Permit CITY OFTIGARD • •
•
, DEVELOPMENT SERVICES PLUMBING PERMIT
���j . PERMIT #k.......: PLM97- 0412
13125 SW Hall Blvd., Ti Tigard OR 97223 503 639.4171 DATE ISSUED 11/05/97
PARCEL: 1S136CD -CARTY
SITE ADDRESS...: 11710 SW PACIFIC HWY
SUBDIVISION--; ZONING: C --G .
BLOCK...........: LO "f....., ..... . • JURISDICTION: TIG '.
CLASS OF WORK.. ;NEW 'GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: rZr .
TYPE OF USE..:. :COM WASHING MACH 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY ORP.. :B FLOOR DRAINS......: 0 TRAPS..............: 0
STORIES......... 0 WATER HEATERS...... 1 CATCH BASINS........ 0
FIXTURES•_..-- _.____.- - - -___ LAUNDRY TRAYS.....: 1 SF RAIN DRAINS.....: 0
SINKS 1 URINAL_.S...... ..... . 0 GREASE TRAPS........ 0
L_.AVATORIES.... 2 OTHER FIXTURES.....: 0
TUB /SHOWERS...: 0 SEWER LINE (ft),. .: 0
WATER CLOSETS.: WATER ' L I NE (ft) ...: 100 '
DISHWASHERS ° 0 RAIN DRAIN (ft)...: 0
Remarks: Plumbing permit for 5,864 sq. ft. retail building
Owner ----- -------- --- • - - - -•- - - - --
CAR TOYS type amount by date ,recpt
• 1 SW PAS^, FIf" HWY. _ . • PRMT $ 93,00 S 1-1-/.05/97 97-300r-
T I CARD OR 97223 5PCT $ 4.65 B 11105/97 97 3006B6
Phone •#k: _
Contractor -- -- --- ._.--- -___.- _ - -_-
TRI COUNTY PLUMBING CO
10835 SE 242ND AVE •
GRESHAM OR 97080 __ ------- .____.______..._._ . .- ..------ •----- ._.__.._..__.._
Pb on e #: 503-658-7773 7773 $ 97.65 TOTAL
Reg #..: 000607
REQUIRED INSPECTIONS -----
This peroit is issued subject to the regulations contained in the . Rain Drain Insp —
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Line Insp __—
applicable laws. All work will be done in accordance with PLM /Underf I oor — .
approved plans. This peroit will expire if work is not started Top -out Insp
within 18�J days of issuance, or if work is suspended for Dore Misc. Inspect ion .
• than 180 days. • ATTENTION: Oregon law requires you to follow rules Final Inspection . _
adopted by the Oregon Utility Notification Center. Those rules are -.—•_—
set forth in OAR 952 -00Zi -0010 through OAR 952 - X01- g''�80: You Day ____
obtain copies of•these rules or direct questions to OUNC by calling _
(L03)246 -138 r -' - ,,fr, . .__.__ ___ _____ , / 40 PF . . .
Issued By: Permitb Si nature; (140(
ti : -.. 7 :--r-•r-'r'F•ti-i°- •i••-F- -1-•i-•i-i--r--r ri-•f -r..-}. ..{.- r... t-+++- r...}- 1-- i-° F• i-+-h-r-+..F.i-i--r--r--r-++ -F-r-++-4 -1--r--F +-F-h .-4-.+++-1--1-4.-1-++++
Call 639-4175 by 7 :00 p.m. for an inspection needed the next Jusiness day
-F• -•-0 --r- + +v$•-H-I--F..F.F...1...{.. .._r- i- Jr• 4-- r--r-++-:-•y'--r--r-•f--i...f i-•i-•i-•i-+••'r•+-S-i-+_ .. }.k.+ ; -r--Fi--r--l-^1.-:•-r--1-++ - r--F-'r•'r';--1-+•d-f-F•a•- +-' t- 1-.r--}-+ +
CITY OF TIGARD Plumbing Application Rec'd B '
131 SW HALL S HALL BLVD. Commercial and Residential Date Recd //)6 ��
TIGARD, OR 97223 Date to P.E.
(503) 6394171 Perm t# ST
Print or Type Related SWR # L�tiq1� dI - D -- f
Incomplete or illegible applications will not be accepted Called I o - 13 'A7
Name of Development/Project On back Indicate Work Performed by fixture.
Job ('DR 7(n / - FIXTURES (Individual) . QTY PRICE AMT ..
Address Street A Suite Sink ' 9.00 0 1
f !" j < L r ( Lavatory 9.00 0
�17�cJ
I9I g # City/ to Zip44611-
Tub or Tub /Shower Comb. 9.00 , A
r/ t NantShower Only 9.00
Nam � / Water Closet 9.00 I (�
Owner Mailing Address / Suite Dishwasher '
9.00
Garbage Disposal 9.00
City /State Zip Phone Washing Machine 9.00
Name Floor Drain 2 9.00
3' 9.00
Occupant Mailing Address Suite
4' 9.00
City /State Zip Phone Water Heater 0 conversion 0 like kind / 9.00 4
Laundry Room Tray / 9.00
Na� / I / Urinal 9.00
r,-/ ( X
r,?G(/d Pzj ( Other Fixtures (Specify) 9.00
Contractor Mailing Addr s y,i ,� / Suite 9.00
li� (2' 9.00
Prior to permit pi ZiFF��yy P o issuance, a copy +� N /�� � i? �� 9.00
of all licenses am Co �Cogt. Board Licit Exp. Date 9.00
required if a 7 Sewer - 1st 100 30.00
expired in COT Pluming Lic. # Exp. Date
database Z 6 x-0 -2 3 p B. Sewer - each additional 100' 25.00
Name Water Service - 1st 100' / 30.00
Architect Water Service - each additional 200' ( 25.00 i 1,
Or 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 0 Addition 0 Altera ion 0 Repair 0 Pollution Device
to be done: Residential 0 Non - residential Residential Backflow Prevention Device* 15.00
Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00
Catch Basin 9.00
Insp. of Existing Plumbing 40.00
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
budding or property
QUANTITY TOTAL
I hereby , ckno I • g - t at I have read this application, that the information Isometric or user diagram is required if Quanity Total Is > 9 .•
given i correct, •. at - 'the owner or authorized agent of the owner, and *SUBTOTAL
that �'? ns sub ,. itte - e in compliance with Oregon State Laws. �3 05 Sig � ure o r` •• gent Date 5% SURCHARGE • /0 _ PLAN REVIEW 25% OF SUBTOTAL 1I 16 tact P a me Phone
Required only if fixture qty. total is > 9
7 OF , RD �5� - �23 TOTAL 617-/. (l+t~i
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow `J
Prevention Device, which is $15 + 5% surcharge
1: dststplmapp.doc 5197
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
Capped / Removed Moved Replaced
•
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I9dstMMptmapp.doc 5/97