12155 SW MAIN STREET 12155 SW MAIN STREET
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CITY SOF TIGARD PLUMBING 13M 94 1bu fold.
Nimicwft ff%m 1hoW Onm PROWMion to contitxlt a plumbing PERMIT vd at 9W
businsseOr m"be rle
owr/operator not Wrin6 flet m*Ode .
Nanta a Oewloprnarl �
P)umtmng Permit No..1`_ z
OeecripMort —_
. .5 L ORS O14-21-010 DUAN. PRICE MAT.
Job Tax Lot Map.Nd
Address
FIXTURES
LAO Block SubdiNsion SM>k
am• «Hama sa l avabry — 7.50Mail _
ino�Q reze U4 .A�ham¢=' TuborTub/Show•rCo-b - ---7.50
-
ess Shower 0;*
_ 7.50 _
Owner clityistate
f W'a1•rC1AsM ---- - - - —7.50 —
_ Dishwasher 7 50
Pho1e Garbage Disposal J - -7.50
Nam@ Was"Machine -- - 750
L Floc Dram_ 750
ress Phone Water Hester - - - 750
laundry RoomTray — 150
Occupant CNy/State LP -- ---- -- -
Urinal750_ -- - -..
Nam-
// U
Other Fbnhxes(Specify) 750
7.50
'lz 7.32.3 - - — 750
tMr1
Co �ctor / zap -
Z
?7004 MISCELLANEOUS
City Bus.Tax No. Sewer lot 100• _ _30(A ~_
1• n eTi LIE No tasna tea.AddN. — - - 15.00
(RitsklorilimIll wow SenAos 1 st 100' _ 20.00
I hoisby ockmMedge tea I haw read fila epQwotllon.Mut tv< 1nMxrnaMon WaW S•rviva ss.AdM D' - - 1 S(h0 -
glven is oorreM tul 1 am rogiafanad with the Stat&Alders Huard,and also Stone&Rain Orale+1st.100 30.00
hwe a SIM Pkx.** ken"OW t»nurnbom plwrn are 0011 that 411 -- -
ptvnftV wad nAa be done In sc omdorm MAth opplIc e"o previsions of(r•- Storm&PrJn Orton Addit 100• -- -- 15.00 - -
gon Revised Statubs CthspWs"7,and @93 end appkoble oodes and that Mablle Horne Spece 2500
no help win be en><loyed unless flim under OPS 093 (II exempt from -- -- -- -
Stall reghtalion.peace gW reason bODW). Back Flow ProvomWn
HOMEOWNERS-1 hereby oerWy Oral I am Ow aer w of the pm*"d♦ Do Nos or AnoHlok4bn ate— 150
sorbed above.M wAhId lm- 111 m►1 psopose to nlalrs a pkmbkv WA8111Man lex Any Trap«Wads Not
RW Dern we WW Ods property Is no bekq oonstrw:MM lex sat,base or roN CerxnsAisd b a Pbekrra � 7.50 _
Calch Basin7.50
-_-. k".Of Exddat. — 40.00 Per I*
-� 40.00 Per Nr
Also.of Pkerlbkhg
an 15.00 min
AUTHORIZED SKU"TURF --- ---- ._- bat New
.or Btrwd.AdAton ta.. rtsn - -_-
...._
Dosch wo* new❑ WMW O ullerlafto Q ("I'D dau 1�•.W
V tit dOr>s
FI-N p#J0001
thin ft or property
U"of 4% . b 0
Tom
"Op"mbaNaltlIN1tAand vcWf/et�p%oraamruoranatlttoriasdlanotoom
� aNlu►realttltrtL�t�«atelllattlapar.dad«absrlt!«lsftla
1MPa Y any Mf11s Orth Miofk M,lOrtMlrMlosd.
_---__- ------ - __._..__._...-_ Axa+.aa���•��,.,
BUILDING DEPARTMENT, TIGARD N? 2921
PLUMBING PERMIT
'J, holder of a valid plumbing contractors license is hereby
authorized to cause plumbing "rk as herein awed to be installed in accordantx wim the plumbing code Of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and subcontractors.
Job :
Owner_-_ _ Address -L___ Date
NUMBER OF T TOTAL
TYPE OF PERMIT J ITEMS FEE ON EACH AMOUNT
Single Famll ry-1 beth-each rt 25.00
Duplex-Each 1 bath unit _ 25.00
Additional bathrooms--each 10.00
Mobile Home S ace-each _ - 16.00 -
INDIVIDUAL FIXTURES C0MMERrIA ___ _
_ 1 to 50 Fixtures in 1 building-each — _3_00
61 to 100 Fixtures in 1 building--each —_— — 2.50 _ T
101 to 200 Fixtures in 1 building-ench _ _ 2.00--.. _
201 or more Fixtures in 1 building-oach 1.50
MISCELLANEOUSSewer-each additional 100 ft. _ - _ 10.00
Water Service to building _
Oth r S cif
PERMIT >_ For Ph, •,Wng Inspection Phone 6.79-4171
4 StatePli-mbirig Contractor By V
TOTAL �_ —_� -_"�-, RECEIPT NO. �S !' Issued By ( _
BU1LLAN6 I. r-PAR lNiENT, TIGAND
� . holder of a valid plumbin�t cantracta;s license 1; hereby
authorized to rause plumbirdwork as herein noted to he installed in accordance with the plumbing code of
T-irg:)rd. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to ti... time the installations are ready for inspection. City of Tigard Business License required
for all contractors and suh-r .,ractors. Job
Owner_1 _�` l - ?lie
AddreSs..._�' �_=._1 J i��.._� j� �.--_-_C`-''- k=L--
L G t3crt 01
OF TOTAL
TYPE OF PER'1IT ITEMS FFE ON FACN AMOUNT
R_ESIPEt1TIAL _ �--- — - -- - ---- — -
Singla Famr�1 bath-_each 25 00
Dupr^x-Ench 1 bath unit
Additional bathrooms-each 10.00
Nlcbile!lame Space-each 15.00 ___ _^ _•____� y_
INDIVIDUAL FIxTI -DR—DAI
1 to 50 Fixtures in 1 buildin each __ 3.00____ �-
51 to 10o rrxtures in 1 buitdin�each _ _ 2.50
-101 to 200 Fixtu,es in t building-each 200
201 or more Fixtures in 1 building--each - 1.50_ -
1.11SCELLANE0US -
Sewar-each additional loo it. _ 10.00 s�
Via ter Ser ice
Other (12eci1X)
PERMIT for Plumbing Inspection Phcne 633•4U1
Brite Plumbing Contractor E' I r� ,�f --
TOTAL --
PERMIT To CONNECT
Tigard Sanitary District
N? 9 1 D DATE S 4
PERMIT IS GIVEN TO`., a f 5i
OF
TO CONNECT A 4
TO THF STSTEM OF TIGARD SANITART DISTRICT
AT ,
fit 4r
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM—
PLETED.
VERMIT FEE PAID ........y.......................TIGARD SANITART DISTRICT
By
CONNECTION INSPECTED AND APPROVED
I;
PEC. MIT PERM Ir 'Ll- 67- 77
Address Permit No. 9
Name of Occupaiit___...____ Permit charge
Connection fee—
Paid by
Date connected
Type of Building Inspection fee
Service Rate Paid by —Date
Contractor AssessmentPaid
Size of connection..,