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114 FC�L, ! Approved ........................................................ �!` ;. ."rG� fl�E ��RSM4l. OFFICE
ConditionaN A provod .. ;
For only the vvo closcribed in: �%�JRI[7l f'r L _)
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SIGN PERMIT
PERMIT #: SGN91-0202 DATE ISSUED. . . . : 12/11/91
EXPIRATION DATE: OPI/0Z.
PARCEL. . . . . . . . . : 2SI02CC-00500
ZONE. . . . . . . . . . . . C-G
BUSINESS NAME. . : TIG,ARD MARKET PLACE
SIGN LOCATION. . : 13500 SW PACIFIC. HWY
APPLICANT/AGENT: RICHARD LITTS
BUSINESS TAX NO:
_=acsssa=e-acasas=a.xvmcasaaaascsc=asses.-==c-_.-ocscansxs cccc::-=..c a-ca =cccccc r.
SIGN:
PERMANENT ( ) FREESTANDING (X) FREEWAY ( )
TISMPORARY (X) WALL ( ) ELECTRONIC ( )
OTHER ( ) BILLBOARD ( ) BALLOON ( )
SIGN DIMENSIONS. . . . . . : 9 X 3 X 2
T3TAI, SIGN AREA. . . . . . . 54 sq.fL.
WALL AREA. . . . . . . . . . . . . sq.ft.
WALL FACE (DIRECTION) : NA
SIGN HEIGHT. . . . . . . . . . . 3 ft.
PROJECTION FROM WALL. : 0 in.
ILLUMINATION. . . . . . . . . : NON
DESCRIPTION OF SIGN:
TEMPORARY FREESTANDING SIGN. 9' X 3' X 2 a 54 SQ.FT
MATERIALS. . . . . . . . . . . . : BANNER CLOTH
EXISTING SIGNS. . . . . . . :
ELECTRICAL PERMIT REQUIRED: NO
BUILDING PERMIT REQUIRED. . : NO
ADMINISTRATIVE EXCEPTIONS. : N/A
PERMIT FEC: $ 25.00
APPROVED BY: I
DATE: 12/11/1
.. . .,.
c1TY of TIGAI2D Permit No.
SIGN PERMIT APPLIC.ATTON
The applicant hereby applies for a permit fear' the work irrlicated or as shown in thq
aoanglPan'ling plans and sped:icationS. ,
ZONING:
_ <:- - ^-
SIGN IDmrION ADDRI:3S:
NAME OF BI ISINMS: u'7---���C Q-
COMPANY: -- — — ——
.�1C. �,I MThe
y of
x �n�\a m Bus ilx�s Tax wliicn na�ut h-2 kept current on a l l
Itre City of�igazd. li�x>ses
persons dc,ing bjsiness in the City. Do you presentl.y have a current business tax'
YE'S (' )i NO ( )- U.L. 1,abe1 I_ - =-_-
PRDPOSM SIGN-. (Check as many as apply)
�� ( � ) FREEWAY ( )
PF-i,1V, 1INr ( ) VULT�, ( ) E LECI'Rf�N7:C ( )
� (�) rALI IX)N ( )
OTHER ( ) BIL1130ARD ( )
EDrnrlMIzoN DATE:
SIGN DBUNSIONS:
TOTAL, SICK AREA (Sq. —
WALL AREA (Sq. Ft.) : --
WALL FACS: —
imair (Ft) : --
pRL1 ECrION F" WAIL:
nni, NAZZON: YES ( 1 NO (,Kj TYPE: _ --
FXISTIW SIGNS:
ACMINI"IRA'F E CCEPr1ON: N/A APPPDVED 110W
AREA f ) REI®Tr ( )
c aglWrS:
All sign permits must be ac m3nied by a scale
pZANN1NG DF3'� x
r . drawing and plot plan. If work aub-iorized under
Permit F_- : zj
Receipt No• `) I - �-1 p a sign permit has not been completed within ninety
^, T days aft x. the is_St��rxx' of the hermit, the permit
BY• shall became null. and void.
II�X�RIC1r1L PF�dII'1' I CITIFY WAT I AM �9BUMM REMRDFn OWNER OF THE
PFnpER7'Y OR AN AGENr iZED BY THE OWNER-
RWFD: Y ( ) NO ' l
BUIIDING PIIZM I'l'
RF7K. ]): YI_; ( ) NO (<1Appl.ican 's Signature / `7
- G r, 1
-�-' Telephone
cp/11KMP1.1 V 1' Address
N:\WORD\0JMDLV\
�MgE A I L ,OX 'E-7 T C .
'
APPROVED vS NV�t�• v4S � ! L�•� • '�r,�: �t-t�v tc�
fes' • C. C�^1t.:. t.•.1l1: y .� ' 1
CITY// of TIGARD
y � .
./:
.01
t
co
APPROVE;])
Ct'fY OF TiGARn
By-V/C_'70'e
wy
Title l-4 yYA
lrlmTprvr� 'W
a ;
CITY OF T I GARD - RECEIPT OF F'FIYMr:.Nl' RECEIPT NO. 19 1
*4ECK (WOUNT a 10. 00
NAME SP OIL.. C'.AEiW AMOUNT 0. Pill►
12825 SW PACIFIC HWY PAYMENT GATE: : 12/10/91
T I GARD, OR Stir O I V I S I ON
97X-'.3--
PURPOSE
7: i.'3.wPURPOSE OF-* PAYMENT AM OUN) f"A 11) PURPOSE OF PAYMENT AMOUNT VAI D
S I UN PERMIT F t)CYN912 M 1 10. 00
i
I
i
i
I
11-OTAI_ 01400W PAID 10, 00
I
- - - ----- CERTIFICATE OF
TIGAR,
nOCCUPANCYaN OF '�J• *cny - D PERMIT �. . . . . . . tBUP90-•O3;3N
COMMUNrTYDEVELOPMENTDP�)�� DATE ISSUED# f�i/1B/91
19125 SW Hd1 Blvd. P.O.Baa 2M7.TOW.0'p°"
---- - - PARCEL.t `SiOca;C 00S0Q�
SITE ADDRESS. . . a 13500 SW PAC 1 f 1 t: HWY ZONING, L t3
gUSDIVISION. . . . t LUT. . . . .
_ . .
BLOCK
. -e
CLASS OF WORK, tALT
TYPE OF USF-- - - 'COM
ULCUPANCY GRP. t B2
OCCUPANCY LOAD aI@
TENANT NAME. . . LONE NjOUR PHOTO
Remarks# Tenant MOL" C)ne Hour Photo, int. partitions, dark rm, eer +' � '"• f
Owners
MERCURY DEVELOPMENT
Phone Mt
Contractors "---`if=ILE�M__- -_-_~-___
( ONTRACTOR NOT ON
Phune Na
Reg M. . a �
of the above referencted building is hereby gi\JP11, and certifies
Orr�_rpancy r Codes for- the group,
the compliance with the State Of Oregon Specialty
arcupw Y, arefere�nc:ed permit wav�iss'-'e`!.
nq use nder which the
NI N' TOR
-PI E D PARTMENT
HU ING
POST IN CONSPICUOUS PLACE
I
I
INV&
Ill P ,ION N��i
City of Tigard Building Departaent
13125 SII Ball Blvd. Tigard, or+ngan 97223
Inspection Line (Rec-O-PhonPl: 639-4175 Business Phone: 639-4171
Inspect ion c_____ _ _-.--- -----—
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beata Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb
Plbg. Underfloor Water
Line Gyp. Bd. -Hoch.
m+
Date Roquestedf-__� Q __-._ Ti = _X
AM PH
Addrea3.� _-.L�/ • `/bcm` C� _�-'SGL.'Z_
Bu l ides:_--�./Lfr c�_� �C 4'=.•�__-_�—u�-�---.- --
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: ` --------.-- ---,-- Dates_�_---
` _APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
�^ Call For Reinap.
INSPRLTION NOTICE
City of Tigard Building Departsent
13125 811 Nall Blvd. Tigard, orogon 97223 u_
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspect.iont__T_- ----- ""'"
Fo)ting Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALt
Post/Beam Strur_t. San. Sewer Fr.tminq -Bldg. )
Poet/Beam Mach. Pain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Meth
Date Aequeatadt-1_L� Titaet !PM
AddreeetQ
THE FOLLOWING CORRECTIONS ARE RR.Q[JIP.RD:
7 � �
'90w A4000,
Tnepector:____k— - / -, Date:l� —
— APPROVED �� DISAPPROVED (Y . APPROVED St1BJECT TO ABOVE
O(Call For Relnnp.
INSPSCPION NOTICR
City of T.9a:rd Building Departaent /
13125 SII Ball Nltd. Tigard, Oregon 9727.3
Inspection Line (Re,•--O..Phone)• 639-4115 Business Phone: 639- 1
i
Inspection:
Footing Plbg. Underikab Mech. Rough-Ln Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Ream Struct.. San. Sewer Framing -Bldg.
Posy:/Ream Merh. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater /Line Gyp. Rd. --Hoch.
Date Requested: I -le
' 1__ _AM _FM
Addreas: ormit
Builders__��,
THE FOLLOWING ODRRECTIONS ARE R2QUIRED:
Inspector: ----'-- --------- ' ---
J Uctes�
F APPROVED u DISAPPROVHD APPROVED SU8t�
To ABOVE
-- Call For Reinap.
INSPECT ON NOT191, ff
City of Tigard Building DepartM
13125 BW Ball Blvd. Tigard, oragon 97223 �✓
Inspection Line (Rec-O-Phone;: 639-4175 Business Phone: - 171
Inspectw:::-- — -- ---- -
Footing Plbg. Underelab Mech. Rougi:-in Appr/Sdwlk
Fouad- Plhg. Top Out Cas Line *INALt
Post/Beam SLruct. San. Sewer Framing -B)du•
Font/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Wator Line �-0�yp. Bd. j -Meeh.
Date Requested:_ . —. TLms -Ic _AM __PM
Address: �_ �`�y�� Permit #1" Vim_
Builders._
THE FOLLOWIN:1 CORRECTIONS ARE REQUIRED:
Inspectot: — Date:_ U /�
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rainsp.
RA' /
n t
�NSPEQTLQN
NOTICE ri x
City of Tigard Building Cepartment
13125 SII Na.11 Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-a1/5 Rua iness Phone: 639-4171
Inspection:
Footing Plbg. Un4arslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out. Gas Line FINAL:
Posh/Beam !Jxuct. San. Sewer Framing -Bldg.
Pust/Hens Mach. Rain Drain Insulation -Plumb.
Pit^,. Underfloor Water Line Gyp. Rd.
Date Requested! �Z- Time! 1L�-�L AN
�{ !
Address:� cJ—D4+ iL y �7U Permit It
Builder:_- �/a
_t c" TL's( i� ty e w-,- �,yrQ�
THIS FOLLOWT.NO OORRECTIONS ARE "B "
QUIREDt " ,160'
J -
I nspector d--' ---- -- -- Dates)-
APPROVED DISAPPROVFD APPROVED SUBJECT TO ABOVE
_CaII For Reinap.
IN-fiPECTION NOTICE `
City of Tigard Building Departaent / /
23125 SR Ball Blvd. Tigard, Oregon 97227
Inspection Line (Rec-0-Phone): 639-4175 Busi-ners Phones 39-4171
Inspections _ __ — -----
Footing Plbg. Underalab Nnch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINALr
Pont/Beam Struct.. San. Sewer !taming -Bldg.
Pant/Beam Mech. Rain Drain Insulat—icons -Plumb.
Plby. underfloor Water Line Gyp. Bd. }--Meeh.
LIJL AM PM
Date Requested[ �- �� Time f� ,,[7 T r�
Addresms 3� Cti C.I'T l� Tom_ _��_ �7 V Permit #055 qoAA
'-G�'?�j(�
eullder� _ �
TR4 FOLI,UW'NG CORREr'TION3 ARE REQ'IIREDi
f
i
1
it
Inspector Datss ~
V�VPROV4D OIBAPPROVRD APPROVED ^UBJECT TO ABOVE
Call, For Reinnp.
HISTORY: VIEW UPDATE DELETE ESC
View comments for selected item
OAPLUMBING PF.RM�TAAAfiAAAAAAAAAAAAAfiAAAAAAfiAfifififiaAAfiAfiAAAA�iaAAAAAASAAAAAA€tAAAAA�
:PI,M90-0205: PROJECT:ONE HOUR PHOTO STATUS:I UPD:12/06!90: - THJ:
PERMITTEE:E.C. MOORE, A.J. LANDSCAPE PRIM. . :BUP90-0338: °
SITE NDDRESS:13500 SW PACIFIC HWY °
66 CPSE HISTORY AAAAAAAAAAAAA&Aaddd&fiASAReq/SenthSchd/Duea);nd/DonefilBy,'iSY.ataI3G
° C007 Application received
H (;010 Plan check by / / 11/06/90 JHJ PASS °
0060 (F) Issue permit 1.2/06/90 JHJ PASS °
c120 Plumbing Under.s.. / / / / 12/07/90 MS PASS °
071.5 Rough-in !nap
0725 Top--out Insp 12/18/90 MS PASS °
C740 Misc. Inspection
0799 Final Inspection
° ° I
aafiAAgaa;iAAdAAfiAfififiAfiafifiAAAAAAAtifiAfiAAAAAAfififififiaAAAAAAaAAAAfifiSAfiAAAAAAAfifiAASAAai
HISTORY: VIEW UPDATE DELE'T'E ESC
View comments for selected item
6APLIIMBING PEFMITfiAAAAAAAfiAAAfiAAAfififiaAAAAfiAAAfififiaAAAAAfifiAAfia^ffififiAfiAAAAfififiAAfififiC
:PLM90--0205: PROJECT:ONE HOUR PHOTO STATUS:1 UPD:12/06/90: :,)HJ:
T'ERMITTEE:E.C. MORE, 4.J. LANDSCAPE PRIM. . :BUP90-0338: °
".I^_'E ADDP.ESS:13500 SW lACILIC HWY °
05 CASE HISTORY AAAAASAAAAAAAAAAA&AAAAAAReq/SentASchd/Due&End/Done&AByAStatAAAC
0007 Application received
H ('010 Plan check by / / 11/06/90 JHJ PASS °
0060 (F) Issue permit 12/06/90 JHJ PASS °
0120 Plumbing Undersl / / / / 12/07/90 MS PASS °
0715 Rough-in Insp
0-725 Top-out Insp 12/18/90 MS PASS °
t740 Misc. Inspection
0799 Final In"etioil
�Aaa�aAaaaaAAAAAnAAAAAAAaAAAAAAAfiAAAAAAAAAfifiAfiAAAAfiAAAfifiAAAAfiAAAAAAAAAAAAfiAAAAi. �
I
i
IN PSCTION NI
/ City of Tigard Building p rtaent �� ^
I 13125 SW Ball Blvd- Tigard, oreg— 97223
In pection Line (Rec-o-Phone)i 639-4175 Business Phone:
-41
Inspection:
Footing Plbq. Vnderslab Mach. Rough-in
Appr./Sdwlk
Plbg. Top Out
Gas Line FINALt
Found.
Poe-(,'Beam Struct. Ban. Sewer
Framing -.Bldg.
Post/Beam. Mach. Rain Drain
Insulation -Plumb.
Plby. '+nderfloor Water Line GYP• Bd.
-Mach.
Date
it t
Address:
Builderi
THE FOLLtAdINO CORRECTIONS ARE REQUIRfa: ---�
Inspector: Date:
_�pPPROVED ----
ROVED APPROVED SUBJECT TO ABOVE
DISAPP --
call For Rainep.
I
RNSPSCT1011 KV 9-9
Ctt:y of Tigard Building Departaent
131.25 SW Hall HlwO. Tigard, Oregon 137223
Inspection Line (Rec-O-Phone}: 639-4175 Business Phone: 639-4171
Inspection:__
s--
Tooting Plbg. Undersla -. Koch. Rough-in Appr/Sdwlk
Fo-:nd. Plbg. Top Out Gas Line FINALe
Post/Beam Struct. San. Sewer Praining -Bldg.
Post/Ream Hoch. Rain Drain Insolation -Plumb.
Plbg. Underfloor Water Line Gyp. 11d. -Mec
Date Regnested:�� /f _ �/�
� —Timet �'n—AM PM
Address:—� 4esmlt 'I1 y
Builder:
THU FOLLOWING CORREILMONS ARE REQUIRED:
Inspector':!
x_"PROVED -� DISAPPROVED APPROVED SUBJECT TO ABOVE
�7�C
Call For Reinsp.
VIECHANICOL
CITYOFT%rARD rcny TWRD PERM-1. T 0256
COMMUNITY DEVELOPMENT DEPARTMENT 0"em
13,26 SW Hyl Blvd. p.0.BOX 23397,Tgoid,Omgon 97223 7, (6031839-4176 DATE ISSUED-.
4:)IIE CIDDREGS. . . - 13500 SIA PAL11- IL, FIWY PORCEL: 2S;102CC--00',500
I SUBDIVISION. - .. . !: ZONING: C---G
bl.-OCK. . . . . . . . . . I LOT. . . . . . . . . .. . . „ .
GLASS OF WORK. . :AL.T FLUOR F'URN. . . . EVAP COOLERS”.
J YPE OF' USI::,- - -- - 'COM UNIT HEATERS— : VENT F*ANS. .. ,. " 3
OCCUPANCY GRP'. . :B2 VENTS W/O API-'IL: VENT SYSTEMS,.
'',)TOR 1:E S. . . P011 t-R S/C 0 M P R E S)S 0 R HOODS. - .. - .. -- -- : :I
-: DOMES. INCIN-
U E I TY P E S 15 HP. .1 IN C TN
/GAS/ ;3--45 Hr'. . - COMIll....
MAX INPUTc B T u 15--,*30 HP. - - REPAIR UNITS:
F*IRE 30 -50 HF.,. . . ., . WOOD STOVES. . "
GAS V)RESSURE. . . *.L 50+ HP. . . . . CLO DRYERS— :
1,10. OF UNITS-------- AIR 1-40NI)i ING U141 TG OTHER UNTTS. " ].
FURN ( 100K El"I'Ll" I <m: 1.0000 cfn— GAS OUTLETS. :?_
F*URN )=400K PTU'. i 1.0000 cfnl,.-
Tenant mmi .- One Haar Photc), .1y1t. r)a-rtj.timis, da*i+. 7-m, mech rm,
Owtie-re FEES
RICHARD LITTS %k m o Lt ri t t)y date recpt
113050 S. W. PACIFIC FIWY P R 11 T $ 36. 00
P L C,K $ `3. 00
TIGARD OR 97223 5PCT $ 1... 80
Ph(ji-tv #-. 639-6070 P A y I'll 11 46. 80 JLH 1.2/0E/90
',cmt-1 ;Act("-.
CONTRACTOR NOT I-IN FILE'
$ 46. 80 f'OTAL
REC)IMPEAD INSPECTIONS
F,is PeTMit is issued subject to the regulations contained in the Gas Line Ivisp
lioard Municipal Code, State of Ore. Specialty Codes and alt other ller-hAviival Irlsp
applicable laws. III work will be done in accordance with Heating Iftit Irisp
approved pians. This pervit will expire if work is not started Hrmd Jiispecti.ovi
:within 188 days of issuarce, or if work is suspended for RCTe Duct I)1!5PeC-'tj0)1
1han 189 days. F'irla'l
...............
1. � _....._....__...._»_.•...._-__-�..,__w �e....��.'_... _._.��.,._....Y_...
..........
............... ... .................-
for ij-15,pectimi 639 4175
PLUMBING PERMIT
CITY OFT'67A� PE RMT T ". ., . . .. . . r, 11,
COMMON" DEVELOPMENT DEPARTMEff one" DATE ISSUED: .12/06/90
13125 SW Hell Blvd, P.O.BW 23397,TOW,Origon qj 223(503)604176
9-"P� 1-9500 SW PftfFff' HWY
SUDDIVIGION— . . :
7
ZONING: C---G
CLASS OF WORK. . :ALT rJARDAGE DTSPOSAI S. "IOBII-F HOME' SPACES.
TYPE OF' USE. COM WASHING MACH. . . . . . . . PACKFi.-OW PREVNTR S. . : 1
0C'CUF'ANCY GRP. B2 1"LOOR DRAINS. . TROPS. .,
3TORIES. . . . . . . . WATER HEATERS...... CAT*CH BASINS— — — :
F 1 XI*URES-,---------.---..--..-.-- LAUNDRY TRAYS. . . .
SF R P T N D R A IN
SINKS. . :I URINALS. . _ . . G R E A S E T RA PS
LAVATORIES. . . . . : J 071ALP FIXTURES. . . . . ..
T*UF4/SHUWERS. . . . : SEWER LINE (ft) . . . .
(J()TE'R CLOSETS.
: l. W A T U R L I N F
DISHWASHERS. . . . : RAIN DRPIhf (-ft) - -
1t F"n'"-f'p-S AY)t M 0 d - 0))e HOW' pa'r,titi.ons, dark rni, 1liveli -rni, p1n-J)q.
Ownf-r:
I CHARD L.ITTS FEES
type an)(aunt t)y date 'r a c.,p i
0,J 11 S,, 11*, 11 A r I F I L 1-IWY PRMT $ 60. 00
PLCK $
f I G A F11 1) (:TR 9?2 3
0- 639-6070 5PCT $ 3. 00
PAYM $ 78- 00 JI-H 12/06./9@
---
CONTRACTOR NOT ON FILE'
PI-Ic)nf- #.-
TOTAL.
REOUIRED INSVIECTIONS
1hispermit is issued subject to the regulations contained in the ROUgh-in insp
Tigird Municipal Code. State of Ore. Specialty Codes and all ether Top--cut 111sp .......
aDplicavle laws. All wort, will be done in Accordance with .--._.—M i s c-. Inspect 1.On ..........
ipprovpd plans. This persit will PIPire if vcrk is not started Vi-nAl
within 180 days of issuance, or if wort, is suspended for more
than 189 days. .......................
...........
fl--onii.ttee
fc�sl-ted Py-
............
.....................................
fc •r ill',PeCtion 639-4175
L
CITYOFTIGARD PERMIT
SEWER ERMIT CONNECTION
CITY IV PERMIT it. . . . . . .. : SWR90--0407
COMMUNITY DEVELOPMENT DEPARTMENT otnloow
13125 SW f W I Blvd. P.O.Boot 23397,ThPM,0"-97P2�, M 8?9 ►iis DATE_ISSUED: 12106/90
S.iTE ADDRESS. ,. .. 13500 SW PACIFIC HWY PARCEL: 251.02C;C--070500
SUBDIVISION.. . ,. . : ZC;NING: (:•••G
14L.00K. . . . . . .. . . .. a LOT. . ..
. .. . „ . . . ,• ..
TENANT NA11E. . . . . :ONE HOUR PHOTO
USA NO. . . . . . . . . . 431.28 FIXTURE:: UNITS. « « - 16
C:I._ASS OF' W(:1RK. . . :AI._T DWELLING UN.ITS. .. : 1
TYPE: OF USC_. .. . . « :C:OM ha(]. OF 1iL1.T.I..raI IGS: 1
CNSTAI._I._ TYPE::, . . . :PUSWk IMPE:RV SLJRFF;CE. . : :Sf
M.AY'k.131 T•e>rlant MCKII-, One HOUr Photo, i1.1t. part-it coria, da•rl-. •rm, nieel•1 -r•in, plmb!�.
(awne.r a _________..__.._.._.....____._....._._.._.__....__.__._._.__... _.._._...._.____._.... ..._.._._ FEES .-_..__.._..•___________..
RICHARD LITTS type amat.rnt by data rer.,Pt:
I.,71050 S. W. PACIFIC HWY PRMT $ J.500. 00
PAYM $ 1500., 00 I I..I_. 12/06190
TIGARD OR 97223
f'11r)1•te it: 639-6070
r::r:INTRACTOR NOT ON FILE
I�hont if: 1.'.500. 00 'TOTAL.
Or-rl
...... _._.-- REQUIRED INSPECTIONS __...._...._
chis Applicrnt agrees to comply with all the rules and regulations Sewer Tnsspec!ti:an ____ __•_ _.,__,M__�_,_
of the Unified Sewage Agency. The pervit expires 120 days from
the date issued. Thp total amount paid will be forfeited if the
permit expires. The Agency dues not guarantee the accuracy of the
side sewer laterals. If the sewer is not lu,ated at the measurement
given, the installer shall prospect 3 fei:t in all directi;ms from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and t y ty,ll install �la eral. �_r___,_•___„____••�.,
�/_ �/ _._....._.__..._ ._._... ._...._._.....__..._ ___._ _......__.._.__.._.._.-......._....
VI a•r m i t t:e e S i.y n a t:t.r•rte:. _�__._. �.._. .:
C:.a 11. fc�r inal.�actac a C,39--41.7;`;
CiTYOFTIGrARD C r r A;�FTLA R D 1`�U1 L D I N G P E*-'R M IT
commui#TY DEVELOPMENT DEPARTMENT OMWMN
-4175
I p5 SW HWI BW. P.O.Bw 23397,Tigam.Oregon 97223(SM)639
(cn RD
t7
10PCC:-00,".J1,W
r
-6s. . 0 0 j.'!C, H W'Y
(�DDHL 56, ZONING: C-0
'MIMMTSION., LOT. . . . .. . . . . . . . .. .
0( K. . . . . . . . . . ..
... .......... EXTERIOP WAI I C 0 14 ST RU C T1 0 11
14 ISSUE1 FLOOR 11REAS---____ _ Ec Wg
FIRST. - - - '- 10'5)0 Sf Nc S:
L
Y%SO9F WORK. :OLT PROTF.CT OPENINGS'?-------
- ! 1. 3 _ W:
USE 011 N- G:
Y j::,L OF- CONST. N THIRD. . . of
) CANC'Y RJAD. ..142 1050 F,f
ROOCONSIF
IRE RET":
IC;CUP6V10 14ASEME'N'T. Sf PiRURATED-
RAGE. f OCCU SEP. R(VTFI)t
;I OR. HI ft; OfI
M T* N M E Z Z':1-.N RLUD REQUIRED——-
L EF T ft RGIAT: ft F IR 5 P K I Y SPIOK DENT -
L DOR LOAD., 50 osf VRNT-. ft REARS ft FIR �)LRM-N HNDIC'.F' MXI:Y
OWEA-LING UNITS: IMP, '3URFP("E r PRO '%'ORR'-N 1:1 A RK 114 6
M.*.DRMS
I 1JOi.1.1E. 18000 -rm, p1nibq.
Tenantjjc)cj ,-. Clue Hott-r Photo, :kflt- pa-rti. t3c)"Is, dark. -rm,
FEES
tyne amount by date -recpt
,,,1(",HARD LITIS 10/25/90 206248
1 .3050 S.W. PP['IFTC HWY I Inylvi 3-� .93 JUA
P R 111 h 1;,-8. 50
OR 9722-1 1.1,V
FIRE 51.40
639--60'70 5
PAYM *r 134. 93 FILL 1.2/06/90
mitf,acto-r-,
1;0HIRPCTOR NOT ON FILE
rj 6 9. A TOTAL
is f?q #. . REOUTRE'D INSPECTIONS
This permit is issued subiect to tht, revulations contained in the V-ranii-riq- Insp
Tiqard Municipal Code, State Of Ore. Specialty Codes and all uther
All work will be done in accot"ance with Byv t,aa-rd Iris�)
applicable laws. ire if work is not started t-,p . , iliq 11-1sp
This permit will exO Final 'L 1
withir. 188 days Gf issuance. or if work is susperded for more Fii .........---------
than M days'.
5jq11atU-r(?- ..........
C( H Y _.....`............_..... _....... .�c ........ ..........
for 639--4175
. IT,` or- l'ic)ARD ov PAYMENT RLCEIFIT 74.
CHECK AMOUNT a 1759.
ONV- HOUR PHOTO FINISH GASIA F)MCNJNT 0.00
A 1p[I R E 5)S Sol PACIFIC HJMAWA� F"AYMENT DATE 12/06/90
SUBDIVISION
TIGARD. OR 17722:1 SW PACIFIC
r-'uRr*nSE CY PAYMLNT AMOUNT PhID FURUOSE OF PAYMENT AMOUNT PAID
p7
Fl UMBING flmm 60.CICI 219.51) 11 . 27
r1r..'CHONICAL PE rlEC9()---02n6 36.00 ST. E4UII..r) PEP
24.cm- 5 0. C)
r`LAN CHECK, FE ISEWER USA GWPP(i,-.o4()7
r-)MOUNT P0111 73.
oilTUALATIN VALLEY FIRE do RESCUE
AND
BEAVERTON FIRE DEPARTMENT
4755 S.W. Griffith (hive• P.O. Box 4755 • Beaverton, OR 97076• (503) 526.2469• FAX 526.2538
.
October 31 , 1990
Ernest C. Moore and AV Landscapes
3951 S.E. Holgate Blvd.
Portland, Oregon 97202
Re: One Hour Photo
13500 S.W. Pacific Hwy.
Tigard, Oregon 97223
6089C-360-013
Gentlemen:
This is a Fire and Life Safety Plan Review and is based on t.',ie
1988 editions of the Fire and Life ,Safety Code (UBC) ,
Mechanical Fire and Life. Safety Code (UMC') , Uniform Fire Code
(UFC) , and other local ordii,ances and regulations.
)'Tans are conditionally approved subject to the following
items:
1 . Automatic Sprinkler Plans: Plans referred to and
examined by this office contain no provisions for the
alteration or installation of automatic sprinkler
system. Not less than three sets of plans for the
installation shall be submitted to this office for
approval prior to installation. UBC 302 (b)
2. Exit Door Hardware_ All doors shown on the drawings
imust be operable from the inside for immediate exit at
all times without the use of a key, special knowledge,
or effort . UAC Sec. 3304
3 . Exterior Exit_Door: Hardware for the main exterior
exit door may be a key operated deadlock if there is a 4
readily visible, durable sign on or adjacent to the
door stating "THIS DOOR MUST REMAIN UNLOCKED DURING
BUSINESS HOURS". This sign must have letters not less
than 1 inch high on a contrasting background. (UAC
Sec. 3304)
"Working"Smoke Detectors Save lives
Ernest C. Moore and AV Landscapes
October 3I, 1990
Page 2
4 . Missin4 Sheet: Please note sheet 3 of 3 was not
included with this plan package. Unless pertinent
information has been shown on it, please disregard.
5. Address Required_ The tenant space number must be
prominently displayed on the street front where .it is
readily, visible to drivers and officers of responding
fire apparatus and other emergency vehi.cle9. UFC Sec.
10.208
6. Fire Ext:inquisher Requirements: Not less than one (1)
approved fire ertinguisher. (s) with a rating of not less
than (*) shall be provided for each (** ) square feet of
floor area or fraction thereof. The travel di9tance to
an extinguisher .From any portion of the building shall
not exceed 75 feet. UFC Sec. 10.303
i*) 2AlOB:C - Light and Ordinary Hazard
4AlO,B:C - Extra Hazard
(**) 3,000 - Light Hazard
f 1 ,500 - ordinary Hazard
1 ,000 - Extra Hazard
Note: Where flammable or combustible liquids are used;
"B" ratings of extinguishers may need to be higher and
travel distances shorter. See requirements .in National
Fire Protection Association Standard 10-1. .
7. Approved Plans on Job Site: One set of approved plans
bearing the stamps of thz building department issuing
the .;orstruction permit and this office must be
maintained on the project site throughout all phases of
construction and must be made available to building and
fire inspectors for reference durinq required
construction inspections. UBC Sec. 303
B. Required Occuvancy Certificate: Prior to the use and
occupancy of the project (space) , a certificate of
occupancy or other written instrument of approval must
be obtained from the building department issuing the
construction permit. UBC Sec. 307
F IIW !W' 1w #
Ernest C. Moore and AV Landscapes
October 31, 1990
Page 3
If I can be of any further assistance to you, please feel free
to contact me at 526-2502.
Sincerely,
/
Gene Birchill
.Deputy Fire Marshal
GB:kw
cc: Tigard Building Department , -
1
lTYofr, air 813M 1w.1409_ 1
i(;r'A-R—D r�orcaon vrrs� PII� CIC/[ JCP
Imo)e39-4171 PEWLT I x/z"
(,l)MMUNITY DEVELOPMENT( L"ARTM[Ni DATE ISSUED
-c-*3 : I✓:)CC �t t i f �— Mj-'T IAac rmP/rrnC s%U z C-(--
IAN)
(--
IAA) USE:
OWNM SPBCIA , NCYr S
NAMEII: ,/r;/t,r,'�lif �� I2FZ�.�JE 'OF:
-- ----
,f FA ISS: _ IA9r RM-,-,W: ---
- - kI00D IMAM/
SINSJUM LAPID:
E'I
--- API?'fa0"IS, rkk7QU1RFD
1
NAW: .� = Jnr _1 L '.d;!�1„ t: �t: PIAM` E �
I+.IXJ*-SS: fir, -� -T'- �, -tY _ _ FIRE nF�'r ------—- —`-'--
BUS TAY:
AFKNIETUDIEER CA==CW-.:
NAMF.-- _-- IMSS DE UZ: _--—
ADOR:SS: OMEz
I'I-341UT ,I` ACCT DEM I AM,"n' AP'OKAY PD- BAI- EM
10--432 00 iii Ming R-M-I t F.e,-M l __? `^
,ZY$ 1.0-431 00 PlumbiM Permit Fees CL'
/h1rC�yiCJ'( 101431 OIL Mechanical Permit Fees _ -16 VG L -- --
XO--230 Ol Stag Wilding Tax (I-A) �� —
DAIding -- _
10-433 00 Plam C v�ck Fee
Building _ �- i
Plumbilil
30-202 00 Sewer (Zx :tion --
30--444 00 Suez' Ynspec tion
51-448 On Street System Deni Chay-xy (SDC-')
52449 00 Parks System Dev Clsazge (FDC) --
31-450 00 Sty D itwge Syst Dov C3" (SSS
10-230 06 Fire ,
_ a
APPISC Mr Slag " =
RrN-r_ived. BY: _ Date Pecai:-ed:
:eI/3587P_WPF r
;9
M'7A'w.AL`-EA-7KA��-wA'w-A'q-mJL�w-�79M,7�A
CITY OF TIGARD RUCE-IPT OF" F`ATIENT RECEIPT NO. 90-" Z 206�4
8
CHECK AMOUNT 134.9-3
A. J. LANDSCAPES CASH AMOUNT 0.00
►'T'RE SS 1-951 SE HOLGATE' VLVD- PAYMENT DATE a 10/25 0
SUDD I V I S I ON
POR71-AND. OR 9'72fG?-- 17-.5c)(4 SW PACIFIC HW)'
If-ePOSF OF F',AYPIENT AMOUNT PAID PURPOSE.. OF PAYMENT AMOUNT U'AID
ild,l rHECK FE 8_Y
57.
7. TUALATIN VALL 51 . 4(l►
1 -50C) SW PACIFIC HWY'
AMOUNT PAIL) -.-,4. 7Z,
1 ^w .w
WASHINGTON COUNTY INSPECTION CARD PROJECT NO,
J0 a DEPARTMENT OF LAND USE AND TRANSPORTATION PERMIT NO. !
FOR INSPECTION', CA�_L: 640-3561, 24 HOURS FOR INFORMATION CA(L: 640-3470 l
_ 1 t � DATE _� 7)
ADORE SS � l l/ f, •L ; r —-- -- -
PERMITEE-,KJ)
DIRLCTIONS J V PHONE NO.. _
BUILDING MISCELLANEOUS _- ( PLUMBING _ ELECTRICAL
fto post/beam nail mobile home
around rain drain temp service
fdn frame apron/ wood stove post beam Storm sewer cover 6 service
sidewalk
slab insul HVAC -out FINAL FINAL
FINAL
gas test sewer JI)SA No.
OIIIFR
PROVED ❑NOT APPROVED �REOUESTED INSPECTION
QOREPAIR ANO RE-INSPECT APPROVED HOWEVER NOTE: STOP WORK UNTIL•
t-:L,
—_
--------- --------------
-----
INSPECTED By �'� _ DATE � 1
'�'�° •� �r � �r � s s as
CITY OF TIGP►RD
MECHANICAL PERMIT Pel Reipt M ---- ------__--
rnit rM
13125 SW 11AIrL BLVD.
P. o. BOX 23397
I>eacrlptbn _
Table 3A Mechanical Code QTY PRICE AMT
T7GARD, OR `.17223 _ -
(503)6.39-4175 1) Permit Fee - -0 -0 10.00
Narm of oevaalxrt«a 2) Supplemental Permit _ -� _ 3_00
1 T Furnace to 100,000 BTU 6.00
Job 'dd`ess 1 i incl.ducts F,vents _
I Address xkC' " Furnace 100,000BTl1 + - —
Tax 1101 MOPNO. 2) 7.50
incl.ducts 8 vents
Nanw(or name of buskvm) 3) Floor Furnace b.00
incl.vent
Suspended heater,well heater
=viAddremddrem Phone 4} 6.00
Owner - or floor mounted heater - _ —
�. Vent not incl.in UO
appliance permit
Name(a nrne c�twdnessl --- 6) Repair of heating,refr ig., 6.00
cooling,absorption unit
Boiler or comp to 3 HP
MMAddress phos 7} 6.00
Ocrtrpeltt absorp.unit to 100,000 BTU
c�yfststs ZIP 8) Boiler or comp to 3 NP-15 HP 11.00
absorp.unit to 500,000 BTU
/ILIA Boiler or comp 15-30 HP 1500
NanN - —absorp.unit 1/2• 1 million
Ma Address Phone 10) Boiler or comp to 30-50 HP 22.50
absorp.unit 1 -1.75 million
14� ---
Contractor Cityrstate zip 11) Boller or comp to 50 HP 31.50
absorp.unit 1,750,000 BTU _
Stets gegistralan No City Bus lax No. 12) Air handling unit to 4.50
10,000 CFM _
13} Air handling unit 7.50
I hereby admovAodge that I have read this application that ttw information given is 10,000 CFM 4
rxxrect,that I am the owner or autttonzed agent of the owner,that plans cutxnitted are in -- —
(xw plane with State laws,that I am registered with the State Builders'Lived,that the 14) Non portable 450
number given is co i td (H exempt from state registration please give reaso r below) evaporate cooler
15) Vent fan connected 300
--- to a single duct
-- -- _
- 16) Ventilation system not 4.50
included in appliance permit _-
17) Hood seived by 4.50
mechanical exhaust _ r
- Date Domestic type 750
r;aynature(owner or moo" --- 18)
Ilescribe work Eladdition 1 1 alteration I 1 repair [7 incinerator
to be done residential ❑- _ non-residential LJi 9) Commercial or industrial 30.00
- -- type incinerator
Existing use of Other i.e.,woodstove,water
building or property _—_--- -_-- 20) 4.50
heater,solar,_clothes dryers,etc.
Proposed use of
N tddivg or property- __—__ -. - 21) Gas piping one to four outlets 2.00
IvIle of fuel- oil [_1 natural gas ❑ LPG ❑ electric
22) More than 4-per ou!let
NOTICE SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- 5%SURCHARGE
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 —
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL —
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER TOTAL
WORK IS COMMENCED.
Special Conditions __-_-----_-.-_ __--
Date issued by
CITY OF' TIGARD
PLUMBING PEIZ M I`l 13125 SW HAIL BLVD.
P. O. 13OX 23397
Appli(ants mutt hold Oregon Registration to Conduct a plumbing TIGA RD r OR 972"1
business or must be property owner/operalox not hiring otrlside Iselp.
Name o10ev.rloprrx_M - (503)639-4175
- Plumbing Pe(mit No.
Address Ooscriptron -- --- --
rY ��/f i /(L 1t QRS B14-211116 (JUAN. PfilCl AMT.
Job ' --._._-__------- - -- --
Tax Lot Map.No.
Address
_-_ _ FIXTURES
Lot �Block ---
Sink % 7.50
ane a namecirizitress lavatory 7.50
I 717r,�i j — 7.50
�>rlMq. :• (l�_.T. �/ -' Tub ur TtrbrSfsovrcr Gonrb. -_- -
Address
!>hc wer Only ----- --- ----7.50 --
(honerCky/Stele IIP �_- Waley(>nel - -7.50 -
(Nshwasher 7.50
-- Phof1e --- Garbage Oisposal _--- _ _ 7.50 -
- ---_- - Nanwr -- ----- Washing Machine - 7.50
Floor Grain 750
M. ws0 Address Phony' WaterHealar -- -- - - 7.50 --
Laundry Room Tray 7.50
Occupant -
City// tate zip —- 7
Urin a1 .SO
- -` Other Fmtures(Specity( N �- 7-130
----- 7.50
7deu�'1�ress-------• Pfao�n --- --- ---- --A 7.50
(antrecinr (:sty%State - 23P- --- - 7.50
MISuEI_L ANEOUS
- --- --- - Cay fAte- Tax No. Sewer 1st 100' 30.00 _
Stilt" s- 770.T t`t�le�F- ars (r�l�c.Two. s t+a.AAdd.100:---— - --- 15.W --
(Resdentia) WaterServke1st100' _ 20.00
I hereby acl:nmMedge that I wive reed dug apportion.that the irdrxmation Water Service ea.AdditXO' - ^1500—,---
given
500— -given is uxroct.dim I am reg%siered*ith the State Bur7does Board.and also Ski 6 rsin Grain 1st 10G' 30.00
have a Pk
State xnbkq iow"ow the num(N"given are oohedh.that a
ptwnb ng work will be done in wj rxdxnoe with QMAcstA@ pro.:sims d Ore. Skim S P!-in Grain Addi1.100' 15.00
gon R.mised Statutes(xsaMera 147 and 693 and+KrplicatAe axles and that Mobile Mortis Space 25.00
no help wou be empbyed unless ticeo sed urn3er()RS 6"(d exa'npt hon --- -- �-'--- -
_;tate raplstra0w.please give reason be". Bair Flow Preverr5on
lK�Mc ONRIFRS-1 tsereby oertily slut I sun dw owner d ora property de _ d Anti('blh�tron Oevice -- 7--W)
aenberf above,at whkh k)c bon I poopooe b make a pkxnbinp Yta sKndon f,y Any Trap or Waste Nor
my own rose aryl this pmperty k not treing oorestnxied for 900.lease or rent. Cdrsac1ed b a Fixbwe 7.50 - —
Calch Basin 7.50
---------_-----.___,_ _----- kwOfExdst.Pkxrb%ry - --- —40000PerHr. ---
Specialty Requested InV-Vons - _40.(X1 Per Hr.
----- --- ------------ - - Rain Drain, - - - _
15.00
Sinyle Fan. Dulq.
,AIM40RIZEO SIGNATURE'---- - Gate _
Describe work new❑ addition 1-1 etteretk n❑ -poll❑ ----- -b19 e done - residential( - - non roeldoMiel Q_ - ---
E stklp taw of MINIMUM MiIMZT FF.F v 25.00 ---
btAkOngrxlxoperty - 76B--TOTAL -
a�rps uat 5% SURCHARGE
p"'ert)' - - ---- -- ----- --- 25% F LAN REVIEW
NOriCE -
TTtic parmrY barxm.a no oil arsd srotd r worSx or co natuLA3n auVwxUad V rv,l oa„ TOTAL
monood*W*i 100 rfeya,ru K orxw*-ribn or wrxk 1•e4mcwrvlad or abarvlo,rod
a parka]rel 180 days of*,IV t'nw atbr"v"14 Is c"mr-ocr301,
t rtCtAI-QOlfOf1KPH1fS ----.-------
MECHANICAL PERMIT Permit #
'I'CX OF TIGARD C
13,125 SW HALL BLVD. Permit �
- f.). BOX 2 3 39 7 D ion ---- --
".t GAitD z OR 197223
-Tabblele 31�A:Mechanical Godo ---. _ QTY PHH:E AMT
'503)639-4175 1)^Permit Fee -- -- A --0_ -0- 10.00
Nam of Developmem 2) Supplemental Permit 3.00
Furnace to 100,000 BTU
Job 1 I incl ducts&vents % 6.00
AdIress % --:K-5-COO Sul
w 6140 C � Furnace 100,000 BTU -
Tax Ld �• 2) 7.50
incl.ducts&vents
l of Bloek St6dMoilon ----- ----- -
- _ Mame(«naneo a btrai►ess) 3) Floor Furnace 6.00
incl.vent _
MaArq Address —- Phoma - 4) Suspended heater,wall heater 600
O vm%r _ or fk)r nvxunt,-d heater - —
cryrsrate 15) Verd ryjt ind.in 3.00 I
_ appliance permit -
- _ me(«name c r lxtcinass) 6 Repair oS heating,rely ig.
Na , 600
r
� � _ ) cooling,absorption unit
'�- f-r G'7�� Boiler or comp to 3 HP
Idaiting Aeeres. Phoma 7) 6.00
i)ccu;,.�ant _--- absorp.unit to 100.000 BTU------ ---
CityrState ap a) Bo+13r or comp to 3 HP-15 HP 11.00
bsorp.unit to 500,000 BTU _-
----
No" Boiler or comp 15-30 HP- 13 W r--
~— absorp.unit rh-1 million
Mar"AM1Mess--- — Ptlolta 10) Boiler or ct-mp to 30-50 HP 22-50
absorp-unit 1_1_75 million
GontradorCity/Ste a — P 11) Boiler or comp to 50 HP 31.50
absorp.unit 1,750,000 B111
State Heratia�No �—-- r.My&n To.No. 12) Air handling unit to 4.50
gi�
10,000 CFM _-
13) Air handling unit 750
I tx Way ackrewkrdpe mar I have road It"appi cabon mat are information Pius"is 10,000CFM i
c,r~.thM 1 sm the owner of aunxxized"of me owner,mat plans sutxrrnrd are in ------— ---- —
r.+xrt(fli ve with Stan laws.mat l am regmtered with the State Builders'rioard.that the 14 Non portable t4.50
Mxnher liven is axnrI (n exempt Isom State regieha ion please g ve rers«t below) ) evaporate COOICr
15) Vent fan connected 3.00 9,00
-- --- - ------ - - ---- --- to a single dud
--------
.-------- ...--- -- - Ventilation system not 4.50
16) included in appliance permit
17) Hood served by 4.50
mechanica;exhaust
f-;rfkmure(owrlar or agent) - --—------ Dale 16) Domestic type 7.50
escFribe work 1 ad�fition I alteration L1 repair p __ inclnera^.or
Cl
to be.done residential l 1 �-non-•esidential 0 1 g) Commercial or industrial 30.00
-- type incinerator _
Existing use of Other i.e.,woodstove,water
building or properly__ __-_-- ----- -- 20) heater,solar,clothes dryers,etc- 4.50
Proposed use o1 _- -- �_-- r
t>uikling or property ---- ---- 21) Gas piping one to four outlets L� 2 00
TWW'of fuel- oil I I natural gas LP i L7 ek!ctric F7 1
- --- 22) More than 4-per outlet
NOTICE SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OP CAN- - 5%SURCHARGE
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 -
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 11T0 DAYS AT ANY TIME AFTER -- TOTAL
1NOHK':' (COMMENCED - -
Special Conditions
Date issued ----by-----
111111 w we
CITY OF 'I'TGARD
PLUMBING NG I��' 1Z M I �. 1312 5 SW HALL BLVD.
1vA P. O. BOX 23397
A,xtlicants must hold Oregon Reglstratio" ..n CCHduct a plumbing T I GARD, OR 97223
business or must be Pmoperty ower-'-;--1,1(0(rut hiring Outside IrcIP-
-- Naffw o(�Deve ram
� --(503) 639- X175
PlumbinK Pcrmil Nu-
r a�-
I'M- ORS 814-21.810 _ 041AN. - PritcF. Anti
job Tax int Map.No.
Addresa _ FIXTURES
Lof Block Subdivision Sok — — — — 7.50 U
—�—
20 sme or tta,ne xi> ss — �— lmakxy — — 750
—Tub or Tub/Shower C,ortrb. 7.50
aq ass - Shower Only
owner CRY/Stale Walercbset __ - --- 7.50 7,yo
Dishwasher
Mane ----- Garbage 0ispasat-�_ _ 7.50
Naffm -- _Wasting Martine 7.50
i
Floor Drain --- 7.50 Z0
ing.Address Plane Water Heater . ..__�.�_-- ��y
_ Laundry Room Tray
Occupant cSty/State LP - 7 -
Urinal _ _ •�
- --- -__ OffwF1wures(Specity) 7.50
7.50 /5-,00
Su ass-- Pha,o 750
- ---- --- ----- � 750
C4D"Irrictor City%State Z)p -- - -
MISCELLANEOUS _
---- - City hue.Tax No. Sewer 151 1170' - — 30.00
tate Y.Boa-rO�Ni tete - s. o. S" aa-Edda.100' - 15.00- -
(Besrlentian Nater ServiceIstIfX)' _ -- 20.00
1 hereby acknovAw*1e that 1 have reed this rpplicatlon.that the inform won Water Suxvioe a&-^ lit", _— 15.00
given is correct.g ud 1 am ."gWeeod%jfh the State Bo;kWs 3owd..d also Storm 6 Rain train 1 St.100' -- - 30.00 -
have it State Pirxnbk%U kwvse that the rxxmbecr.given are c0r-60 tfut On - --
prumbwv work will be done in aocoedenrm with applicable provicions of Off Stam 6 Part Drain AddQl100_ 15.00
go Revised Statutes Chapters 447 and 193 and applicable codes and that Mobile Home Spatz 25.00
no help wNl be emr*yyed unless g %Sod tawlw C41S rAl(it exempt Aran - --
State reason be"
please give reasbekrw). Back Flow Prevention
WwFOWNFRS-1 Ixxeby rvr*the 1 aim#.re owner of the P"wty rte- Device or Antl4'1otkntion Device / 7.50
scrbed atxnve.at whir+bcaWn 1 rxgw5 a b.m ake a pkxnbtq kv"fkam c r kx Any Tran or Was%Nal
y oven jibe&M thio prvparty isnot bena
kq votrudad lot cafe.least. Cor
e or renk+eraed to a Fixture - 7.50
m ---
(xr n tiasM 7.50
---...- -- ----- ---
kw.o(Exw.Pt:xmbiry 40.00 Per Hr.--- --
- ---- - `>,peciaPy Requested InsPacdoas '40.00 Per Hr.
---^ Rain Drain,
------ -- - __ - 15.00
Single Fam. Dw1q. -
AUT110MTED SIONATUAE
Deacribo work new L] addition —
txl d me residential _- non-maldential - -
MINIMUM PERMIT FEE -- 25.00
Exts' ,tae of SUB-TOTAL 60C
bt 4,u:r y or iXrpwrty --. -- --- -
�
ioend V"of -- -- 5% SURCHARGE 0�
�orpoopMty--------`— 25% PLAN REVIEW /1',0_0_
TWO pwvo b000rn*e mA and v1f wwoonc�
oce of oautruodon mAhodxod la not oorm -- - --- --- TOTAL �,L
—osd wlthkt 180 dalrner M c ondniribn or wrxlr 4 otwpwdod or abandcxred fo,
a gator fit I W days N w ry tlnw ef%w work to c"Twronood.
ttf'[ClAlO(1♦rtKiMJH't _ —
Dale laved _ by