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8945 SW PINEBROOK STREET
ADDRESS: 2�9� s InLaML i:\records\microflm\targets\buildinr;.doc INSPECTION NOTICE City of Tigard Building DepartaEnt 13125 SN B&1I I lvd. Tigard, Oregon 17223 / Inspection Line (Rec-O-Phonu)t 639-4175 Bunineax phone: 639-4171 Ineptction: --- ----�__,_-- Footing Pibg. Underalab Mach. Rough-in ANpr/Slwlk Found. Plbq. Top Out Cas Line I►AL: Poet/9eam Struct. S&n. Sewo- Framing -.'•.dg. Peet/Beam Rech. Rain Drain Insulation -Plumb. Plbq. Underfloor Nnter Litte Gyp. Bd. -Neth. Date Requestedt .wSJ _ - Ij Timet AH PM Li AddreaR^ 6, YJLL(/� Ifs_ C/1+ P•tbi�tlJrt 9 Builder �CORRMZCTIONS TBE 10 No ARR REQDIREDs Lnspector:_ _ _ �. Date:S// - PPROVED DISAPPROVED AP^ROVP.D SUBJECT TO ABOVE ^—Call For Reinnp. a INSPECTION NOTL city of Tigard Building Del .rtsmant 13125 SR Ball Blvd. T1^-cd, Oregon 9722 Inupectton Line (R�ejc/-�O-Ph�oine)t /639• X7/5,/Bu/el/nnese Phones 639-4 71 Inspection# C/ (r'/ _ W�// �j � o ooti Plbg. Underslab Mooch. Rough-in pp /Sd f- tioqnd Plbq. Top Out Gas Line FINAL: Pout/neem strict. San. Sewer Framing -Bldg. Poet/Beam Hach. Rain Drain Insulation .-Plumb. Plbg. underfloor Nater Line Gyp. Bd. -Mech. Date Requested: r� ' L /� Times _AN _PN Address s ��� `� C.L Permit #s�� Builders_ THE FOLLOWING CORRECTIONS ARE REQUINED: Inspector - _ _ Dates APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE _Call For Roinep. unit ied Sewerajae Non - Residential arjency 150 North First Avenueufrll Questionnaire Hillsboro, Oregon 97123 503 648-8621 I. Official Name and Address of Non-Residential Applicant. 2. Standard Industrial Classification Number T (SIC No.) 3'-,Location of Business (if different than above), 4, Approximate Number of Employees: _� -.—_- __ ------ -------- Full Time Part Time 5. Contact Person and Alternate (Name, Title, Phone Number). (Alt.) 6. Principal Business Activity (Examples. restaurant, circuit toad manufacturing plant, frozen food , processing, etc.) Please be Specific: I MAkr Si'QN�'2_�L S_�AA.L- Non-manufacturing L\A Manufacturinq 1. Type of astewater discharged? Sanitary or Domestic ❑ Combination Other (Please Explain) Industrial ❑ Floor drains from washdown arca --- ----—— - B. Quantity of wastewater discharged in gallons per day? (An estimate may be obtained from your month 1, .iter bill.) IV Less then 10,000 E] 10,000 to 25,000 L] 25,000 to 100,000 More than 100,000 X 9. Characteristics of wastewater discharged (if other than sanitary or domestic) ? Acid [� Toxic Organics [j Other (Please Describe) Alkaline Color, Dyes -- — Metallic: Oil and Grease (Petroleum) 10. Does wastewater pass throw a device to separate se ,d and/or grease or oil? ❑ Yes Yr No Sanitary or domestic wastes are those that are derived from an ordinary living process and free from a special treatment requirement before being discharged into a public sewer. CERTIFICA N: I cer Y that information supplled-above is tide and correct to the best of m; knowledge. i✓ - f �_ure Title Date Do Not Write in This Space - Agency Use Only Date Received: ___� User Name: Basin: Application Issued Date: _ By: Permit No. Permit Issued Date: By: _ SIC No. _�. Ell EM I ESI -- 82_-434 CITYOFTIFARD , „6ARD COMMUNITY DEVELOPMENT DEPARTMEN'r 0111GON 13126 BW i WI Blvd. P.O.Box 23397.Tgard,Oregon 97223(603)B31i4176 L U C K,, I.E.IS Jul .i ' L A i'.� C IYPL C)F OCCUPANCY Y GRF . ,. fR3 v�T0RIE;S. . . . . . . ; i �,. (K t: UL, LIC-1-IT. . . , 't r LOUR LGOO. . . . ,: h plSf VF1..._: . , . . 756"A PF')RKING L PACIL.S. . ie in a.t•kS : ii-I"LlP 1s'51'_I:)iNG NO"I' i ul; Hii!A! 1-NY IYIF::i::.l1CIHJ,+..rfl. EQUIF'MEN . _ . ...._.. .__.__._....... . ...........__.___..__. ..___._._._.._. . ._ ).!L.UiIJB+ i NCS I=.L.F:G 1)I :.J. . . . .1l L!iCKF i__C16i :O WA"r•E.R FIEF=i l k:RSR. . . :V) T IiAF':i. . .. . . . . . . . . . . . .0 "1'Uh/:;iF-HUWE H1,3. I.k1 LAUN GRY '1-F+i i (L!. . . -0 !-441 1'-Il [t1 i�',... . . . . " , . ,0 WATER CLOSE-T G. . :GCI SEWER L I IVE. ( f t ) . :0 6RE ASE: -i kill•'6. . . . . . . a 0 011':i14WAS[4ER2.;. . ., . .lp W11I'CP LINL:: f t ) , 9I', QTHEF: F I X11..;1 GB'. . . . . .0 GARB(4GL DISI-'. . . :0 RAIN 1)R(A l k, + i't ) . :0 WASHING MrC'1 i. :W 'Jt= R01"14 Ui•i i.i`d . . :1ri _..__._.. ..,..�_.,. .. ._...._...... MLCHANILAL ...._,__..._ _..._._ LLS _,....__..._..... . FUEL 'TYPE::., _..--• UN t Ii, 114 . . c Ili type alnt,+Ant, ia; +Jate VENTS . . . . . '0 I PR'r $ Elb. 50 JH ii 3/c:c?/1)3 MAA INPUT :+dI U i U VEN i="Ni�lw;. . : I%' I.��'I_.l� $ 4',1 . Ji i iii:: /4:'`)/'3.3 F'URN < 100K :QI HOODS. . . . . . .0 F35 C, .t 43 JH 03/29/99 - i=URN ) lOvo-" . „ 1b W001ki'Ti:)VE_.: ., .0 'LOUN F URN. . . . :0 CLO DRYERS, BUll_/LMP 011-iii.-JR 1.1N3. Lr Mile I EFF F•IA6 L.BE R(-'1E•,R I5F4ilD OR 972 4 i•1 c11 t�� #: ,WNF.I `tl O rt e # Reg #. . : 00011I0 This permit is issueC siblect tc tre 'eyuiatior!a contained in the RF-UUIRE.!) Tigard Municinal Code, 5ta.e of Cre. Speciai.tIi Codes and ail other 1:001 'fOUTICi Insp applicable la1+s. All worn will be done 1n accc _ apprave4 F ra m x ri y l n s p _ians. This permit cii ey.vi,o if w-1, :s no' in IN Rair1 clwain InsFa nays of issuance, 'v If Na+ /., d&95. Ea�.1 t I rl i n y F 2.rt a J. `�'� T (`� /� 71 1)125 Sw Itat� 'LNCK/RECTCITY O1' A I4Jt71.1�D r��9nZ� PEPI4IT 0 /45 �J 3- / 7 COMMUNITY DEVELOPMENT DEPAR'CMENT wd,Oregon9 (503)639-4171 DATE ISSUED A- JOB ADDRESS; �� S �/J>�'fr�f�GdkTAX MAP/LOT ,2S I )AL U3.2UU SUB: — LOT: LAND USE: VALUATION: ��� OWNER SPECIAL NOTES NAME:: _S2l"," hWgi�Cg� °'' _- REISSUE OF: - — ADDRESS: ,%�4%S _S �'' ,llp' LAST REISSUE: -t FLOOD PLAIN/ PHONE: ( .� '' ' ' SENSITIVE LAND: _ CONTRACTOR APPROVALS RE UI—RE 0 NAME: C t e %A e A" _ PLANNING: VAC '3-�0o ppfi+2 �EouCf.� ADDRESS: ENGINEERING: EIRE DEPT: PHONE: — OTHER: Vn T/,-" CONTR. BOARD #: —__-�-- _ r: 11 DATE: ITEMS REQUIRED SUBCONTRACTORS: PLUMB: ____ LIST/SUBCONTRACTORS: MECH; ______-- __-- BUS TAX: ----------- ARCH/ENGINEER CALCULATIONS: NAME: _ TRUSS DETAILS: ADDRESS: — OTHER: PHONE: PROPOSED BLDG. USE: -- COMMENTS: I/-P&LV f --- W.Afff SIGNATURE Received By: _ ____ _ Date Received: r PERMIT n ACCT # DESCRIPTION AMOUNT / AMOUNT PD. BAL. DUE"i+ 10-432 00 Building Permit Fees 10-431 00 Plumbing Permit Fees 10-431 01 Mechanical Permit Fees 10-230 01. State Building Tax (5%) Building Plumbing Mechanical 10-433 00 Plans Check Fee Building Plumbing Mechanical 10-230 06 Fire --- 30-202 00 Sewer Connection 30-444 00 Sewer Inspection - 25-448-02 Commercial TIF Fees 25-448. 04 Industrial TIF Fees _ — _---- 25-448--06 Institutional TIF Fees ---- 25-44803 Office TIF Fees ___-- 25-443-01 Residential Traffic Fees _ — — 25-448-05 Mass Transit TIF Fees _- 52-449 00 Parks System Oev Charge (PDC) 31-450 00 Storm Drainage Syst Oev Chrg (Ss-DC --- ..— ---- 24. 445--01 Water Q ty (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu of) TOTAL nm/3581P.W111- i C.;.I 7Y' C1F' 'F T C7FIF2U - FtC CE:T �t OF F�4"fYI+IE:N N'1' RF.C;E'I P'1" NO. :93-P-38360 C;1AEC t,l AMOUNT : 46 I t t;ACH AMC)IJN'1` : 16. 00 .,IAMI� : PACIF. ;yPEC,IAL.'I'Y PAYMf=N7 DAl'F : 03/&9/93 i IgllFiE.SS : ST©NE.WARE, INC gtjF3L)T V I S I ON : I 6945 5W PINEBROOK (:;7 OR y r wUr�r:��OGk: tart• PAYMU N-r Flf 1L'1l 1hJ7 F A 1 T) P"URF Cl.:E oF" r-A I MENT F1l�iC1l.IN'f F A I� _.._._.. _._.._w.�._..._...._____..._. So. 210 1c,4 E?{�. 00 LAND USE-. AG�t��l., HtIF•19 .,_.,(�F� •� � fBUILDING Pf+RM 68. 511 131 . 13UTI._D PP".R 3. 3 VL.AN C'HF:E.K FE: C u,R 44. 5:3 fU"LFII._ AMOUNI` POTD - - -> :-26. 4h