Permit CITY OF TIGARD PLUMBING PE RM I T
PERMIT #.......: PLM96 -0169
DATE ISSUED: 08/08/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 2S 1 13AD -01700
SITE ADDRESS ° 16920 SW 72ND AVE
SUBDIVISION ° ROSEWOOD ACRE TRACTS ZONING: C-G
BLOCK..........: LOT..... ........ :30
CLASS OF WORK.. :ALT GARBAGE DISl :'OSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE :COM WASHING MACH . 0 BACKFLOW PREVNTRS..: 3
OCCUPANCY GRP.. :B FLOOR DRAINS......: 2 TRAPS ° 0 '
STORIES ° 0 WATER HEATERS 1 CATCH BASINS : 0
FIXTURES -- -- - --- LAUNDRY TRAYS.....: 0 SF RAIN DRAINS ° 0
SINKS • 5 URINALS 1 GREASE TRAPS ° 0
LAVATORIES.....: 2 OTHER FIXTURES 8
TUB /SHOWERS : 0 SEWER LINE (ft)...: 0
WATER CLOSETS..: 3 WATER LINE (ft)...: 0
DISHWASHERS • 1 RAIN DRAIN (ft)... 0
Remarks: Tenant Improvement: Borders, Inc
Owner: - FEES -- --
BINGHAM INVESTMENTS type amount by date recpt
3939 NW ST HELENS RD PRMT $ 234.00 JSD 08/08/96 96- 282714
PLCK $ 58.50 JSD 08/08/96 96- 282714 •
PORTLAND OR 97210 5PCT $ 11.70 JSD 08/08/96 96- 282714
Phone #: 224 -2676
Contractor: •-
MARXMEN PLUMBING INC
9665 SW 163RD AVE
BEAVERTON OR 97007 - --
Phone #: 579 -2200 $ 304.20 TOTAL
Reg #... 102432
REQUIRED INSPECTIONS --
This permit is issued subject to the regulations contained in the Water Line Insp —
Tigard Municipal Code, State of Ore. Specialty Codes and all other Top-out Insp
applicable laws. All work will be done in accordance with Storm Drain I n s p _,,,_, _
approved plans. This permit will expire if work is not started Rain Drain Insp
within 180 days of issuance, or if work is suspended for more Misc. Inspection ______
than 180 days. Final Inspection
P e r m i t t e e - amre: 640/4.14.6 // 74� �� __ -
Issued By: ∎� - --'(' 41 7 C i _ -_ - _ _
Call for inspection - 639 -4175
JUN -17 -96 h[ON 15:27 P. 02
UO'II1NO lt):l'! VYVV keys vv-av -••• -- - ---
City of- Tigard PLUMBING PERMIT APPLICATION Planck(Rec, # 0(0------ C
13125 SW Hall Blvd. Permit # Pc,. 96 - ore 9
Tigard, OR 97223 I f . 2 ( , ,.r� 56, - 3/
(503) 639 -4171 0
MINIMUM $26.00 PERMIT FEE + ST. SURCHARGE
• rwn. ert>.ocon.m Lim Sin ate Fem On
V201 ooKr • )41) 16 'CAI'
ease A `�� ❑ 1 BATH HOUSE 5140.00 O 2 BATH HOUSE 5195.00
Job I (o920 ' ) 72 i AAVGr.I U- 0 3 BAmt - I HOUSE S225.oa
Addre55 cream. m Fee includes all plumbing farttaes h the dweiUng and the Mat 400 reel
116r/Sc r 012 4 1 2 Z 4- of water service. sanitary sewer end start sewer. See fees below_
ra,..to..T..rum* 5b3• Q . .ZCa7lo FIXTURES QTY PRICE AMT
13 It46 P eve-1-v rfriggr Sink /5 9.00 e
re•+o �• - Lavatory "2. 9.00 1
Owner 14IJ1 - }}tj. 1246 47 Tub or TubiShower Comb. 9.00
cersrt. m Shower Only - 9.00
17 i2- - u.Arc , lP / O lz • 1 ZJ O Water Closet ] 9.00 _
w�rrn nm' bawd 31� • gl•Iloo Dishwasher - /1 9.00 '' AA
�
130 9.4p c, 4 I i4C' • y Garbage Disposal 9.00
Occupant ,;a me re,.,. Washing Machine -� 9.00
11 r A Add e jf 1 . Fioo Drain i 9.00
a ,,,,,, e „ :a Water Heater 1 C00
M44 Ap ot- , fit i 4-0 1 o 4 Laundry Room Tray 9.00
wnu r Urinal • /- t 9.00 et
r Other Fixtures (Specify) 9.00
. .:MaisCey(AQ rv • Luse ,ae.o Road TM D`i tar WoS1 e,G, ° 4 900
Contractor
pa krn 6 /r a iln / ', �. 9.00
emm.. is � �
ewer 1st 30,00 ew 100' e t � 1 L_
Zig. Rtd lee. ury am Yu xa Sewer • ea. Adrift. 100` 25.00
Water Service 1st 100' 30.00
• I hereby ackn- _ • •0 that I have read this application, Mal the Water Service ea, AddR 200' 251.00
information given to correct. that 1 am the owner or authorized agent of .
Storm F. Rain Drain let 100' 30.00
the owner, that plans subrrritled are In compliance with Slate laws, that
1 ern 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 =woo 25.00
give reason beiaw.) Mobile Horne Space
Bark Flaw Prevention
d ( *//29 / / J 6 Device or Antl-Potudon Device 3 9,00 21
. ..� ! me Any Trap of Waste Not
�j
A L f Z j t " t( ' d alai Connected to a Fixture 9
Describe work rtew addition C aeration Q iepait 0 Catch Basin 900
to be done residential 0 non- residen5al 0 Insp. of Exist Plumbing 0:...•- 40.00/hr
Specially Requested Inspections , 40.0O/hr
GdsUng use of ,
Rain Drain, single family dweling 30.00
building or property
Residential backflow prevention
devices •-• 15.00
Proposed Use of
building Or property , •(Except residential back/low
prevention devices)
NOTICE , . •NlInlmum Fes $28.00 SUBTOTAL Z34€V
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF I I •�a
5% SURCHARGE 5
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25% OF SUBTOTAL 6S` /?o'fr t I
COMMENCED. ,
,f �,
TOTAL. 7 v -I.70 " 21810.,
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