Permit a ,
. .;._
CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES DATE
PERMIT #: ISSUED: 2 00531
/2 2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15618 SW 72ND AVE PARCEL: 2S112DD -00200
SUBDIVISION: OREGON BUSINESS PARK III ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 5 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Relocate plumbing fixtures: drains, sinks, toilet and urinal.
FEES
Owner:
Description Date Amount
PACIFIC REALTY ASSOCIATES [PLUMB] Permit Fee 11/23/2004 $182.60
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [TAX] 8% State Surchari 11/23/2004 $14.60
[PLMPLN] Plan Review 11/23/2004 $45.65
Phone : Total $242.85
Contractor:
CASCADE PLUMBING CO.
2630 N HAYDEN ISLAND DR SP#3
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Phone : 503 - 544 -7464 Water Line Insp
Top -out Insp
Reg #: LIC 120893 Final Inspection
PLM 34 -412PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR
952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)
246 -6699.
Issued By: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
r , ,
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RECEIVED
NOV 18 2004 . e-e, 40 6190 acci k le,A0 IN b*
P l u m b i n g P e r m i t ApDlicali&lTY OF TIG , • D r,-,R (-) F F I C f 1 [ U . I. ti
BUILDING DI A N ,111I 1_ i jy - a/ '
13 SW Tigard. OR 99123 �►
nor= 503. 639.4191 503.59/11960 amt ir- / 2l / 0 U cr Omer Penal No.:
4- RoarlaspeaionLaw 503.639A19S . -•1I Dare1lsdtrRy: AA! lit see Page Zrev
la6onet - :.i .
,_ - www-C .ei der u .7 ; c t otNeel Mcdeeat Sgple l itarma6m
a . � C74�. T. ...a.,_ �'ls: ilja:r sr t�: •.o: • kr .: ....
o Pleweo 0 Demolition, For tpaedkriwatsr7ow Kw al:Wisc
Dr op 1 Qty 1 Ea. I Total
1$ RPM 0 Othec _ New 1- 2- family dwelling (includes 100 R for tack Wilily caneccdon)
` � � '':, a= +lcF �es'r£ n)� ■ 24910
t - ° J i*�.i 443 •
Q 1- mtd 2- 8eaa'ly dwelling SFR (2) bath 350.00
0 Accealy building 0 Mu11i-family SPR (3) bath 39900
s
Each addition) ba*hlkitcbcn 44.00
0 Master builder 0 Other: Foe sprinkler (..._ sa.1L) Page 2
MarlIS Z- - . - 7.;? .._.. ;,�•- � sreeraitic
lob site edgy= t I • 3 r Camp basin armae drain 16.60
QgrJStatriZEP:
Dryoiell,Inach Erre. or trench drain 16.60
Footing drain (no. linen tL: _, Pate 2
Suita/h) 1. no. PICJett t» 1 a.0) C co i • Maoar6eoioed bra utilities 11000
Cross stectfifireetinen m job sites CIO VACCIr, c5 i �O 1 9 Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (ao. linear ft.: ___) Page 2
Storm sense (no. linear ft.: __._, Page 2
Sllbn 1 i as no. Water =vice (no. linear IL:. ) Page 2
ruettere or Item
ToewitP/Ptocel M Absorption valve 16.60
. ,� . � ' f :. tr - y'= Bao>dlow ptw.errter Pages 2
. -(1Lf Y l 1 N -k v- S Backwater valve 16.60
J� \ (- Clothes washer 16.60
v Dishwasher 16.60
_ r - r. _ , ` ' _ Dradoalg fountain 16.60
ti - ' �. °' . _. " � . . '. " .,.`,#s/.R - - --: ` •`.•.` E ectoresuri 16.60
N . � AO ', to 6- 51 t P i nn - 66 pion tank 16.60
Fu
Addle= 16.60
Addle=
. r us Floor deaioMaascioldhub 16.60 ,2•
Qaeba®edisposal 16.60
Ftlone ( ) Fax: ( ) .� tiatelib
16.60
t ',�QP1 c P tuml - 4 Cc . faOXIM,loii aaP 16.60
Connect name: GoA 1 c.( Merged gas (`atue S ) ■ Page 2
Addles= 2 ' 1 ma • 0, • . - . ,' " Pruner 16.60
Roof drain (oommerd•Q 16.60
K'T'7777 AI'. p • e" -
�p� (� SSnt/ 16.60 vain y IIM V, 0 D
Maw (3*) X, 14-^ 7 4S'L -4- Falc : (S'D3 , - -2R`\ ^ (0 0 e 1 TabfsbowMshower Dan 16.60
Erato* Urinal . - 16.60 . Q
i s n q. r.. Water closet MI 16.60 4/• , 0
• i s• ii. 1, _ Wilier Mawr 16.60
Odra:
\ ■ • Subtotal IYJ! 1
ob./stamp: ne d I . O. - Minimum permit fee: E72 50
1 r r Residential badminimum Alow minimum Pmt fete 576.25
�•� - � f Plan review 0.5 of hermit fee) 'y 5.
GCS Lie: 1 W . ) ` . 3 9:,...„ I.1° 'O : 1 - LL 1 43 State surcharge (8% otpe n it fee) f y. 60
A,oOtotfzads l - _ 1 - H Date i ling Tier permit a� ' beta MI a apt�ed is net as complete.
obtain Milan
Mt *Fee methodology sat byTri -Cormty Building Industry Service Rove.
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