Permit (14). PERMIT PLUMBING PERMIT
CITYOFTIRD n NO• : PL8'�1980
G I OF GARD
COMMUNITY DEVELOPMENT DEPARTMENT OREGON TE ISSUED: 9/25/89
13125 S.W. Hall Blvd., P.O. Box 23397, Tigard, Oregon 97223, (503) 639 -4175 PF I M . PMT. NO • 891975
JOB ADDRESS: 15590 SW 72ND AVE 7 2 5 7 5 �'✓ K 2 � L
TAX MAP /LOT 2S112DB SUB: ORE BUSINESS PARK III LT: BK:
LAND USE:
LOT SIZE:
ITEM: NO: NO:
WORK CLASS: NEW WATER CLOSET TRAP
USE TYPE: COMMERCIAL URINAL BKFLOW PRVNTR 1
CONST.TYPE: LAVORATORY TRAP PRIMER
OCCUP.GRP.: TUB SHOWER GREASE TRAPS
DISHWASHER
GARBAGE DISPOSAL
NO.STORIES: WASHING MACHINE
DWELL.UNITS: LAUNDRY TRAY BLDG.DRAIN (DIA
FLOOR DRAIN
SINK SEWER (FT) 250
WATER HEATER STORM /RAIN (FT
OTHER
REMARKS:
building 218 undersiab
FEES:
0 Realty Assoc Pacific PERMIT $87.50
N 111 SW 5th ave
Portland Or 97204 FIXTURES
PHONE 224 -6540 STATE TAX $4.38
OTHER $21.88
C
O
N
T
R
A
C
T
R TOTAL: $113.76
RECEIPT NO. 1/49 cii
This permit is issued subject to the regulations contained in Title 14 J
of the TMC, State of Oregon Specialty Codes, zoning regulations REQUIRED INSPECTIONS
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done in accordance with the plans and PLB. UNDERSLAB
specifications and in compliance with all applicable codes and RAIN DRAINS
ordinances. The issuance of this permit does not waive restrictive SEWER
covenants. Contractor and subcontractors shall have current city STORM DRAIN
business tax permits. This permit will expire and become null and WATER LIME
void if work is not started within 180 days, or if work is suspended or
abandoned for a period of 180 days any time after work has FINAL
commenced. It shall be the responsibility of the permittee to assure
all required inspections are requested and approved.
Permittee Signature
Issued By: CALL FOR INSPECTION 639 -4175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OF TIGARD <
PLUMBING PERMIT 13125 SW HALL BLVD.
P. O. BOX 23397
Applicants must hold Oregon Registration to conduct a plumbing TIGARD, OR 97223
business or must be property owner /operator not hiring outside help.
N ame of Development (503 )639-4175
C:P-,- 2. / Plumbing Permit No / g 0
-
Address Description
_2_5 S7 J. ♦ k? h ORS 814-21 -810 OUAN. PRICE AMT.
Job Tax Lot Map. No. •
Address FIXTURES
Lot Block Subdivision 7
Sink
• Name (or name ofbusiness) Lavatory 7 -50
Tub or Tub/Shower Comb. 7.50
Mailing Address Shower Only 7.50
Water Closet 7.50
Owner City/State rip - --
Dishwasher 7.50
Phone Garbage Disposal _ 7.50
^ Washing Machine •7.50
Name - -"
Floor Drain 7.50
Mailing Address Phone Water Heater 7.50
Laundry Room Tray _ 7.50
Occupant City /State ZIP 7.50
Urinal _
Name Phone Other Fixtures (Specify) 7.50
7.50
Mailing Address Phorie 7.50
Contractor City/State ZIP 7.50
MISCELLANEOUS
City Bus. Tax No. Sewer 1st 100' 30.00 3 0
State Bld9s. Board . State Plumbers Bus_ tic. No. Sewer -ea- Addit- 100' 15.00 / S
(Residential) Water Service 1st 100' ' 17 ° / 20.00 0
I hereby acknowledge that I have read this application. that the information Water Service ea. Addit' / 15.00 l
given is correct, that I am registered with the State Builders Board, and also - Storm & Rain Drain 1st. .100• 30.00
have a State Plumbing license that the numbers given are correct, that all • t 5.00
plumbing work will be done in accordance with app ble provisions of Ore Storm & Pin Drain Addit.100'
gon Revised Statutes Chapters 447 and 693 and applicable codes and that Mobile Home Space 25.00
no help will be employed unless licensed under ORS 693. Of exempt from
State registration, please give reason below). Back Flow Prevention / 7.50
owner 7 517-
Device
HOMEOWNERS - I hereby certify that I am the owr of the property de- or Anti Pollution Device
scribed above, at which location I propose to make a plcmbki0 installation for My Trap or Waste Not
my own use and this property is not being constructed for sale. lease or rent Connected to a Fixture 7.50
•
Catch Basin 7.50
P. of Exist. Plumbing 40.00 Per Hr.
Specialty Requested Inspections 40.00 Per Hr.
Alter. of Plumbing within
an Existing Bldg. 15.00 min.
AUTHORIZED SIGNATURE Date New Bldg. or Build. Addition 25.00 min.
Rain Drain, sirxile faanly.. .
Describe work new ❑ addition ❑ alteration ❑ repair ❑ d ellirg 15.00
• be done residential • non-residential •
6dsting use of ) �z
bulldrq or l property SUB -TOTAL
y cY
b�x Lute of 5 $ SURCHARGE
orptoperty 25% PLAN REVIEW 2 / 8B
• This pan m
idt becomes null and void* work or construction authorized is not corn TOTAL .1/ 3 7 -4.
m wtltiln too du i, or W construction or work is *impended or abandoned for
• period of 180 days at any fkne alter work Is commenced.
11 ClAL OONomT10Ns .
Date issued by
c P L /C/2 2/8
UT I F I ED SEWERAGE AGENCY OF WASHINGTON COUNTY
FIXTURE UNIT RATING-5
6/d, 77- gh e l /22C 111i TOTAL TOTAL
FIXTURE VALUE S/_ c%/ d /S CII7L I ``L ai-/ i9 NUMBER NUMBER r
RAPT 1 STRY /FONT 4 � I 51.900 — I
BATH - TUB /SHOWER 4
- JACUZ /RHPL 4 I
CUSPIDOR /WATER ASP 1 I
D 1 ASHER - COmmER 4 I
DOMEST 2 I
DRINKING FOUNTAIN 1 / /1
FLOOR DRAIN - 2 INCH 2 I z /4 I 1/ Z.
- 3 INCH 5 /4 I
- 4 INCH 6 I I
GARBAGE DISPOSAL
- DOM (TO 3/4 FP) 1 6
- COMM (TO S HP) 3 2 I 1 __
~ - I ND (OVER 5 HP) 48
OIL SEP (GAS STA) 6
SHOWER - GANG 1 I
- STALL 2 - I - 1
SINK - BAR. 2 7 7 //4 1 -z/ .
- BRADLEY S
- CCMMERCIAL , 3
- SERVICE 3 / / / 3
WASHER. CLOTHES ' 6 / .
WATER EXT 6
WATER CLOSET 6 7 7 /4 4 I //6
URINAL 6 l / 10 • 1 .. ....
,F / ><�ufrP C6c,N O / 70 I l
V DU Cnun-74 0 ! `s I I
LEE ,UC/ paid / //6 <5 I I
,5 byte /7e,-, -� 9 92o2 3 st'R90-7/� I 9
if 0 - 03SoI .
(,t S� /�/o, 3 �� {06
2 . 16
DATE /O3 / / I NSP TOTAL
BUS I NESS OSP= 8/0 2.../A = EDU
ADDRESS 72-57 fW / 7 a /� in PERMIT NO.
. COUNTED FROM
TAX MAP /LOT
INSPECTION NOTICE
City of Tigard Building Department l/
P.O. Box 23397
Tigard, Oregon 97223
� Phone: 639 -4175
Type of Inspection V ` ,
Date Requested 1 ( I 1 Tim A.M. P.M.
�j
Address 2 S el c,--/
tv � Permit # 25 Q f ` A
Owner ,t4Agi 2 t D Lot #
Builder
The following Building Code deficiencies are required to be corrected:
f
Presented to ,/� Approved
Inspector ✓// / Disapproved
/ f
Date /: I `y '/(.— / /p `
v CALL FOR REINSPECTION
❑ YES ❑ NO