Permit Support Document Plumbing Permit Application _
Building Fixtures
City of Tigard tE u 1.\04-7,�Z \ e:kait .: , I-4 4 C __ °� _.
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• 133155 SW}call Blvd. >ai i OR ¢ * flan h ��.<e p fittazar J*rrp No.:MSV.1076-0`-�.k_
Mimic 543 k i$`4'a rim >tpa Sob ts (writ_
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Iminci +tsn lice 503-639,4175 F 1RY3c Rt k,ea i,.' 1t1 1 Jcr :Rice Page#ttv
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Demolition _________---
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V+ @ "ItlS 0.wSf L eNOttan W _ _
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4 4r,R3nt3r°altera'3rrn rel c +w ,, usher. I+aw1 2famlly duelling!iirieludoi 1' ft. for each t.trbtvran:ncstion I p
{j#,r' ; to L3k, A€ xi a },t k;, a` .ks,� SFR{1 t hat#a .P f ..._ 3'8,7+1 5`..�._..> ( SFR t_y bads
-"K mlki f3mI't ''I-..insg i Q t a tmnercialiodustriai --- -
-. '."_--` SFRt3)bath a 52Ki_3_ 1 --
gj #k,rs..r.,.2+,iIPk r*rl '- 'tiEti3oce€ansrh° _..�... t_Less -.._€_ Fach additional ba :i c 1 25.6h 1{
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i ri*el vs r twildrr l 0 Other Fire sprinkle! t P) _ "I :, Page' _. .
isis " 4 " k ,,x - ECM` TION . ' .�= Siteutuirica. _ .
a" y^�/� _�.� ,,pp {� Catch basin ur area drain I- 18 76 s 1 .:
to ...Cr a ks v s [ t i } , G W ( )� C 7 { 18,76
GK7 y t wail,(each line.or trench drain
C t iSicie VIP ` -i 6.40 ? fe'��. L7'2- Footing drain tno.linear rt.:,,�) Page 2
Silile l'1dg%ap4 t Pno eel as me , j a t.4'-..v.. ^ �rC.$➢ c-t Manufactured home utilitiesTv id).t3
c,O. s,c- itIr nt _tojtabrite' i ;t ' # '� mawicks j 58.7.6
18-7Ci 1
Rain drain connector _ —. ..
p__.. __.._.....__._.r.. .._..r_m-..._._ --__ Sanitary sewer(no.linear f#: e�, I gg Page 2 ��}# ¢��
},..._._. _ ...-. -_--- - Storm sewwer(no.linear tl.. 1, # 1 Page'_ I ('1;„: t4
_._....._.... ._._._.�. ____....._ __ Waterservice(no.linear L 1 Page 2 rKj`1t
Silid nron- Lo tn o.: REloxcf huwreatoCrr vitemve:
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itia 1t4p pa el n" (� - U C 00 SsekYo»pre%ater ..- - , S1 k
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l ::, :- . Ctitit33i }F•levfJRb ::: - Di)i Clos cr washer — - _ 02 �'1 25
''1 r'?In '' ' ail'. ! 2502"
f shwaskrer
y r t'a'° .-y}y/,f-=54- `' 4 ..r, 'e Drinkingfountain ; ._•, '
F e` ?a A'e, ey'07€1 ,7 i Lt'' e",7 " L�{,}i' f'? Ejta.tntSfsumis k w5C12
} i.: 4.it4i"-R'£` 1"€',(444:.:' 1,: ' ::: } '1" i, Exlrarvsiaatank 1 12.51 ___,_
i'''' a Fixturerse er cap 2S,i1't
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.rive: A, ,Y-LL- t - At."l`'!.''
� '-. I Flcwr drum lino sin lmh ,5 02
f c$dre : r tr° jt k f ,
( Garbage disposal 25,tt2 1Cil} ate LIP: a ? 1 h bib j - - 25.02
i 2 Hose gg
Pfkc;I ( '� q C�^? Fax:( ) Ice maker 1 12.51
r 4 f .3 ��O".T (FLRSO" ,, Illttr epttx!preaaetrtp '5.0? _
` 13, iness name: Medical gas(value:S 1 Pagr 7
i C'c+htaet Larne_ Prime n
54 —t kie _ _ ..,� 1.51
ROW"dram(commercial) 6 12,51
d lrc -
at: _ ,,i\.
Sink•basin'lavatory 4- ,..5 0.
_ Solar units(potable.waled 62,54 i
_
1
it met ) Fax:
) 'Cubxlaewcl: uiwerI'ut )) 12.1i ' 5 �1
E-mail 1-74.5 t ? @✓t `1 t'l Z"CA Opt,
4 Urinal 5 02 t"a' IItT ebrset _ I 25,021 ---
.-T )_tdtT h4alc., a '!r{1SrwfSa mime: ts.."____ y4 /L -- : $7°2, y t meµ_"3
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Other
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(Si(,it State 1� 4 r
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1 Phone:( ) Cax:( Minimum jicauni fer, x72 50
C.(f3 t 1t Plumbing Lie.ni,: __.__ u
Finn review t21'i.iz#gl3trrtsit fix)
tulhnricul signature: ? dy i?C3 (R [ tit fee)
_ 1tlCr1LPE9114t1CFl.Lti}Frit)!mimet. Ibis ._ °
r + ._ )late, perm- it at; exore4Il8 permit'is um ubt n«et+titlrtw 1R4F ,...E ... 1
e,_„ After It his been ar Ceptf d as ct snplale,
"Fa,unutN ks8y Awl by ttiC'ousst}l tlditt lt.Ia try Sc;,r ":u ist„,, nl
ii„TN'.l+i/mos ri int-e 51;Ap vxa toQI )
'f46.4k 16100 ea t'OM N l!))
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