Permit PLUMBING PERMIT
' PERMIT �.......: PLM96-0031
DATE ISSUED: 02/23/96
CI � T � ��"� � � �m���r-�&����m�r
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COMMUNITY DEVELOPMENT DEPARTMENT PARCEL: 2S112DC-00701
SUBDIVISION....: FANNO CREEK ACRE TRACTS ZONING: I-P
BLOCK.........': LOT.............:38 �u�^� --� �
______ _________
1,... 7-5 , �����-��-�-� �___
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE....:COM WASHING MACH : 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP. . :B2 FLOOR DRAINS.. . . . . : 0 TRAPS... . . . .. . . . . . . : 0
STORIES........: 0 WATER HEATERS • 0 CATCH BASINS.......: 0
FIXTURES - LAUNDRY TRAYS • 0 SF RAIN DRAINS.....: 0
SINKS • 0 URINALS • 0 GREASE TRAPS • 0
LAVATORIES.....: 1 OTHER FIXTURES....: 1
TUB/SHOWERS....: 0 SEWER LINE (ft)...: 0
WATER CLOSETS..: 1 WATER LINE (ft)...: 0
DISHWASHERS : 0 RAIN DRAIN (ft)...: 0
Remarks: Capping off numerous fixtures and adding a lavatory, water closet, and
flow-thru water heater
Owner: -- FEES ---------
PACIFIC REALTY ASSOCIATES type amount by date recpt
15350 SW SEQUOIA PKWY STE 300 PRMT $ 27.00 JSD 02/23/96 96-276225
5PCT $ 1.35 JSD 02/23/96 96-276225
PORTLAND OR 97224
Phone #: 503-624-6e
Contractor: -�-~~-^- -
DEAN WARREN PLUMBING
3111 SE 13TH
PORTLAND OR 97202 ---- - ---------
Phone #: 236-4152 $ 28.35 TOTAL
Reg #..: 000172
-- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Top-out Insp
Tigard Municipal Cede, State of Ore. Specialty Codes and ail other Misc. Inspect ion
applicable laws. Ali work will he done in accordance with Final Inspection _____ __
approved p\aos. This permit will expire if work is not started _
within 18ii days of issuance, or if work is suspended for more __ ______ _
than 180 days. - __ ----- -
_ . ___ --
_
Permittee Signature: �� � ��^�*w���-- ---' _____ -'-� ------' ---
-
_ Issued ___ -
.
Call for inspection - 639-4175
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() 2 - 21 - 1 0 •is
�itji of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
� ��C
'x'3 125' SW Hall Blvd. Permit # Puh 1-v3
Tigard, OR 97223 Sw0 q(D .0(955
(503) 639 -4171 •
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
NVAe et Oetelopenent New Single Family Residences Only
Job LS 9 s7 Sw 7,R = �
0 1 BATH HOUSE $ BATH HOUSE 5195.00
Address cay�sm: zo Fee Includes all plumbing fixtures in the dwelling and the first 100 feet
( - S - A of water service, sanitary sewer and storm sewer. See fees below.
ra "a"' of Bidnw) FIXTURES QTY PRICE AMT
FA ' 1 U3 t~ Sink 9.00
teeing Addfess Pnaw #3 DO Lavatory / 9.00 q
Owner y 5 3 ,.6 O S ti.) se.0, i A Pkw Tub or Tub/Shower Comb. 9.00
"418t"' zo Shower Only 9.00
7/6 Water Closet / 9.00
Al, ame a mono a (or arYwq Dishwasher 9.00
Occupant A k kin � c T.4 / 4 �_i 1 t S Garbage Disposal 9.00
'`"° "dtri pea. Washing Machine 9.00
/ 596 S W 7.. Floor Drain 9.00
Water Heater 9.00
776-4a �s<a. Laundry Room Tray 9.00
PL L6-- 9.00
d A-ri WAr l /'/ ,/�L L6-- Other Fixtures (Specify) 9.00
Using kda«e PAoir
Contractor / - clot. T R ti W/}7�JZ 9.00 9 3) 11 S. E, 13 a 3(a - Lj /Ste hlA -TF_J2 9.00
sa 9.00
7 mj€ J.-q y„-d) - Sewer 1st 100' 30.00
teats " M0. alp Om Tat Na Sewer - ea. Addit 100' 25.00
C5)3 d 1 7 a a b 8 3 P,f Water Service 1st 100' 30.00
I hereby acknowledge that 1 havelread this application, that the Water Service ea. Addit 200' 25.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are In compliance with State laws, that Storm & Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit 100' 25.00
number given is correct (If exempt from State registration, please .
give reason below.) ///��� Mobile Home Space 25.00
�'/
Back Flow Prevention
k yC � Devi ce or MO- Pollution Device 9.00
Nom, owner a egan' We Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new 0 addition alteration 0 repair 0 Catch Basin 9.00
to be done residential 0 no r Identlal 0 Insp. of Exist Plumbing 40.0o/hr
Specially Requested Inspections 40.00/hr
Existing use of Rain Drain, single family dwelling 30.00
building or property
S E //A ti t , EA S G°7,0 E. o /= Residential backflow prevention
devices 15.00
Proposed use of L✓e, `2k ,
building or property
'(Except residential backflow
prevention devices)
NOTICE *Minimum Fee 525.00 SUBTOTAL Z-7VC°
PERMITS BECOME VOID IF WORK OR CONSTRUCTION I
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF • 5% SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED . ' r
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL /' 3 i
TOTAL
• Special Conditions
Date Issued by
Tenant Name: 6 4 - 10 - 011765 Accumulative Sewer Tally This SWR #: ° /& — /DSS
Address: 15151 'Lt) '72- This PLM #: q 10-00 '5 1
- fixture Value Previous # Previous Credits Capped Fixtures Fixtures New New
Value Capped off value added # added total #s total
Count off #s count value values
—
Baptistry/Font 4
Bath - Tub /Shower 4 Z 4
- Jacuz/Whpl 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commer 4
- Oomest 2
Drinking Fountain 1 1
Eye Wash 1
Floor Drain /sink - 2 inch 2 a 41 ..
- 3 inch 5
I
- 4 inch 6
- Car Wash Drain 6
Garbage Disposal 16
- Dom (to 3/4 HP)
- Comm (to 5 HP) 32
- Ind (over 5 HP) 48
Ice Machine /Refrigerator Drains 1
Oil Sep (Gas Station) 6
Recreational Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2
Sink - Bar /Lavatory 2 4 q i y
- Bradley 5
- Commercial 3 1 3
- Service 3
Swimming Pool Filter 1 ,
Washer, Clothes 6
Water Extractor 8
Water Closet, Toilet 8 W I , l!/
1
Urinal 6 2 1 Z
TOTALS ZS Co :1( �j � I e
Total fixture values: ) /6q divided by 16 = ►).i5 EDU crr 1Z bL)'S —
HISTORY C–VeAa Oh 1 4 DO 1 5
PLM# /5 -a3y EDU# no SWR# qS 0 Zt.14 PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
:'J.9.,,,.,,.,.. ,.,.2
-2 'L/
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling 4142),
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /Flr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: 4' /
L4 9 A.M. P.M. Entry:
Address: 1 ' � S a- -'Y1 - �
Tenant: I V Ste: MST:
BUP:
Con /Own: MEC:
PLM: 7 0 0 7i
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
_ Inspector: Date.
(A APPROVED DISAPPROVED /CALL FOR REINSP. CF CO