Permit CflYOFTIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PLUMBING PERMIT
PERMIT . PLM95 -00 143
639 -4171 DATE ISSUED: 06/22/95
PARCEL: 1S1260C- 01107
SITE ADDRESS...: 09637 SW WASHINGTON SQUARE RD
SUBDIVISION ° ZONING: C -G
BLOCK.... ...... ° LOT
CLASS OF WORK.. : TE_N GARBAGE DISPOSALS..: MOBILE HOME SPACES.:
TYPE OF USE -COM WASHING MACH ° BACKFLOW PREVNTRS. ° :1
OCCUPANCY GRP ° ° :B2 FLOOR DRAINS :4 TRAPS
STORIES °1 WATER HEATERS °1 CATCH BASINS
FIXTURES - LAUNDRY TRAYS SF RAIN DRAINS
SINKS °5 URINALS GREASE TRAPS
LAVATORIES.. °..: OTHER FIXTURES °
TUB /SHOWERS SEWER LINE (ft)
WATER CLOSETS..: WATER LINE (ft) °
DISHWASHERS RAIN DRAIN (ft) •
Remarks: Food Court Restaurant
Owner: -- FEES
SBARRO - type amount by date recpt
9637 PRMT $ 99.00 JDA 06/22/95 95 --
SW WASHINGTON SQ. RD. PI_CR $ 24.75 .JDA 06/22/95 95---- - - - ---
TIGARD. OR 5PCT $ 4.95 JDA 06/22/95 95 -- - --
Phone i#:
Contractor: - -•- • -•-
NATIONAL ELECTRICAL SERVICES
25432 74TH AVENUE
KENT WA 98032 - - -- - - - - - --
Phone #: 206 -850 -1616 $ 128.70 TOTAL
Reg #° ° : 37605C
-- - - - - -- REQUIRED INSPECTIONS -- - - - - --
This peroit is issued subject to the regulations contained in the PLM /Underfloor
Tigard Municipal Code, State of Ore. Specialty Codes and all other Top -out Insp
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This peroit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for pore -
than 180 days.
Permittee Signature:
4
Issued By: ,'- 0
Call for inspection - 639 -4175
•
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125:,SW Hall Blvd. Permit # �S� -O/ - c
Tigard, OR 97223 ed 15
(503) 639 -4171
•
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name of Devakerme New Single Family Residences Only
&M he wg TO is.) s' Address Aess ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job
96, 3 / lciy4S II Cc la d ❑ 3 BATH HOUSE $225.00
Address ce,,rs.ta ao Fee includes all plumbing fixtures in the dwelling and the first 100 feet
j 1 G b /L. fr2 d_ ' 72 2- 3 of water service, sanitary sewer and storm sewer. See fees below.
Name for none of Busmen) FIXTURES QTY PRICE AMT
Sink S 9.00 4 -f3
Meting Addresa Pens Lavatory 9.00
Owner Tub or Tub /Shower Comb. 9.00
C"'"s'a'a zip Shower Only 9.00
Water Closet 9.00
Name (or name of tlgness) Dishwasher 9.00
- F3A K 00 ceJ 1 ` Z z _ r 4 Garbage Disposal 9.00
Occupant Men Addrev Phone Washing Machine 9.00 b
9 (.i ( Wf S k sq. /2 d_ Floor Drain `i 9.00 ,4,-4
r;Zi cawsami 1 a Water Heater I 9.00 q
`T ,- ( v¢ K a_ 977 Z '3 Laundry Room Tray l 9.00
Name Unnal 9.00
A v '-L PLO »t b (C' th 5+ -��'eg ,) Other Fixtures (Specify) 9.00
Malang Address l v"ene 9.00
Contractor l
cy 74 4 S 9.00
Gty,St.te ro 9.00
Xe►T er1 n-03 Sewer 1st 100' 30.00
State Ra N0. G ^' eus a i i Sewer - ea. Addit. 100' 25.00
e92 3 9 PLA b 37- 3y1 e!3 6-0 Water Service 1st 100' 30.00
I hereby acknowledge that I have read 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
.‘.4-- Back Flow Prevention
� 4/ �� Device or Anti - Pollution Device ( 9.00 q
*mature (water or agent) /1 e Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new addition, ' alteration 0 repair 0 Catch Basin 9.00
to be done residential 0 non - residential 0 Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr
Existing use of
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of
building or property
'(Except residential backflow
/�2 prevention devices)
C A ju b lA -K NOTICE (9361' 2 2 '? $ 'Minimum Fee $25.00 SUBTOTAL `'_ a
PERMITS BECOME VOID IF WORK OR CONSTRUCTIONS
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
. _ FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS L`
COMMENCED PLAN REVIEW 25% OF SUBTOTAL e? /
TOTAL
/c.
Special Conditions
Date issued 6 by ('/-.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4 1
Inspection:
Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough -in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing Ci
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. - Elect.
Date Requested: 7 /p— ( 5 Time: AM AM PM
Address: �G ,3 7 �J - , S6 im
Builder: (..o 39 - 3 O Zc" Permit #1 O /q3
THE FOLLOWING CORRECTIONS ARE REQUIRED:
---- , X
. ; . . „ . . . .• r . 0 . r
In pector:�� Date: /l7j1t
� ` _ PROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.