Permit PLUMBING PERMIT
CITY OF TIGARD DATE PERMIT I SSUED: 04/08/96 -0V
COMMUNITY DEVELOPMENT DEPARTMENT
PARCEL: 2S 1 i 2DA -00400
S I Trel5DDRESS d ; TIgerd,e tego r5 s 720...
a REDWOOD �LN *105
SUBDIVISION ° ZONING: I —P
BLOCK LOT •
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP.•:22 FLOOR DRAINS 0 TRAPS : 0
STORIES • 2 WATER HEATERS • 1 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS : 0 SF RAIN DRAINS • 0
SINKS • 1 URINALS 0 GREASE TRAPS • 0
LAVATORIES • 0 OTHER FIXTURES ° 0
TUB /SHOWERS ° 0 SEWER LINE (ft)...: 0
WATER CLOSETS..: 0 WATER LINE (ft)...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Tenant improvement — Cirrus Logic. Install one sink and one water heate
r.
Owner: FEES
PACIFIC REALTY ASSOCIATES type amount by date recpt
15350 SW SEQUOIA PKWY #300 PRMT $ 25.00 JSD 04/08/96 96 -277934
5PCT $ 1.25 JSD 04/08/96 96- 277934
PORTLAND OR 97224
Phone #: 624 -6300
Contractor:
DEAN WARREN PLUMBING
3111 SE 13TH
PORTLAND OR 97202
Phone #: 236 -4152 $ 26.25 TOTAL
Reg #..: 000172
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Rough—in Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM /Underfloor
applicable laws. All work will be done in accordance with Top—out Insp
approved plans. This permit will expire if work is not started Final Inspect ion
within 180 days of issuance, or if work is suspended for more
than 180 days.
Permittee Signature:
Issued By. .
Call for inspection — 639 -4175
I
City bf Tigard P BING PERMIT APPLICATION Planck/Rec. #
• 13125 SW Hall Blvd N c o� 10 0fr ((P ( q� c1 G oil Permit #1 QG ' ooe
Tigard, OR 97223 0 � V 51 5,�,2 9C-0 ictf
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
wma °'"'°"""
°'d New Single Family Residences Only
C iRRv&S 1-n -( C■
5 eT ( o5 ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE:$195.00
Job fro (O S p Sw R. E� w - 1 - �)},.' F • ❑ 3 BATH HOUSE $225.00
Address Grow. Fee includes all plumbing fixtures in the dwelling and the first 100 feet
77 -(-f -P-d of water service, sanitary sewer and storm sewer. See fees below.
No"" (of po of °ioi""r FIXTURES QTY PRICE AMT
/ n / A G - l.A ST Sink I 9.00 9 12
1 t.''"0 Adams A ' °" ' Lavatory 9.00
Owner ) 53 5Q S w SE4 u0; A- Pktjv Tub or Tub/Shower Comb. 9.00 .
crynk • 4 1✓ Shower Only 9.00
7-/ GAA>2 _ / Stn tT 300 Water Closet 9.00
Nun. to Nom of aa.wq Dishwasher 9.00 ` " u O4:
Garbage Disposal 9.00
Occupant ". a ,,
Pbals Washing Machine 9.00
Floor Drain 9.00
cnis 4 Water Heater j 9.00 ci °U
Laundry Room Tray 9.00
"""' Urinal 9.00
.' -' ( )Pr " t'JA1rrv2Edv P� E6--, Other Fixtures (Specify) 9.00
/ Yam n°°«a Pear 9.00
Contractor
3111 s..E. 1 3 6 " R3 & -y( 9.00
.. tl �/ c.o.. AI 9.00
Pn RT1-.,4 vv 4 Sewer 1st 100' 30.00
Sim ""'°'°°" N0• City es T� Na Sewer - ea. AddiL 100' 25.00
99(og3 NQ , ( - e 01 i a 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
Back Flow Prevention
Device or Anti - Pollution Device 9.00
c.o.. (......9..0 Deis My Trap or Waste Not
Connected to a Fbdure 9.00
Describe work new )° addition Q alteration 0 repair Q 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 Rain Drain, single family dwelling 30.00
building or property
Residential backfiow prevention
devices 15.00
Proposed use of
ouilding or property
'(Except residential bac/dlow
prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL Dj
PERMITS BECOME VOID IF WORK OR CONSTRUCTION ,S
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE • i CC
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL 'j6'. S )
Special Conditions -
Date issued by
enant Name: C. S ` Z Accumulative Sewer Tally This SWR# Co - 0 5
� A d dre ss: (,, ('AZ ' S,4 /eJ.- n'zvr/ L_.. - This PLM #: -0 •
-
Fixture Value Previous # Previous Credits Capped Fixtures Fixtures New New
Value Capped off value added # added total Is total
Count off #s count value values
Baptistry /Font 4
Bath - Tub /Shower 4 / l i / /
- Jacuz/Whpl 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1 -3 I '
Dishwasher - Commer 4 / a
- Domest 2
Drinking Fountain 1 3
Eye Wash 1 ,
Floor Drain /sink - 2 inch 2 U% / c'
- _ (-- / L
- 3 inch 5
- 4 inch 6
- Car Wash Drain 6
Garbage Disposal 16
- Dom (to 3/4 HP)
- Comm (to 5 HP) 32
- Ind (over 5 HP) 48
Ice Machine /Refrigerator Drains 1
Oil Sep (Gas Station) 6 -
Recreational Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2
Sink - Bar /Lavatory 2 / (o - 3 E /(n 3
- Bradley 5
- Commercial 3 ` T / 9 27-
i r
- Service 3
Swimming Pool Filter 1
Washer, Clothes 6
Water Extractor 6 Cr /
Water Closet, Toilet 6 / r (' 1 tC -, / q / �
Urinal 6 (n --- c(/' [ — 3`°
TOTALS ---91c7
- e2 V
Total fixture values:.- - divided by 16 = 31 v = 1 `( EDU ._ I—' " C ` y °ls
HISTORY
/ 0 PL M# 9 M# ' - 00 / ( SWR# QCr- el °s" PLM# n`' - O c `' 3 EDU #I 2 SWR# qS - a 3 90
9 PLM# c)`' "03 7 ; EDU# SWR# 9S —077.7 PLM# -01 EDU# /O. SWR# -
PLM# q`' -o 'EDU# / 3 SWR# S`7 -GV9v PLM #q`' - / EDU# / / SWR# 9S -C 3('? v
PLM# g' 5.-- v3/ EDU# / 7 SWR# 9 -o/c./, PLM# c ? 5 vvcEDU# // SWR# 'PL' - G'jL 3
11og,nq oun$w■ui 2
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -41
Footing Rain Drain Cover /Service iir INAL:
Foundation Water Line Ceiling -
Post/Beam Mech. Shear /Sheath Framing . 41120
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. . -Bldg.
San Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: /,`2196 A.M._eP.M. En �
Address: .6 Ag /At►
Tenant: !, /dff / k MST:
BUP: Q6 Off
Con/Own i /G /leE4( 4C MEC:
PLM: f6-c.67
ELC:
THE FOLLOWING CORREC REQUIRED: ELR:
Q ., rJ� /f- - / •`
Inspector: ' 1. Date77 7
_ROVED _ DISAPPROVED /CALL FOR REINSP. CF CO