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12700 SW NORTH DAKOTA STREET STE 200 OOZ US 1S MAW HIMON M.S OOLZ6 i i N W F- N H SID F=- 0 Z J S CA 12700 SW NORTH DAKOTA ST STE 200 1 PERMTdTY OAF TIGARD PERMITELECTICAL#: ELC96I0391 COMMUNITY DEVELOPMENT DEPARTMENT DATE I SSUED a 06/18/96 13126 e•#V Hap Nvd.Tigard,Oregon e7229c;.10e (609)en4171 PARCEL e 1 S 133AD-16200 SITE HDDRESS. . . : 12700 SW NORTH DAKOTA ST #200 SUBDIVISION. . . . : MLP94-0013 ZONINGsC—P BLOCK. : . . . . . . . . . LOT. . . . . . . . . . . . . ..003 Project Description: Installing one service or feeder to 200amps and six branch circuits. --------------------------------------------------------------------------------- ---RESIDENTIAL UNIT---- ----TEMP SRVC/FEEDERS---- -----MISCELLANEOUS----- 1000 SF OR LESS. . . . 1 0 0 — 200 amp. . . . . . . 1 0 PUMP. iRRIGATION. . . . e A EACH ADD' L 500SF. . . : n_, 201 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 — 600 amp. . . . . . . 1 0 SIGNAL./PANEL. . . . . . . : 0 IMANF. HM/ SVC/FDR. . !. 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . 0 ----SERVICE/FEEDER----- ----BRANCH CIRCUITS----- ---ADD' L INSPECTIONS--- 0 — 200 amp. . . . . . : 1 W/SERVICE OR FEEDER: 6 PER INSPECTION. . . . . : 0 201 — 400 amp. . . . . . 1 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0 401 — 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC* 0 IN PLANT. . . . . . . . . . . : 0 601 — 1000 amp. . : 0 ------------------PLAN REVIEW SECTION----------------- 10004 amp/volt. . . . . : 0 ) -4 RES UNITS. . . . . . . . : ) 600 VOLT' NOMINAL. . e Reconnect only. . . . . 1 0 SVC/FDR )- 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner: --------------------------------------------------------- FEES ----------------- MAGIC CLEANERS type amount by date recpt 12700 SW NORTH DAKOTA PRMT $ 90. 00 CJS 06/18/96 96-280706 5PCT $ 4. 50 CJS 06/18/96 96-280706 TIGARD OR 97223 Phone #e Contractor: ----------------------.-------------------------------------•------------ ECONO ELECTRIC : 94. 50 TOTAL 54L + N MICHIGAN AVE ------- REQUIRED INSPECTIONS ------- PORTLAND OR 97217 Wall Cover Elect' l Final Phone #: 503-735-4705 Elect' 1 Service Reg #. . : 067212 This peralt is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature applicable laws. All Mork will be done in accordance with approved plans. This pewit will expire if work is no: started within 198 days of issuance, or if work is suspended for Pare than 198 days. Issued By IL -----------OWNER INSTALLATION ONLY----------------------------- R The installation is being made on property I own which is not intended for 9) sale, lease, or, rent. OWNER' S SIGNATURE. DATE:s $_ --------------------------CONTRACTOR INSTALLATION ONLY---------------_---------__ SIGNATURE OF SIJPR. ELEC' N: DATE s LICENSE NO: Call for i n spec.•t i on — 639-4175 _ I.P. Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd, Tigard, OR 97223 Permit # ELI—'q6-O 391 Date Issued E_ I8- 96 Phone (503) 639-4171 ��TY O�TI®Alta FAX (503) 684-7297 TDD No. (503) 684-2772 Inspection (503) 6394175 1. .lob .Address: 4. (Complete Fee Schedule Below: —� Name of Development_—_ o`L Nwnbrr of Inspection@ per prmK sllowed Address 12700 N Dakota ��G� a00 _ Service Included: Items Cost(es) Sum City/State/Zip_Tigard, Ore. 4a. Residential -per unit 1Gn0 sq. ft. or less $110.00 4 Name (or name of business)_jia 1_c,, Cleaners Each addNla,d 500 or n.or Portion thered $26.00 Commercial IrJ Residential ❑ LIrMed Energy $26.00 — 1 Each Manurd Hone or Modular Dwelling Service or Feeder *111111,00 2 2a. (Contractor Installation only: -` 4b. Services or Feeders Electrical Cortractor Econo_ F Inste tion,alteration,or relocation {�('�r i C C r�. J n C 200 amps o•lots "o.00 tP ( Address_,5A24 N. Michigan Aye. 201 arcs to400-mw tleo_ao 2 City_Portland. __ State_Or. Zip 97217 401 amps toeoaampe __ $120.00 2 00 Phone Flo. 735 4705 -- PGR. 699-5226 ov amp.to 11)00 amps -- sm 0000 2 _—. _ over 1000 amps or voNs $340. _ 2 Job NO. _ Reconnect only $5000 __ 2 contractor's license NO. 3 4—1 9 5 r �— 4c. Temporary Services or Feeders Contractor's Board Reg. No._ Imtellallon,alteration,or relocation Signature of Supr. Elec'n �(J1 "='�-- �� 200.mot or lett 2 License No. 21 4 6 5 Phone No.7 3 5 4705 2ot'mps to 400 wrps $50.00 2 — --- -- 401 @rugs to 800 amps $75.00 2 Over 800 amps to 1000 volts 3100.0E — 2b. For owner Installations: see"b"above. 4d. Branch Clrcults Print Owner's Name_ tow,altoratlon or extension pow pone Address e)The nee for Maraca Omits wrrh • City -- State_--._ Zip _ purchase of s"ce or fMade IM. v 2 Phone No. _ b)The fees branch «branchNcirc„Ns wrdwrn L The installation is being made on propeiry I own which Is purchasaofService orhsdbrM. 2 First branch circuit $36.00 2 not intended for sale, least=, or rent Each additional branch circuli Owner's Signature __— As. A,e!,;ellsneotn (.iervlce or feeder not included) 2 3. Plan Review section (if required): Each pump or"stlon circle i $40,00 2 Each sign or outilna ApMMg $40,00 Signal ckcurt(t)or a(Molted energy — 2 G Please check appropriate Item and anter fee In section 58. panel,aftention or extension $40.00 a7 __4 or more residential units in one structure Minor Labels(10) $100.00 F. Service and 'eeder 2.25 amps or more System over 600 volts nominal 4f.Each additional Inspection own r 5 Classified area or structure containing special occupancy the sllowsble In any of the above as described in N E C Chapter 5 Per Inspection SUM Per hour $6.3.011 Submit 2 seta of plans with application where any of the above In Plant $63.00 apply. Not required for temporary construction 3ervlces.LU $, Fees; J NOTICE 5o. Enter total of above fees $ — 5%Surcharge (05 X total }1903) s PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal AUTHORIZED IS NOT COMMENCED WITHIN 100 DAYS. OR II: Q. Enter 25%of line A for CONSTRUCTION CR WORK IS SUSPENDED OR ABANDONED FOR Pler Review If requW (Sec.3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS fSubfcfaf : COMMENCED. ...a LJ Trust Acc,wrlt A Pm Mp Balance Due : �,/•�— Econo Electric Co. Electrical Contractor Licensed Bonded Insured Residential • Commercial • Industrial June 12, 1996 I Si /Madam, As per our conversation concerning Magic Cleaners, I am submitting our permit application for the electrical installation. I understand that, you will not issue the permit until the current problem is .resolved. Therefor, you will hold the electrical permit and issue it when all is in order. As I will be leaving town for a period of time (about two weeks) , I wanted to make sure that we had a permit for the work, when the problem has been fixed. C 644- Sincerely. ! '/ I .S. Anterola IL R w i 5424 N. Michigan Avenue • Port and, 0 )eon 072117 • (503) 735-4705 BUILDING PERMIT CITY OF T PERMIT #. . .. . . o113UP96-0317 COMMUNITY DEVELOPMENT DEPAOITMENT DATE 0125 sw Has Blvd.Tigard,oreg" 97MN1iW !tel SM4171 PARCEL: 1 S 133AD-16200 SITE. ADDRESS. . . : 10700 SW NORTH DAKOTA ST #200 SUBDIVISION. . . . : MLP94-0013 ZONING:C—P BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . S003 -------------------------------------------------------------------------------- REISSUE: FLOOR AREAS---------- EXTERIOR WALL CONSTRUCTION— CLA6S OF WORK. :ALT FIRST. . . . s 700 sf No So Es WE TYPE OF USE. . . :COM SECOND. . . : a sf PROTECT OPENINGS?---------- TYPE OF CONST. :SN . . . e 0 sf No Se Es WE OCCUPANCY GRP. eB TOTAL------s 700 sf ROOF CONSTs FIRE RET?s OCCUPANCY L.OADe 23 BASEMENT. s 0 sf AREA SEP. RATEDe STOR. : 0 HT: 0 ft GARAGE. . . : 0 sf OCCU SEP. RATED s BSMT?: MEZZ?: REQD SETBACKS--------- REQUIRED------------------- FLOOR LOAD. . . . : 0 psf I.EFTe 0 ft RGHTs 0 ft FIR SPKLeN SMCK JET. . sN DWELLING UNITSs 0 FRNTs 0 ft REARS 0 ft FIR ALRMeN HNDICP ACCeY BEDRMS: 0 BATHS: 0 IMP SURFACEe 0 PRO CORRIN PARKINGs 0 VALUc. $: 6000 Remarks : Tenant improvement Owner: ----------------------------------------------------- FEES' -------------- MACKENZIE/SAITO type amount by date recpt P. O. BOX 69039 PRMT S 56. 50 B 06/17/96 96-280654 PLCK f 36. 73 B 06/17/96 96-280654 PORTLAND OR 97201 FIRE $ 22. 60 B 06/17/96 96-280654 Phone #s 224-9570 SPCT $ 2. 83 B 06/17/96 96-2280654 Contractor: ---.a-------------------------- R & J PLUMBING 20374 SW ERIN PL ALOHA OR 97006 ------------------------------------ Phone #: 642-7073 t 118. 66 TOTAL Rey if. . : 107138 ------- REQUIRED INSPECTIONS -------- This permit is issued subject to th- regulations contained in the Framing Insp Tigard Municipal Code, Stat* of Ore. Specialty Codes and all other Insulation Insp applicable laws. All work will be done in accordance with Firewall Insp approved plans. This permit will expire if work is not started Gyp Board Insp within 188 days of issuance, or if work is suspendnl for Bore Susp Cei ing Insp than 188 days. Final Inspection IL - — a N permittee Signatureci�o Issued By: Call for inspection — 639--4175 Commercial Suildina Permit ! k lication city df Tigard 13125 SW Hall Blvd. / Tigard, OR 97223 (50:3) 639-4171 Jobsite Address: O 5 eco IV,0Aka 'i4 •sef Tenant: &.4 C C/L-.tAi4;C S Suite X r0 0 ice Use Only Valuation: 6 600 ,pG PlancWRec Permit# Owner: litJ C. L� Map A.TL # itA vL"_LL.� t t� Address: _ r Z 7 C?O S W ,'V A'94ko fe,4 _ Aoarovale Re_ quitted , r , Planning Phone Engineering �9� � �h%�*r,,�l- � C. , Other Contractor: S t Address: 27 A�d QR 70 0 6 Type of const: _ ` Phone: (0 �2 -" 70 7 r 7111s �,�ly� Occupancy class: _ ,,._T ( (� '(h�! ice- �(Spdnlelefed? "es 0 Contractor's License # / 07 3 V(} t ,�1M _ (attach copy of current O►ogon Iken Y" Sq. ft. of project: �D Cr,ntact name & phone. l�o'y l 42 - 7073 Story (1st, 2nd, etc.) _ + y.6 - /o s , / � Proposed use: ArchitecUEnglneer: L �' l r Z i/�e S� CL Address: Z �/O �w fll�jprn,¢,r/�� U/ Previous use: 7�i( rx Ncts: Plumbing 6 mechanical plans must be submitted at time of Phone: •-Z '7 Z building permit application. SO � �� m JOB DESCRIPTION: � /.�tJ RQc/CM E ,r/1 W K� App!icant Signature & Phone number Received by: Air Date Received: " 11 ' lv Permit 0 Account Description Amount Amt Pd. Bal. Due Bldg. Pecnit (BUILD) Sir SO 51i 5D Plumb. Permit (PLUMB) Mech. Permit (MECH) Sats Tax (TAX) z,V 3 2'%3 Bldg: Plumb: Mich: .� %Planck PLANCK) Mech: Sewer Connection us ) Sewor Inspection (SWINS Parks Dev Charge (PKSDC) Residential rIF (TIF-R) Mass Transit TIF (TIF-MT) Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutlonai TIF (TIF-IS) Office TIP (TIF-0) _ a Water Quality (WQUA ) at -- F- N Water Quantity (WQUAT) _ Fire Life Safety (FLS) woo m Eresion Cntrl Permit (ERPr.MT) J Erosion Planck/USA (ERPLAII) Erosion Planck/COT (EROSN) TOTALS: ''� � IQ034 0 LU MAI tj N t �! Ilk IL � I _UUP I I WCt, yr ` � 7 � v1 VI �r Q. °� r ./ '�L i p�F 4!ry,-!M. �G, ° mow•,..r♦•.wy,�,_ n ty ,;�,�., ... � r;i,. ,,ti�...�,,�� w'••s... ...•...M�1MY"MOr.W'�fryt•14itM..vfr Malw'•w�►-'M:rN lr.r. .1r n.l'•....,-l.•...Yrs,`_...: �•.ML• I Q 1 Y � V � � c ,n a � 3 c� �� i i i � I ;a; aso 0s. a PLUMBING PERMIT • CITY OF T PERMIT N. . . . . . . a PLM96-0122 COMMUNITY DEVELOPMENT DEPARTMENT DATE I SSUED s 06/18/96 13125 WV Hall Mvd.TIpM.Creon SM3*11100 (SM GW4171 PARCEL s 1 S 133AD-16200 SITE ADDRESS. . . : 12700 SW NORTH DAKOTA ST 02w) SUBDIVISION. . . . : MLP94-0013 ZONINGS C—P BLOCK. . . . . . . . . . s L07. . . . . . . . . . . . . 1003 ------------------------------------------------------------------------------ CLASS OF WORK. . sALT GARBAGE DISPOSALS. s 0 MOBILE HOME SPACES. s 0 TYPE OF USE. . . . eVOM WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . s i OCCUPANCY GRP. . sB2 FLOOR DRAINS. . . . . . a 0 TRAPS. . . . . . . . . . . . . . s 1 Sr TORIES. . . . . . . . 1 0 WATER HEATERS. . . . . : i CATCH BASINS. . . . . . . 1 0 FIXTURES--------- --- LAUNDRY TRAYS. . . . . S 0 SF RAIN DRAINS. . . . . S 0 SINKS. . . . . . . . . . a 0 URINALS. . . . . . . . . . . 1 0 GREASE TRAPS. . . . . . . 1 0 LAVATORIES. . . . . 5 1 OTHER FIXTURES. . . . 1 0 TUB/SHOWERS. . . . : 0 SEWER LINE 0 WATER CLOSETS. . s 1 WATER LINE (ft) . . . 1 0 DISHWASHERS. . . . s 0 RAIN DRAIN (ft) . . . 1 0 Remarks: Installing I lav, 1 water closet, 1 water heater, 1 backflow prevention device, and one trap. Owners ►---------------- FEES -------------- MACKENZIE/SAITO type astcunt by date recpt P. O. BOX 69039 PRMT $ 45. 00 JMH 06/18/96 96-280608 5PCT $ 2. 25 JMH 06/18/96 96-280608 PORTLAND OR 97201 Phone Ms 224-9570 Contractors ----------------------------- RON HOVORAK (R A J PLUMBING) 20374 SW ERIN PLACE ALOHA OR 97006 ------------------------------------- Phone ----------•------------------------- F hone #1 796-8109 —MBL • 47. 25 TOTAL Reg #. . s --•----- REQUIRED INSPECTIONS ------- This perei. is issued subject to the regulations contained in the Top—out Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Mi sc. Inspection applicable laws. All work will be done in accordance with RP/Backflow Prey approved plans. This permit will expire if work is not started Final Inspection within 189 days of issuance, or if work is suspended for Bore _ than 189 days. 6__' PO j) Permittee Signature _ 3 Issued B y s 0 Call for inspection — 639-4175 a It ut� City of Tigard PLOMBING PERMIT APFLICATIOi, Planck/Rec. # 13125SW Hall Blvd. Pennit # Pt - z' Tigard, OR 9722:' S(A.) --OZ q.3 (503) 639-4171 MINIMUK $25.00 PERMIT FEE+ ST. SURCHARGE w..a o.+r P Now Single Family Raaidances Only // 0 1 BATH HOUSE$140.00 O 2 BATH HOUSE$195.00 Job Z 7 0 0 5 GG/y,�A T? 0 .1 Bk n I!0USE 5225.00 Addressawrw. �� ar Fee Includes all plu,ruaV fixtures in chs dweift and the limit 100 feat R of water service. sanitary sewer and avrm sewer. See face below. Mom I. a w-mwq FIXTURES QTY PRICE ANT Sink 9.00 Meft Aer.r Lavatory 9.00 / Owner Z 7 O O !G(J l�-)'��kd f-�- Tub or Tub/Shower Comb. 9.00 aw+sw all Shower Only 9.00 -// A Water Closet 'A 9.00 ,OD Nam I&. of r....., ^hhwasher 9.00 W ZEE Garbage Disposal 9.00 Occupant Me",,,,,,. Washing Machine 9.00 1270 Floor Drain 9.00 DID Water Heater 9.00 �� yQ C( r Laundry Room Tray 9.00 Urinal 9.00 Other Fixtures (Specify) 9.00 {{ M� .Ww 9.00 Cbr�t�idor Z,2 3 1 U 5 W ( iQ �ef C • 9.00 �,�I.,. T ar 9.00 -0/1,14 t 9700(o sewer 1 st 100' 30.00 Uwe ftqewaw ru.T.f.. Sewer-ea. Addft. 100' 25.00 O 3 Water Service lot 100' EE 30.00 I hereby acknowledge that I have read this application, that the Water Service ea. Addle. 200' 25.00 information given is correct. that I am the owner or authorized agent of Storm S Rain Drain tat 100' 30.00 the owner, that plans submitted are in compliance with State laws, that 1 am registered with the Construction Contractor's Board, that the Storm a Rain Dram Addle. 100' 25.00 number given is correct. (If exempt from State registration, please give reason below.) Mobile Hans Space 25.00 of d2C Back Flow Prevention � t Device or AntFPollutlon novice 9.00 y,0h 94..,.,,... ....I, r Any Trap or Waste Not Connected to a Fixture 9.00 Cid Describe work newaddition 0 alteration Q repair Catch Basin 9.00 to be done reside tial Q non-residential Q Insp. of Exist. Plumbing 40.00/hr a Specialty Requestad Inspections 40.001hr Existing use of I ► 1 Rain Drain, single fainly dwelling 30.00 building or property /l/G r'l/ � Residential backflow prevention devices 15.00 J Proposed use of ��N building or property (� -(&cept raafdo"af backflow prievenNon drvfcaa) W 'J NOTICE •IVlirtimum Fee$25.00 SUBTOTAL (�s PERMITS BECOP9E VOID IF WORK OR CONSTRUC'i ION e'/.SURCHARGE AUTHORIZED IS NOT COMMENCED WITHIN 160 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PUN REVIEW 25% OF SUBTOTAL COMMENCED. TOTAL , P Special Conditions ' Date Issued by. RSG'D 6y V r-po - Dcv lr SAYS or-- __- ` CITY CSF TIGARD DEVELOPMENT SERVICES 13INS W Hill Blvd,W CP,=(603)W4171 � CERTIFICATE OF OCCUPANCY PERMIT M. . . . . . . : BUP96-0.317 DATE TSGUEDe 07/23/96 PARCELe 18133AD-16200 SITE PDDRC,ss. . . : 12700 SW NORTH DAKOTA ST #200 SUBDIVISION. . . . iPP1995-073 ZUNINGW-P BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . e003 •'iURI13DICTIONs TIG (-LASS OF WORK. sAL'T TYPE OF USE. . . COM TYPE OF CONSTRs5N OCCUPANCY GRP. e B OCCUPANCY LOAD: 23 TLNANT NAME. . . :MAGIC CLEANERS F •n►arkss Tenant improvement Ownert PACIFIC CREST PARTNERS 1430 EASTSIDE ROAD HOOD RIVER OR 97031 Phone #: Cont ract or: R & J PLUMB I NC 20374 SW ERIN PL. AL OVIA OR 97006 + Phone #s 6427--7073 1 Reg #. . : 001071 This Certificate grants occUpancy of the a:nnve referenced building or portion thereof and confirm- that the building has been inspected for compliance Witt- the State of ron Specialty Codes for tha gromp, occupancy, and use !.ender which the r•e erenc:ed permit was i Rsi..ted. a � � BIIILDINC INSPE.C'TOR SUxLDING OFFICIAL J m FROST IN CONSPICUOUS PLACE 0 W J l F- SEWER COW ION PERMIT CITY OF TIGARD PERMIT 0. . . . . . . s SWR96-0243 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED s 06/16/96 13126 svv H&N Blvd.Tigmrd,or"m 97222•81N IN"004171 PARCEL s 18133AD-16200 STTF ADDRESS. . . : 12700 SW NORTH DAKOTA ST 0206 SUBDIVISION. . . . s MLP94-0013 ZONINes C—P LILUf:K. . . . . . . . . . s LOT. . . . . . . . . . . . . s 003 TENANT NAME. . . . . iMAGIC CLEANERS USA NO. . . . . . . . . . s FIXTURE UNITS. . . s 8 CLASS OF WORK. . . sALT DWELLING UNITS. . s 1 TYPE OF USE. . . . . ICOM NO. OF BUILDINGSs 0 Ns FALL TYPE. . . . sLTP IMPERV SURFACES 0 sf Remarks: Installing 1 lav, i water closet, 1 water heater, 1 backflow prevention device, and one trap. Owners ------------------- -------------------------------- FEES -------------- MACKENZIE/SAITO type amount by date reept P. O. BOX 69039 PRMT f 2200. 00 JMH 06/18/96 96-280608 IPORTLAND OR 97201 Phone Os 224-9570 C:r.ntractors ------------------------------ CONTRACTOR NOT ON FILE -----------------------------_.------ Phone 0s f 2200. 00 TOTAL Reg #. . i ------- REQUIRED INSPECTIONS ------- Tris Applicant agrees to comply with 01 the rul, and regulations Bawer Inspection of the Unified Boole Agency. The -oreit expirvs IN days from _ the date isfeed. The total amoc.,t paid wit' by forfeited if the 43 IC r permit expires. The Agency Joos not •urantoa the acevracy of the side zowtr laterals. If the sawn- is not locatad at the measurement given, the installer shal. prospect 3 feet in all directions from the distance given. If not to loca'.ed, the installe,� shall purchase a "Tap a,a Side Sewer" Petitit and the Agency will nstall a lateral. 4' ) f1 A�"C ')e r an i t t,e Signatures 4 � Issued By( a Call for inspection — 639-4175 t— N W J • Commercial 15uilding Permit ARp119ation City of Tigard 13125 SW Hail Stvai Tigard, OR 97223 (503) 839.4171 Jobsite Address: 170D ( U� Wzz� I-MTk- ! - Q Tenant: X11` l lc U�4X S auk@/ 2-00 y 4: Planck/Rec Valuation: Pennit Owner: Map &TL# _ Address: �, �iDDravals Ronulrsd Planning' Phone: Engineeft Other C q 3� e Contractor. Address: Type of const: Occupancy class: Phone: Sprinklered7 Yes No Contractor's License (attach copy of current Oregon license) Sq. ft. of project: _ Contact name $ phone: Story (1st, 2nd, etc) Proposed use: Architect/Engineer: Previous use: Ad4ress: _ r a. Note: Plumbing & mechanical plans p� must be submitted at time of N building permit application. Phone: _ OD JOB DESCRIPTION: ! PLM tl� —0I2-Z 5 W J Applicant Signature & Phone number R.�ceived by: Date Received: Permit 0 Account Description Amount Amt. Pd. S&L Due . Bldg. Permit (BUILD) Plumb. Permit (PLUMB) Mech. Permit (MECH) State Tax (TAX) Bldg: Plumb: Mech: Plan Check (PLANCK) Bldg: Plumb: Mech: -02-0 Sewer Connection (SWUSA) 22Uy -'� Z 74M Sewer Inspection (SWINSP) 1 Parks Dev Charge (PKSDC) Residential TIF cnF Mass Transit TIF -MT) Commercial TIF (TIF-C) Industrial TIF (TIF-1) Instituti� I TIF (TIF-IS) O' TIF (TIF-0) 4. W4,ter Quality (WQUAL) OL � � Water Quantity (WQUANT) Fire Ltfe Safety (FLS) m Erosion Cntrl Permit (ERPRMT) J Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) �\ TOTALS: O Tenant Name: Aocumuletlw 8wwer Tally This SWR# P-- .,1 I S 3 Address: Mirtv-N th wn (z( �zoo Tfws PL.M#: Fixture Value Previous Prevkws Credits Capped Fixtures Fixtures New Mel New N Value Capped off vakw added fi added Bs total Count off Ns count value vakm Baptistry/Font 4 Bath-Tub/Shower 4 -Jacuzzi/Whirlpool 4 Car Wash-Each Stall 8 -Drive Through 18 Cuspidor/Waller Aspirator 1 Dishwasher-Commercial 4 -Domestic 2 Drinking Fountain 1 Eye Wash 1 Floor Draintsink-2 Inch 2 Z z IL Z 4 -3 Inch 5 -4 Inch 8 1`d -Car Wash Dm 8 Garbage Disposal 18 Domestic to 3/4 HP Commercial to 5 HP 32 -Industrial over 5 HPi 48 Ice Machine/Refrigerator Drains 1 Oil S Gas Station 8 _~ Rec.Vehicle Dump Station 18 Shower-Gan Per Head 1 ' -Stall 2 Sink-Bar/Lavato 2 -7 14 i' 1; Ito - Bradley 5 -Commercial 3 Z 2- Service 3 q9 Swimmina Pool Miter 1 77 Washer-Clothes 8 Water Extractor e Water Closet-Toilet 8 '-) Z 4 (p ry' _ p, Urinal 8 I (D U) I TOTALS /- j Total fixture values: 101 divided by 18= ( Z EDU 1 Dv'S 5 HISTORY i�(17�0 (o•3� " �6" 0�1 PLM# J4-olio EDU# SWR# PLM# EDU# SWR# PLM# EDU# 5 SWR# -cro j PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDUP SWR#