Permit II CITY OF TIGARD MASTER PERMIT
I • COMMUNITY DEVELOPMENT Permit #: MST2012 -00049
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/28/2012
Parcel: 2S112BCO5000
Jurisdiction: Tigard
Site address: 14880 SW 83RD AVE
Subdivision: LA MANCHA ESTATES Lot: 3
Project: Federal National Mortgage Assn
Project Description: Unpermitted addition
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 412 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0
Detectors: Yes
Total: 412 sf Value: $41,983.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell- Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add'l 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0
Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0
601 -1000 amp: 0 601 +amp- 1000v: 0
1000 +amp /volt: 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet
ADD SF VB R -3 412
Owner: Contractor:
FEDERAL NATIONAL MORTGAGE ASSNOWNER Required Items and Reports (Conditions)
BY RECONTRUST CO
400 NATIONAL WAY
SIMI VALLEY, CA 93065
PHONE: PHONE:
FAX:
Total Fees: $1,891.32
This permit is_issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be do in accorda •: with approved plans. This permit will expire if work is not started within 180 days of issuance, or if w•• sus. - -•ed for more the 180
day ATTENTION: Oregon la. :quirts you to follow the rules adopted by the Oregon Utility Notific •• Center. hose rules ar set forth in OAR
95 - 001 -0010 through OAR + -001-.0's ou may obtain a copy of the rules or direct questions to OUNC by calling •0 2.14 o .801.3 2 344.
Is ed By: 0 K ,i Permittee Signature: !IS
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date. ` sh— r
This permit card shall be kept In a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
• f .CS 1 - V'' ( FOR OFFICE USE ONLY
City of Tigard � Received (o la • Permit No.: ��� T�44.2-o Y 5 -
II
° 13125 SW Hall Blvd., Tigard, OR 972, Plan ■ G . Phone: 503.718.2439 Fax: 503. C' 'J `� Date/ ! I Other permit: 66e016 2 – '
1 Review r
T I G n R D Inspection Line: 503.639.4175 ' - ' % *10 1 Date ReadyBy: 2 /g /� Jas: RI see Page 2 for
Internet: www.tigard or.gov PR i) Notifi ed/Methoa: o � ( Supplemental Information
C !
TYPE OF W (Si �1IXS 7
(i REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ton Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ Wriq aV
❑ Accessory building ❑ Multi- family Number of bedrooms: ((��
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 14880 SW 83 Ave. New dwelling area: If ) square feet
City/ State/ZIP: Tigare/OR/97224 Garage/carport area: square feet
Suite/bldg. /apt. no.: I Project name: Covered porch area: square feet
Cross street/directions to job site: Murdock Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: La Mancha Estates I Lot no.: 3 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: R1244745 Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Unpermitted addition Valuation: $
Existing building area: square feet
. New building area: ' square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: FNMA Type of construction:
Address: 10600 SE Mcloughlin Blvd. #211 Occupancy groups:
City/State/ZIP: Portland/OR/97222 Existing:
Phone: (503)816 -1913 Fax: (503)653 -6801 New:
® APPLICANT ® CONTACT PERSON NOTICE
Business name: Portland Premier Realty All contractors and subcontractors are required to be
Contact name: Cassandra Skelley licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 10600 SE Mcloughlin Blvd. #211 jurisdiction in which work is being performed. If the
City/ State/ZIP: Portland/OR/97222 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 816 -1913 Fax: : (503) 653 -6801
E -mail:
CONTRACTOR
Business name: � - "�.t BUILDING PERMIT FEES*
Address: v `� \ (Please refer to fee schedule)
Structural plan review fee (or deposit):
City/ State/ZIP:
Phone: ( ) I Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
Amount received: 4D—
Authorized signature: 0 .
s Q61 ) 4
This permit application expires if a permit is not obtained
Print name: Cassandra Skelley Date: 03/06/2012 within 180 days after it has been accepted as complete.
y * Fee methodology set by Tri -County Building Industry
Service Board.
l:\Building\Permits\SIT- PermitApp.doc 10 /01/09 440- 4613T(11 /02/COM/WEB)
Electrical Permit Application _ V FOR OFFICE USE ONLY
City of Tigard - � , ' t Da e � e17M "l a
Permit No.: p 2 -
II 11
13125 SW Hall Blvd., Tigard, 0 ..,) .so, z - tew
<
C Phone: 503.718.2439 Fax: 503 1960 % 10, Date/B v
Other Permit:
Inspection Line: 503.639.4175 nn� Date Ready/By: Suds: El See Page 2 for
TI G A It D A N Notified/Method: Supplemental Information
Internet: www.tigard- or.gov `t` O � , �G� lA pp
TYPE OF Waft, Gp`` 1 PLAN REVIEW
❑ New construction ® Addition/atte.:. >$ Wlacement Please check all that apply (submit 2 sets of plans w /items checked below):
'■•. ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E °, "1 -2 °, "1 -3 ",
Job no.: Job site address: 14880 SW 83 Ave. toolrP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard/OR/97224 ❑ Healthcare facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Murdock Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: La Mancha Estates Lot no.: 3 1,000 sq. ft. or less 168.54 4
Tax map/parcel no.: R 1244745 Ea. add'l 500 sq. ft. or portion 33.92 1
Limited energy, residential
sq. 75.00 2
DESCRIPTION OF WORK ( with above 9• ft. )
Limited energy, multi - family 75.00 2
_ Unpermitted addition residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
14 W V l (' 1) P 200 amps or less 100.70 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
Name: FNMA 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 10600 SE Mcloughlin Blve. #211 Over 1,000 amps or volts 552.26 2
City/State/ZIP: Portland/OR/97222 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)816 -1913 Fax: (503)653 -6801 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits – new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
® APPLICANT ® CONTACT PERSON above service or feeder fee,
7.42 2
each branch circuit
Business name: Portland Premier Realty B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Cassandra Skelley branch circuit
Each add'I branch circuit 7.42 2
Address: 10600 SE Mcloughlin Blvd. #211 Miscellaneous (service or feeder not included)
City/ State/ZIP: Portland/OR/97222 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: (503) 816 - 1913 Fax: : (503) 653 - 6801 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: cassandra1127 @msn.com Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: I J A JA 1 " panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18 / hr
Phone: ( ) Fax: ( ) Inspections for which no fee is I rf'✓
specifically listed (% hr min) 90.00 / hr � (f ....../
CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEE S
Suprv. Electrician signature, required: Subtotal: cf d
Plan review (25% of permit fee): —
Print name: Date: State surcharge (12% of permit fee): (0 )2.1--
•
TOTAL PERMIT FEE: (00 _In)
Authorized signature:
This permit application expires if a permit is not obtained within 180
•
Print name: li�T/] {4 ff kopo ( ki / ( ! Date: days after It has been accepted as complete.
Number of inspections allowed per permit.
\
I:Building \Permits\ELC- PermitApp.doc 07/01 /10 440- 4615T /05 /COM/WEB
Mechanical Permit Application \ I t: , FOR OFFICE USE ONLY
r
City Tigard Ti and Received o "
Date/B : 6O /,- •' Perm No.: 175���� — /
■ C a 13125 SW Hall Blvd., Tigard, OR 97223 `IAA. ' L O�� Plan Review
Phone: 503.718.2439 Fax: 503.598.19601' D. t e/B y . Other Permit:
Inspection Line: 503.639.4175 `
T 1 G A R D p Q pP� GR• 2 Ready/By: Juris: El See Page 2 for
Internet: www.tigard- or.gov 4 \ >,\ 5 %
��� .01�• % • otifed/Method: Supplem Information
AsL TYPE OF WORK C COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
'� � Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For spedd information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. J Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 14880 SW 83d (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/ State/ZIP: Tigard, OR 97224 Furnace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Murdock Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: La Mancha Estates Lot no.: 3 Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: R1244745 Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
Non permitted addition
r Flue vent for water heater or gas
e 014 -�" fireplace 23.32
t 14 Log lighter (gas) 23.32
ff �e y Wood/pellet stove 33.39
316111411 Wood fireplace/insert 23.32
® PROPERTY OWNER ❑ TENANT Chimney/liner /flue/vent 23.32
Other: 23.32
Name: FNMA Environmental exhaust and ventilation:
Address: 10600 SE Mcloughlin Blvd. #211 Range hood/other kitchen
equipment 33.39
City/ State/ZIP: Portland OR 97222 Clothes dryer exhaust 33.39
Fax: 503 653 -6801 Single -duct exhaust (bathrooms,
Phone:
(503)816-1913 ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ® CONTACT PERSON Attic/crawlspace fans 23.32
Business name: Portland Premier Realty Other: _ 23.32
Fuel piping:
Contact name: Cassandra Skelley $14.15 for first four, $4.03 for each additional
Address: 10600 SE Mcloughlin Blvd. #211 Furnace, etc.
Gas heat pump
City/ State/ZIP: Portland/OR/97222 Wall/suspended/unit heater
Phone: (503) 816 -1913 Fax: : (503) 653 -6801 Water heater
Fireplace
E -mail: cassandra1127 @msn.com Range
CONTRACTOR Barbecue
Business name: , f Clothes dryer (gas)
""� " -, Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Minimum permit fee ($90.00) £V.-f-
Phone: ( ) Fax: ( )
Plan review (25% of permit fee)
CCB lic.: State surcharge (12% of permit fee) /v
TOTAL PERMIT FEE `,�
Authorized signature: , (� I T his permit application expires if a permit is not obtained within 180
V I days after it has been accepted as complete.
Print name: 0A554 C � — c I Date: 3 /& // Z — • Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 09/09 /10 440- 4617i(1l/021C0M/WEB)
Plumbing Permit Application
Site Utilities roe( orrice.: usE ()Nix
Re ceived / n
City of Ti and G / Permit No.:
g Dat - r j sr 2,_2 9
a 13125 SW Hall Blvd., Tigard, OR 9722 Plan Review
' e Phone: 503.718.2439 Fax: 503.5 *.ii " • 0 \�. Date/By: Other Permit No.:
inspection Line: 503
C. � - Date ReadyBy: Dais: M See Page 2 for
T [GA It D Internet: www.tigard or.gov Q \ Notified/Method: Supplemental Information
TYPE OF WORK } ` O �`S� G � lS�� FEE* SCHEDULE
❑ New construction ❑ Dente re%, For special information use checklist
Vv Description I Qty. I Ea. I Total
IZI Addition/alteration/replacement ❑ Oth jS New I- 2- family dwellings (includes 100 ft. for each utility connection
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
co I. and 2- family dwelling El Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 50032
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler (- sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: l yt, o . � iJ AV Z- Catch basin or area drain 18.76
City/State/ZIP: 7 - 16 . A . 1 , 6 ✓ 97 Z 19 Footing drain line, lior near trench drain 18.76 Page
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: rl ajza Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: _) Page 2
Water service (no. linear ft.: ) I I Page 2
Subdivision: l 1 4 p-N GJJ p i414.T _ 5 I Lot no.: 3 Fixture or item:
Tax map /parcel no.: K �f wi ■ j r / / r ! [ Backflow preventer 31.27
Z P (�, Backwater valve 12.51
DESCRIPTION t CRIPTION OF WORK ([
Clothes washer 25.02
U _.1-t i IT ¢ () �O D [ r] 611..t ��� Dishwasher 25.02
Drinking fountain 25.02
t t Q �i 1I Ejectors /sump 25.02
Ea PROPERTY OWNER I ❑ TENANT 61N Expansion tank 12.51
Name: F N ''1 4 . Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 1 D 6, CO F. (i.GLO1L& l �• 7- UO /
E-4'�- Garbage disposal 25.02
City/State /ZIP: P) rrl J 0 d 2 y7 2 Zz Hose bib 25.02
Phone: ( )$) 2/ to _ / 9 )3 Fax: Q 2 2) 66 - 6 ed / Ice maker 12.51
Fr APPLICANT m CONTACT PERSON Interceptor /grease trap 25.02
_ J C Medical gas (value: $ ) Page 2
Business name: ?o �L{R0�1 n 7 n Q a� I jut �} 7
1� // Primer 12.51
Contact name: DEsl � Roof drain (commercial) 12.51
Address: I bb000 S� 1 -i _6 lit llv 13, U) D //i Sink/basin/lavatory 25.02
City /State /ZIP: PQQ r/ I-N 0 O 17 2_2_2_ Solar units (potable water) 62.54
Phone: (1.2) v 6- - , / p � q i 4 I Fax: : (,b? k) 53 6 W1 Tub /shower /shower pan 12.51
E -mail: r 7 S ■1 AW a 11 27 (Jo h , co / Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: ou velf Water pipe g/DWV 56.29
Address: Other: 25.02
City/State /ZIP: Subtotal 9' , CO
Phone: ( ) Fax: ( ) Minimum permit fee: $72.50
CCB Lic.: dpi ,- Plumbing Lic. no.: Plan review (25% of permit fee) r-- ,
State surcharge (12 %ofpermit fee) (0, g
Authorized signature: �- TOTAL PERMIT FEE ter • gQ
• Print name: �% Date: This permit application expires if a permit is not obtained within 180 days
_ V l � l ��e _ _ / after it has been accepted as complete.
"Fee methodology set by Tri -County Building Industry Service Board.
1:\ Building \Permits\PLMU- PenmitApp.dac 10 /01/09 440- 4616T(10 /O2ICOM/WEB)
III Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. - Fee (ea) Total Square Footage: Permit Fee:
Footing drain - l° 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37 2,001 to 3,600 $169.69
Sewer - 1st 100' 62.54 3,601 to 7,200 $233.20
7,201 and greater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54- Medical Gas Systems:
Water Service - each additional 100' 37.52 -
Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee:
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
Other Inspections or Fees Qty. Fee (ea) Total each additional $ 100.00 or fraction thereof, to
Inspection of existing plumbing or for and including $10,000.00.
which no fee is specifically indicated 90.00/hr $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
(minimum charge - 1/2 hour) each additional $100.00 or fraction thereof, to
Inspections outside of normal business 90.00/hr and including $25,000.00.
hours (minimum charge - 2 hours) $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
each additional $100.00 or fraction thereof, to
Reinspection Fees 90.00/hr and including $50,000.00.
Additional plan review for revisions _ 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum charge - 1/2 hour) each additional $100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees * .
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath - Tub /Shower ❑ Any new commercial building with water service 2" and
lacuzzi/Whirlpool greater, except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918- 780 -0040.
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918 -780 -0040.
Eye Wash
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
4 Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal - Domestic-food related that meet the qualifications above.
- Commercial -food related
- Industrial -food related
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) Comments 'regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav - Non -food related
- Bradley
- Commercial- food related
- Service
Swimming Pool FilWr
washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs, a sewer permit will be issued and
Water Closet - Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
I:\ Building \Permits\PLMU- PermitApp.doe 2