Permit CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
PERMIT # - PLM98 -0056 l,L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 04/17/98
PARCEL: 1S134BC -00600
SITE ADDRESS...: 12390 SW SCHOLLS FERRY RD
SUBDIVISION MLP93 -0006 ZONING: C —G
BLOCK LOT •002 JURISDICTION: TIG
CLASS OF WORK..:NEW GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 1
OCCUPANCY GRP..:B FLOOR DRAINS • 1 TRAPS : 1
STORIES • 0 WATER HEATERS • 1 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: Plumbing for a new 1,948 square foot automated car wash facility.
Application amended by PE off the BUP plans.
Owner: FEES
THOMPSON /DAVIDSON LEASE type amount by date recpt
12475 SW MAIN ST PRMT $ 79.00 DLH 04/17/98 98- 305017
TIGARD OR 97223 5PCT $ 3.95 DLH 04/17/98 98- 305017
Phone #:
Contractor
WESTERN PLUMBING
9460 SW TIGARD STREET
TIGARD OR 97223
Phone #: 503- 639 -5296 $ 82.95 TOTAL
Reg #..: 000024
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Sewer Inspect ion
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Service I n
applicable laws. All work will be done in accordance with Rough —in Insp
approved plans. This permit will expire if work is not started PLM /Underf 1 oor
within 180 days of issuance, or if work is suspended for more Top —out Insp
than 180 days. ATTENTION: Oregon law requires you to follow rules Final I n s p e c t i o n
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952 -0001 -0010 through OAR 952 -8001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By: Permittee Signature: Aic /
I
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + ++ + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CiTY a TIGARD Plumbing Application
Vt � Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd 2 2,
IGARD, OR 97223 Date to P.E.
Date to D T
503) 639 -4171 Permit # ° CM '
Print or Type Related SWR # it • - , S
Incomplete or illegible applications will of be accepted Called
Name of Development/Project On back Indicate Work Performed by fixture.
Job ge /A - 7 X 70/ FIXTURES (Individual) • - . QTY PRICE AMT
Address St e /,dddr.ei, Suite Sink 9.00
/ U J79 Lavatory 9.00 /...---
Bldg # Ci tate IP Tub or Tub /Shower Comb. 9.00
' N • rel5 �� Shower Only 9.00
4 , 0 j(// 2 Water Closet 9.00 y�
Owner Mailin A dr Suite Dishwasher 9.00
X24
Ci to Zip Garbage Disposal - 9.00
j 9 7'13 Phone Washing Machine 9.00
Name Floor Drain 2' 9.00
3 , 9.00 9--
Occupant Mailing Address Suite 4' 9.00
City /State Zip Phone Water Heater 0 conversion 0 like kind
/ 9.00 qi
Laundry Room Tray 9.00
' Name �� / Urinal 9.00
��� /J��� ! /�G Other Fixtures (Specify) 1 9.00 Gt i
Contractor M 8 5 / / � / , �„ / � , Suite I .c1 C ( C Or Cu Creln G.e_(ZOr c6r 9.00
Prior to permit C' fate `(/ Ph n 9.00
issuance, a copy -0 j / (�� .r/ /f � Kv��2,3 faw 9.00
of all licenses are 0 rego ns . nt. Board Lic.
required if o�,� Exp. Date 9.00
��p ,/6 -W Sewer - 1st 100'
i database lt expirea in COT PlurirLq Lic. r�� D Sewer - each additional 100' 25.00 '
e DEC/
Name Water Service - 1st 100'
Architect Water Service - each additional 200' 25.00
Of Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00
Storm & Rain Drain - each additional 100' 25.00
Engineer City /State Zip Phone Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00 ��/
Describe work New Addition 0 Alteration 0 Repair 0 Pollution Device
' to be done: Residentia 0 Non - residential 0 Residential Backflow Prevention Device' 15.00
Additional description of work: Any Trap or Waste Not Connected to a Fixture ( 9.00 II
Catch Basin 9.00 I
v
K 1A 1(J n( / 1 , , „ Insp. of Existing Plumbing 40.00
�j L /�J�/�/ per/hr
Existing use of Specially Requested Inspections 40.00
building or property _ per/hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information �'
Isom or riser diagram is required d Ouanity Total Is > 9 given is correct, that I am the owner or .. thorized agent of the owner, and 'SUBTOTAL
that •Tans s bmitte /re in co •Iia / Oregon State Laws. �.
Slgna •�� Date ` ' Y
/' ' 4���, 5% SURCHARGE �r� I
Contact � Person
�t Name
�/ / / /�/f�y / Phone PLAN REVIEW 25% OF SUBTOTAL
I ,E� l!��C.C1.Io • �...� u"J7�+ 6/ 9� �i � Required only A facture qty. total is > 9
TOTAL
'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
I tdststplmapp.doc 5/97
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved • Replaced . Removed /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet X
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater X
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I.ldstslplmapp doe 5197