10130 SW NIMBUS AVENUE BLDG D STE 1 i
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10130 SW NIMBUS AVE D1
(IFITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd.,llgard,OR 97223 (503)639- 171 PERMIT SUED: 05 5/97PLM9 - 0155
DATE ISSUED: 05/0!5/97
PARCEL: 1S134AF,-01800
SITE ADDRESS. . . : 10130 SW NIMBUS AVE #D-1
SUBDIVISION. . . . : 1 KN01_L. BUSINESS CENTER TIGARD ZONING: I—P
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :2 JURISDICTION: TIG
----------------------------------------------------------------------------------
CLASS G1�7 WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :COM WASHING MACH. . . . . . : 0 BACKFLr ' PREVNTRS. . : 0
OCCUPANCY GRP. . :B FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . .. 0 URINALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 2 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : SEWER LINE (ft) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DISHWASHEP .. . . . : 0 RAIN DRAIN (ft) . . . s 0
Remarks : Install '-'wo lava
Owner: --------- -------------------------------------- FEES ----------- - --
FORUM PROPERTIES type amoun.. by date rer_pt
PRMT $ 25. 00 DRA 05/05/97 97-294158
T'IGARD OR 97221, 5PCT t 1. 25 DRA 05/05/97 97-294158
Phone #:
Cont ract or--------- - __.-----------------_---
UNIVERSAL PLUMBING
10928 SW 49TH AVENUE
PORTLAND OR 97219 --•----------------------------------__--
Phone #: 503-452-7480 $ 26. 25 TOTAL
Reg #. . ; 0011 ].
----- -- REQUIRED INSPECTIONS --------
This pereit is issued subject to the regulations contained in the Top—out In!sp
Tigard )lunicipal Code, State of Ore. Specialty Codes and ill other Final Inspection
apniicable laws. All work will be done in accordance with _-
R approved plans. This peroit will expire if work is not started
within 199 days of issuance, or if work is suspended for sore
4 ' than 1941 days. —
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m Permitte Sign tune: --�. --
L1J
-J T s s o_i e d y
Call for inspection — 639-4175
ATY OF TIGARD plumbing Application Peca By
:1?.5 SW HALL BLVD. Commercial and Residential Cale Reca
�GiARD• OR 97223 C.ue to P e
i�—"
303) 639-4171 Catn ro D
Prnrma■
Print or Type Re,aten:SwR a
Incomplete or illegible applications will not be accepted Called r- -
- pm
Ce
me of vetoenvProlea FIXTURES QTY
(I lividuai) PRICE AMT
tj b Mpg 5 e,Aro p Sink - 900
Address 5�'eel AddressSuite Lavatory 900
oQ��''^''•
rue or runishower Ca-D
900
9 :,Iyi51 9�j Shower Only _
i ovr� 9 00
Name/ Water Closet 9.00 __ J
Dishwasher 9.00 j
Owner madmg Address Sint Garbage Disposal 900
L'Z Washing Macrame 9
�.ry gate Lp Phone 00
f=lpor Uram
2 900
Name J'
900
900
Occupant Mailing address Suite Water Heater9 00
_ Urinary Roeln Tray 9 00
CafyrStats Zip Phone
Umar
900
Name Other Fixtures(Sotafyt 9.00
U vS9 (0 �
htaili Address �9 9.66 i
ontractor supe –
9.00 I'I
'ror t0 Issua%„ 1g1121 g.00
acclicant mutt l ZIP Apne
P9.00
�fS� ?ygU
aravlae all Oregon Co Cont.Board Lic.11 Exp. Oat* 9.00
contrac:ors - j
license Plum LiC.t� �3 S ' 5?;?
L.00
SExp Oate Sewer-tsl too'
nformauon -� `C.or CCT COT Business Tax or Metro a Exp Onie Sew*r"each adaibonai 100' 25.00
aatabase). !�/ Water Service- tat 100•
30.00 i
Name !Toler Senna-each additional.00' 2&00
Architect /� Storm 3 Rain Drain- 1st too-
30.60
Ar Mailing Addles Sun* Storm S Ran Oram-each additional 1CC- 25.00
Moble Home Space 25.00
Engineer Citylstale Zip Phone Zarrmereat Back Flow Pr*ventk-Cevlc*or Anb-
Polh.iDon Device 23.00
escnbe work New AAddition J Alteration C Recan C I �^s`denttrl 9ack!low-revent,on Cevree• 1--
1 re none. Residential o Non-residential J I 1500
any Trap or Waste Nct Connectea 10 a Fixture 9 00
�':Cnal OesCnpbpn Of wort( — i
Catch'3asm -
d nSr.or exUbnq i-umomq Q00
Fx
U) s00
ng use ro Soe tslly Rsguested Inspections 40.00
c:ng or property per.hr
- Pan Crain.single.'amily dwelling �— JO JO
J :_o pd ;r of Groase Tro s
^mg or property_ p 9.00
ED
_
�7 - QUANTITY TOTAL I d
-j a s o*bac moving reolac,ng any fikturss7 ver` No] Isorrssrc ter 0-sq an s seu►sd f c„ar,ity row s ,i
� /ea see back of ft•rml 'SUBTOTAL
e-eoy acknowledge Iha, save read:hls application.that the information _
13 Corea that I am n cwner or authonzed agent of the owner and 5%SURCHARGE
I:clans submitted are _cmaliance with Ore on State Laws. .
gnature o w nAgen)r - —`- Oat* PLAN till 35!4 OF SUBTOTAL
jp� _9 �.pn,.,a�,h,f i tura W al
TOTAL
=onact on Name Phone L—
I t
Minimum permit fees 325-S'4 surcharge ex,.-,t nsslaenn Bsckfl
P"evennnn peNp wnk:t is S15•5%sure* .9e ��
j'dsts almsop doc sof
Jo �s�- 3376, .___
LEASE COMPLETE AS APPROPRIATE I -----OJ.ECT:
Fixtures to be capped. moved or replaced Qty
Sink
Lavatory
Tub or Tub/Shower Combinat,on
Shower Only _
Water Closet
Dishwasher —
Garbage Disposal
Washing Machine
Floor Drain 2"
-- 3.,
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
OMMENTS REGARDING ABOV
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
/ 1
Date Requested: ,— A.M. ✓ P.M. _ MST:
Lcxation:-- �_'-' '�15�_ �.cC_ L}Z'� _ BUP:
Tenant: �-J _ Suite:- —Bldg: NEC:
Contractor: I'
----- I'lione: PLM: J,'
Owner: } Prime: ELC:
�— -4 J�.1 — _ ELR:
SCP:
BUILDING BLDG(coni) Uo X MECHANICAL ELECTRICAL SI E
site Post/Hearn Post/Bearn .over/Service Sewer/Storm
Footing Roof UndFl/Slab Roo,-�do Ceiling Water line
Slab Framing Top Chit (las Line Rough-in UO Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
i3smt Damp Drywall Storm Furnace Temp Service MOC.
Masonry Ceiling Rain Drain A/C UO Slab
Shcar/Sheath Fire Spklr/Alm CrawVFound Dr Heat Pump Low Volt
Approved Approved Approved Approved -
Appr/Sdwlk Not Approved ved Not Appmved Not Approved Not Approved
FINAL FIN FINAL FINAL FINAL
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n Call for ion O Reinspection fee of S_ —req 'red before next inspection n Unable to inspect
Inspector: — Date: Page _of_
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