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Permit CITY OF TIGARD PLUMBING PERMIT \, DEVELOPMENT DEVW LOPMEN SERV6CES DATE ISSUED: 7 -0435 13125 ISSUED: 12/17/97 2 0 1 .A PARCEL: 2S101DA -00101 SITE ADDRESS : 13190 SW 68TH PKWY SUBDIVISION • TRIANGLE CORPORATE PARK ZONING: C —P BLOCK • LOT •003 JURISDICTION: TIG CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 1 MOBILE HOME SPACES.: 0 TYPE OF USE :COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 0 OCCUPANCY GRP..:B FLOOR DRAINS • 0 TRAPS • 0 STORIES • 0 WATER HEATERS • 0 CATCH BASINS • 0 FIXTURES LAUNDRY TRAYS 0 SF RAIN DRAINS • 0 SINKS • 1 URINALS • 0 GREASE TRAPS • 0 LAVATORIES • 0 OTHER FIXTURES • 2 TUB /SHOWERS...: 0 SEWER LINE (ft )...: 0 WATER CLOSETS.: 0 WATER LINE (ft)...: 0 DISHWASHERS • 0 RAIN DRAIN (ft)...: 0 Remarks: University of Phoenix tenant improvement. Owner: FEES GERDING /EDLEN DEVELOPMENT type amount by date recpt 4650 SW MACADAM AVE PRMT $ 36.00 JSD 12/17/97 97- 301847 STE 200 SPCT $ 1.80 JSD 12/17/97 97- 301847 PORTLAND OR 97201 Phone #: Contract or ASSOCIATED PLUMBING CO P 0 BOX 301362 PORTLAND OR 97230 Phone #: 331 -0582 $ 37.80 TOTAL Reg #.. 000578 REQUIRED INSPECTIONS This persit is issued subject to the regulations contained in the Rough—in Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM /Underfloor applicable laws. All work will be done in accordance with Top —out Insp approved plans. This persit will expire if work is not started Misc. Inspection within 188 days of issuance, or if work is suspended for sore Drinking F o un t a i than 180 days. ATTENTION: Oregon law requires you to follow rules Final Inspection adopted by the Oregon Utility Notification Center. Those rules are set forth in DAR 952 - 8881-0010 through OAR 952-0881-8888. You say obtain copies of these rules or direct questions to DUNC by calling (5031246 -1987. �� Issued By: -ma Permittee Signature: + + + + + + + + + + + + + + + + ++ +++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Plumbing Application Recd By 13125 SW HALL BLVD. Commercial and Residential Date Recd /0 ? TIGARD, OR 97223 Date to P.E. 9 -4171 Date to DST .�/ (503)-S3 Permit * P 9? `-a)I3( Print or Type Related SWR • Si '1 7 - o39 Incomplete or illegible applications will not be accepted Called /o 3P T7 4r3 °4'"- Name of Development/Project Job TrtiAN le coepo,p.it park FIXTURES. (Indlyldual) ,. '.2 ... .. w; *' ; QTY ;; :11,a, CE AMT Address Street Address � Suite Sink I 9.00 c ) 319 0 S U/ 68 Pakk,l:.�l Lavatory 9.00 Bldg a rty / State OR Z Tub or Tub/Shower Comb. 9.00 Name 1 9 I q7/1.7 Shower Only 9.00 . t eGI »,j wf C9 • Water Closet 9.00 Owner Mailing Address Suite Dishwasher 9.00 251.5 $ 1 .0- Garbage Disposal I/ , 11-1) I 9.00 � tty!$ {a mi OA Zip Phone Of tt I ,�q 1 6000 Washing Machine 9.00 Floor Drain 2' 9.00 NaVAilie/3•1 {� ©F I'�1DR/1►X 3' 9.00 Occupant Mailing Address 7x Suite 4' 9.00 13110 SW 66 17 Arl4w0,1 Water Heater 0 conversion 0 like kind 9.00 City/State I Zip 1 Phone �+8 Q R 91.113 laundry Room Tray 9.00 Urinal 9.00 N J J PI im 11...„. Other Fixtures (Specify) 9.00 Contractor Mailing Address J Suite PO am 301 764 1 - Ice M r Corm a+ _re fer, / 9.00 9 (Prior to issuance City!$t to Zip Phone 1 - Co ti 444 SAP /1i lo t/eNJ;A3 rrO(1�.A, / 9.00 9 applicant must po -tlaiJ r OR 1723o 33100O 9.00 provide all Oregon Const. Cont. Board tic.* . Date .10-0 ee 9.00 contractors 7890 1 1 - 5 - 9 7 I i d 9.00 licennse Plumbing Lie. 8 Exp. Date er - 1st 100' 30.00 into cesor if expired g - 412 P 6 to - 31 - $ Sewer - each additional 100' 25.00 in COT COT ax or Metro* Exo. Date Water Service - 1st 100' 30.00 1 database). I se ) - 1 - q 8 Water Service - each additional 200' • 25.00 Name 1' MaCkenZi C Storm & Rain Drain - 1st 100' 30.00 Architect G /cop Storm & Rain Drain - each additional 100' 25.00 or Mailing Address , 0690 SW • 6ztAtrdf Mobile Home Space 25.00 Engineer City /$ to Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00 fortldit OR I72D 224 q;i70 Pollution Device Describe work New 0 Addition 0 Alteration 0 Repair 0 Residential Backflow Prevention Device' 15.00 to be done: Residential 0 Non - residential w Any Trap or Waste Not Connected to a Fixture 9.00 Additional description of worts Catch Basin 9.00 I i Insp. of Existing Plumbing • 40.00 T T im /o VPt +1Gk ( peper/hr ic Q S p e cially Requested Inspections 40.00 Existing use of //LL per/hr building or property (brrlMtPC i A i Rain Drain. single family dwelling 30.00 Proposed use of /� Grease Traps 9.00 building or property l Or'',' tP( i0.) QUANTITY TOTAL Are you capping , moving or replacing any fixtures? Yes CI No Isometric or riser diagram is required if Ouanity Total is > 9 (If yes see back of form) *SUBTOTAL -Z/ I hereby acknowledge that I have read this application, that the information 5% SURCHARGE J � ° y given is correct, that I am the owner or authorized agent of the owner. and - I S that plans submitted are in compliance with Oregon State Laws. PLAN REVIEW 25% OF SUBTOTAL • • Sign re f Owner/ ent Date Required only if fixture qty. total is > 9 J0 - .Z7 -q7 TOTAL Contact Person are Phone 'Minimum permit fee is S25 + 5% surcharge, except Residential c kflow CiItL( l.4.1 rnaam 331 05'0 Prevention Device. which is 515 + 5% surcharge l:5dststptrnapp.doc 5/97 . • PLEASE COMPLETE AS APPROPRIATE TO PROJECT: • Fixtures to be capped, moved or replaced Qty Sink Lavatory Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain 2" 3" 4 " Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I:1Slptrnapp. 5197 �M vcry� Orr A'''' X Accumulative Sewer Tally 9 03 ) Tenant Name; %17 ( This SWR# i. -- Address: / 7/90 di.-- &o it Zr . K� This PLM #: ec^^ — 0 Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New # Value Capped off value added # added #s total Count off #s count value values Baptistry/Font 4 Bath- Tub /Shower 4 ` - Jacuzzi/Whirlpool 4 Car Wash - Each Stall 6 - Drive Through 16 Cuspidor/Water Aspirator 1 Dishwasher - Commercial 4 - Do tic 2 Drinking Fountai f '/e ^1'"f ^' E - E / / j - 5 _ Eye Wash 1 -_ Floor Drain /sink - 2 inch 2 �j /0 S /D - 3 inch 5 - 4 inch 6 i (0 / CO - Car Wash Dm 6 Garbage Disposal 16 / - Domestic (to 3/4 HP) / / / /r'o - 7a - Commercial (to 5 HP) 32 - Industrial (over 5 HP) 48 Ice Machine /Refrigerator Drains 1 / / / Oil Sep (Gas Station) 6 Rec. Vehicle Dump Station 16 Shower - Gang (Per Head) 1 - Stall 2 Sink - Bar /Lavatory 2 /6 c_ /4 - - Bradley 5 - Commercial 3 i" 3 / 3 g A - Service 3 / . 3 / 3 Swimming Pool Filter 1 Washer - Clothes 6 Water Extractor 6 Water Closet - Toilet 6 / U (,U /0 &C) Urinal 6 T .I.,/ 47 OZ TOTALS / / V / / `" / . Total fixture values: /..'i divided by 16 = ti D EDU /�C G fry' HISTORY A PLM# 97 -D i W EDU# 9 SWR# g7 -o'6 I PLM# EDU# SWR# 1 PLM# c7-7 - 60 3 EDU# S SWR# gv -°51 PLM# EDU# SWR# PLM# EDU #,v 9 SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# is \dsts\swrtaly.doc