13430 SW 121ST AVENUE-1 - 1 1 �.1 �! Q,._l 1_,Pl;1•lil 1 1 l� r 1 1 „9 .
, 0 SW 121ST AVENUE
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CITY OFTIGARDPLUM81NG Pk--PMT-7
PIF.PMTT NE) . : PLO(J2137
COMMUNITY DEVELOPMENT DEPARTMENT
13125 S.W.Hall Blvd-P.O.Box 23397.Tigard,Oregon 97223 (503)639-4175 1:)A*f*r.;*. 15C51JED . 1.0/2 C.>/06
I .NU . '7-77271737J7
J00 AODPESS , 1341,30 !:iW14-21.S'T AVI:-..
'I AX MAI:*- /I OT SUB :
I AND 1.151.
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NO
WORK C',LASS : WATER GLOSEET TRAP
USE TYPE. : S'1NE-',I. I-- I-AWILLY UPTNAL. F3KFI..OW PAVNTA
CONS1 .*TYI-"'I*.-'- : L A V 0 WA TO PY 'I PAP PWIMEP
U.171.113 . GPI.-I TUB 511.40WE-11 GPEA511i- I'PAPi
D1 SI-11WAS11--W.44
(;AP14AGI;.: 17151:-OSAL
NO . STEIAILS : W0511-4T.W.) MACH-11NE
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51,101,11- TAX
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NO . 171300 TOTAL
This permit is Issued subject to thp requlatIons contained in I Me 14 IAF GL-113:11 NEI.
of the TMC. State of Oregon Specialty Codes. zoning regillations
and all other applicable codes and ordinances, and it is hereby 1:41 (,11.1134:,1) INSWE.1.111E)INS
agreed that the work will be done In accordance with the plans and I
specifications and in compliance w,th all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and
void if work is not-started within 180 days.or if work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
Permittee Signature
Issued By
1Y I (:'I' ('IN 639— '11. P i
SEPARATE PERMITS REQUIPED FOR WORK OTHER THAN DESCRIBED ABOVE
i
C'!TY OF TIGARD PLUMBING I U.5
Applicants must hold tyre on Registration to conduct a plumbing PERMIT Tigard CR 97223
%11 Blvd.
business nr must be properly 0"W/Clperator not hiring outside help. P E,`M I�T Cfi)41-r)
�^ Name 01 Oswlotxr+snt
Plumbing P
Addn>�.a 1; ermil No.
/ -- ' OetcAptlon
Address �--'—
Job Tax lot r -- ORS P14-21-610 Map,No MANPRICE AMT
—
91ock Sub Moron FIXTURES
.- Sink 7
err»(u,.ems o s+ness Lavatory ------ -
��' .. • ���/�9/".LS - 7.50
Ar ry Address - r Tub or Tub/Shower Conal
7.50
,1 S7 Shower Only - 750 -
Owner te ZIP Waler Closet -- - -
7.50
f� 7� --
1 � Garbage Disposal - - - _ ---
7.50
NAme Washing Machine - -
7.50
q:- Flm Dfain -
P' INAter Hasler �Y 750
Occupant
City/Otale --sundry Room Tray` _ 7.50
drmat -name 750 _
-- _
Other Fieturss(Specify) --
t
7.50
':C ---- 750
Gxttractor / q c '`� np -? 7.50-- - -
_
MISCELLANEOUS
City t4 fax No _
Sewer tel 100' _ 3000
late 1, p,----- to . IS ►r o Sewer-ea.AW" l00' -- 15.00
(nw1K�AntiAl) �- _
J- i. Wet-SerAw 121 100' 2000
''1e'et►Y edcnrrrMdpe 1txM 1 have read thla spr*caaon,that tM kdcxrr+e kxr water Servbe as.Addit.20D, - — 15,00
h ven ie that I evn►epielerod with thO Slay&„Mdor's Board.and also —
have a S4&j*Ns Pkwrt>tng arnnea Nut N»nu*w%ghren arm oo"*M Nut all Storm d Rain Drain 1 M.100' 3000
rk►mbkV work,wO be dole in AaWft a wfh WWMo pr ,ot Ore- Skim&Pyn DrMn A4dN. 100'
gnn newsod Statutes C�+apten 447 and 6q3 and WVk bte Dods.and Nut 1500
Stals help w4l be @m[*,Yed unless fioensed undw ORS 6O9 (it exempt from McWb kb►�Spete - 2500 -
►eglMraW.m•plisses W"reason babes). 6ac1r Flow Preverrtion --- - --
NOMEOW.MpS-1 hereby MVy Chet I air,ft owner d the pmpaty de- Devke or Arwrbauhon 0evtce 750
W rR»d ebova•M vAtlell bcalbn 1 propoea b make a pkinbktg helaNaUon kx -
^rY o"use and Nie MOD"be not balnp"Wtir xted Ax saie,leas or resin C-Trap d Walla Nal
I Caretaded to•Fitrhxe 7.50
----- Cook"seem 7.50
tnsp.d EY M.PMnnbing _ 40.00 P«Nr
eNY �'^�dna 40.00 Per Nr
an EX"V 81A0 15.00 min
Al/T11(Kt12Fb 4JUMTURE - -
pal„ New SM9.a OuNd.Adid" 280)RMn -
Usecrkty work _te
new - �S�41fanil i
[� diddiliOn a
❑ tWation[] A,-
-
LV
he done non•rerapel
siderIll dill' 15.00
Euhtllog usa of
btif*v a pro► silty_. It S r( PAIC Q-
�
,t �� ------- - OU&TOTAL_ _r
d pRlperty
1151" IR boom""nal rntd wW N
oonNuolln+autnorurad Is
a oeuked et
"*M�dr"11=1dMa70orr Or 10`11*b ms"Perm ebendened k„ � '�'�
*"all any St1N Mer work M oermar1ood
WW"L OOIR1fl1011!>f
- - t)Ma bsuecf _ by --