11810 SW LYNN STREET-1 -- 11810 SVJ LYNN STREET --
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PI IJIME.4ING, PE".11MIT
CITY OF T167A RD PE".PPITT N0 . : PL.890293
(CITY01FILSARD
COMMUNITY DEVELOPMENT DEPARTMENT 04100H Alt
13125SW '-all Blvd.,P.O.Box 23397,Tigard.Oregon 97223,(503)6'4175
5 W I-INN $1
if:lx MAV-1/1.J'I
AND
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WOPK CLAS5 WATEP CLOSE V P
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Dl.F-M-)WASHF.J4
GAWHAOF 011,4,105AL.
NO (11' 1 1: ':.J : 1XI6AEPI.-IINC4 MACHINE
DWFI. I 11N.1 I'S I—AUNUPY 'T'14 AY 61.AX.'s . MAIN MIA
FI-00W DPAIN
SI N K SEMEP (1 'T
WA' 11P VIFATE.:P CiII(A.M/PAIN 111"I
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IL.I. 1.101' !.i MFCII0N'T(`A1.. INC,
A AVE
C r-13 1- U 1.al I I cI P, 9/r.-2:1 -1
T -;031 ' -.4'
'T(*.)'T*AI $,el 1 2.5
R NO Vlellt.lm
This permit Is issued subject to the regulations contained In Title 14 NC) .
of the TMC. State of Oregon Specialty Codes, zoning regulations ........""'-'.•"'"""""""'""'
and all other applicable codes and ordinances, and It Is hereby I!I';:Q(.IIPI:A*) IN5Pr_'C'T*T1:1NFi
sorer that the work will be done In accordance with the plans and P'(35 T & FA::AM
specificatior a and in compliance with all applicable codes and AllX)OPI.1-.1,N
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall he% current city
business tar permits This permit will expire and become null and V:1:NAL.
void if work is not started within 180 days.or if work is suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assu,e
all required Inspections are requested and approved
Permittee Signature
Issued By
i A I I i W I
E E
IPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
P.O.B:)x 2.3397
CITY OF TIGAR D PLUMBING 1312 SIR HELu IlvJ.
*,�J �d CR 9TZ23
ApOiunts must hoW Oregon Registration to conduct a pl,.lm&ng PEIRM 7 1, 6394175
business to mw be properly owner/operator no hiring outsiJe help.
Nam*of DWqbp"WA
Plumbing Permit No.(2165
Job �1 _a '-� , -L►J_t��,L. tJfiset42t-6t0 OVM1. PRICE AMT
Tax Map.Nd.
Address
-- .— -- FIXTURES
l of Block Sut-WSW
ams or nanw- f; s_ness) Layslory
Tubo<Tub/ShowwComb 7.50 -15
latuiq resp Shower Only ?..So
------ Water Clmet 7.50
Owner Oty tee Zip --_ -_
_ Dtshwashei 750
Gartage,Disposal_ - -- - -- 750 _
- __-.___ _ _ - --_. Wastung Machine
- yL'' Floor Drain----- --- 7.50 -
Tv1aXi �s Phone Water Healer 7 50
C— Laundry R-oo�m Tr.ay _7.50
ityl$Occupant LV _
---- -_ . 7.50
llnnal
ams "- .- --- x ,e dtt+er Fixtures(Specify!'---- _ ---_7.50
h1ft'LAtL45 M 61ltr+i CALS_ '►� ' 7.50
Pt Arte — -
?- 7.50
Dintrector Istat. ' 71p _` 7.80
�►6) f. (�jQ .J / MISCELLANEOUS _
City Bus Tax No' g, 111 100' 3000
67Z, -� Hewer-ea. R 100 - - - - 15.00 -
alc r. tale U! C. ------ .- --
(Reatdential) W der Seiv{ce 1$1 100 20.00
I hereby ackrxyaletigs that 1 have read ttua��pNutb� i k+tormal.�, Water Serviw*a.Acbit.20Dr -y - 15.00 --
given is oorect that I aur,regieiered wMh the State Builder's Bowl.and 111110 Storm&Rain Dr„rn 1 St.100' X00
lave a Stale Pkrnt*V icanee Mast the nuts wz gel ars correct.that all - -
r*rmbing workwill be done In wcaxdance w+th apr cable provialons of om- Storm i Pyn('rmo%AWN.100' _- 15.00 -
g-In Hehled Stsoulsa Chapters 447 and W)and applicable xc*s one thou motille Harte Sp” 25 00
no help was tie em~trim licensed under ORS693 (.l exoHTV!nom — --_-- - --�__
State reglees i.11n,please glhro reason beaow). Back flow Prevention
1.00ME:tOWNCRS-1 hereby owttty tut I am the own w of the prop"de- Device or Mtl-Poaution Device 7.50
scrtt,ec above.at which location 1 propose to make a pttrnWq hetalladon Mr Any Trp or waw Not
my own tree and fts propertf 111 not NokV a"tru~for"if,lcase or rant Cconrocied b a F 7.50 -
Catch Bann— 7.50
kap.of Exae1.Plumbing
Specialty wP paWs - -- 40.00 Pw Hr
After.of Pktrr**V wfd*
an Exis"bldg 15.00 Mn -
----- -----
At t TUBE' S Dam q New Bldg.a tilfl
Build.Adon 126.00 tnkt.
- / irtale Earls . _._
l scribe work now❑ sWition[ a.'terR"0n Mpeir C:l c hin --- 15.m
to be done residential tan-reeidev_tTiaf -- �------ - _---__
Ea WUV use of
* -TOTAL
Ptorr of — � _' _��, �
aprop«tY TOTAL 7�
NOT>rE ------ — - —
Tt*partnM fleoornq txtM and sqa«.cork a aonatrtio6pn.untart=ed as nos Dor ----
n►srxud wNftYs UO dley.,er r oer.tatltabn or work b led or aDrndoned for
a urkld d 180 days M any fart♦after wak is court wdnoad
OPAP leeued __ __. by
f
Address I I-Aln q W. I Permit No. 1.5za
Permit charge
Owner M.D. Spencer Connection fee 30U.00
Paid by
Type of bu ' j. ing Residence Date connected 2--24-72
Service rat; 9.00. Inspection fee---,- 25.00
Ed Farrel XD6 Byencpr 2 'q
Contractor Paid by
Size of connection— 411 Assessment— -
5--5-6)
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PERMIT TO CONNECT
44—
loot
'` Tigard Sanitary District
PE19 7 8 DATE
PERMIT IS GIVEN TO fir' - 1� � ?.r_,r�,5 ►�.L_— --- ---—OF
TO CONNECT A ✓ T—__._--
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
r' ffII
THIS PERMIT MUST RE POgW#I1 'JN THE DF-lCRIAF.D PREM19FS UNTIL CON-
NECTION IS MADE AND INSPEC'dON OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID #.� -�• TIGARD SANIT#.RY DISTRICT
....V...�........
By
r+ct•s-a .�1trc4o�'J
CONNECTION INSPECTED AND APPROVED
Date Superintendent