- Storm d,P in Drain Addd.100' ,- 1 i.00
gtxr Revised Statutes Chapters 447"893 and et.pllcable rxides and that Mobile Horne Space 25.00
no help w1*be employed artiest Ik�snssd under OHS 693 (11 exe"K frim —
State registration.please give reason below). Back Flow Pnevwft-)n
HOMEOWNERS-I hereby oor&, Cut I am the owrw of the property de- Device or Mtl-PolhAiun Onvrce 7.50
embed above,at which location I propose to make a pkrnbitg krstallation kr Any Trap or Waste Not
my own use and this property is not bektg arx"trvdwd Ins sale,lease or rent Connected to a Fixture 7.50
Catch Basks 7.50
Wisp of Extol.Plumbing -- 40.00 Per Hr.
— Specially Requested Inspections 40.00 Per H►
-_- Frain Drain, 1500
0- Single Pam. Dw1q` J_
CC AUTHORIZED SIGNATURE Liam
cn
r Describe work now f ) addition I altmAtkm O repels( I -- -
~
121n dune resiclerttial11 rxxt reeklential ll -
Extstln(j use of MINIMUM PERMIT FEE 25.00
bulkfklp rN procxrrty __ - - SUB-TOTAL
Proposed
°r�'�' 25% PLAN REVIEW
n ►n
s urge of -- --- -5$'SURCHARGE -- .
'
NOT1ct= _ _ _
This Pen*beooee null and void 41 work or ooneeuohm auttwwitad is rvA rrn- TOTAL 46 r1�
menoW wkf kr 100 dal%,K f M otrutnir Ian or work is oUspervied rr abendorvod kx
a IWW r4 11110(11"M arty tints aftw work Is orrrxnerwxM
4"CtAL OONO(T)OKS
Data klstfad __ by -_ -