14410 SW 94TH COURT i
ADDRESS:
W 9gar
Co UkT
i-bewtds\rnleroll!n\large l Vwilding.dw
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 6394175 Business Phone: 6394171
Date Requested: �C +)-I -�q �/_% 1 A A.M. 1. MST:
Location: 1 .�� ^Cj L 1 r ! (� rN l _ BUP:, —
Tenant: Suite: Blrig: MEC: .036
Contractor: ,-n Phone: PLM:
1
Chimer:__ Phone: _�_ 3 ELC:_
ELR: _——
_ --~—� SIT:
BUILDING BLDG(eon't) PLUMEINGECHANICAL`_. ' F,LECTRICAL SITE
Site Post/Beam Post/Beam os Team Cover/Service Sewer/Storm
Footing Roof UndFl/Slab Rcagh-In Ceiling Water Linc
Slab Framing TOP Out Gas Line Rough-In lJG Sprinkler
Foundation Insulation Sewer Hood/Duct Rcwnnect Van,
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling 12,un 1lrain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Ih Heat hung l.ow Volt _
Approved Annroved (�_A proved ) Approved Approved
Appr/Sd%�!t. Not Approved Vol Approved vcd Not Approved Not Approved
FINAL FINAL CFINA17 FINAL FINAL
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-1 Call for reinspec ❑Reinspection fee of S required before next inspection D I Inablc to inspect
Inspector:_ __ —`����_ Date: r-1 �" � J _
_ Page or
CITY OF TiGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 630-4175 Business Phone: 6394171
Date Requested: ( �l �� ��7 M. _ P.M._� MST:
I.ocation: BUR
Tenant: q Suite _Bldg: _ NEC: t2c7
Contractor:__e,--, " Ili—" Phone: PLM: --
L
Owner: Phone: ELC:
ELR:
ST{':
BUILDING BLDG(can't) PLUMBING MECHA gICAL ELECTRICAL SITE T
Site Post/Beam Post/Beam Post/T3-•am Cover,'Service Scwrr/Storm
Footing; Roof UndFI/Slab Bou h-In Ceiling Water Line
Slab Framing; Top Out (7111-1-1.mc Rough-In UG Sprinkler
Foundation Insulation Sewer Ilood/Duct Reconnect Vault
Bsmt Damp Drywall Storni Furnace 'Temp Service MISC.
Masonry Ceiling Rain Drain A/C U(i Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr I lent Ptunp I ow Volt
Approved Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL ✓- FINAL FINAL
al;for reinspection D Reinspection I'm if S __required before next inspection C]ilnahle to inspect
Inspector: _ Date:.1Q' •� �_� Page_ _of,
CITY OF TIGARD BUILDING INSPECTION DIVISION
l \� 24-Hour Inspection Line: 6394175 Business Phone. 6394171
Date Requested: �� / 7 _ A.M. _ P.M. MST: _
Location: _ S t��.� Ca _ _ BUR v _
Tenant: Suite: Bldg- MEC: G
7
Contractor: — Phone: 6
cod ��V PI.M: _
(timer: Phone: � 1 .?J _ GLC: _—
ELR:
_ — SIT:
M
BUILDING BLDG(con's} PLUBINGM� ECHANICA.L ELECTRICAL SITE
Site Post/Beam Post/Beam Post[Beam Cover/Service Sewer/Stonn
Footing Roof UndFUSlab Rou t-ht Ceiling Water Line
Slab Framing Top Out Gas Linc Rough-In UCi Sprinkler
Foundation Insulation Sewer c tet Reconnect Vault
13smt Damp Drywall Stoma Furnace Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/round Dr I leat Pump Low Volt
Approved Approved Approved Approved Approved --
Appr/Sdwlk Not Approved Not Appioved _Nes A proved Not Approved Not Approved
FINAL FINAL, FINAL FINAL
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�.,�-Gv lI Tom, /"'^ �'` it�iT---L.-�r �:'?�LL�� ��_.7_L_Gs•zy� �__- _____
- SyPr�O�t.;•T �.�+moi t� e `zJ _.�_t_Z�r_�T��- �C;�i'o,v --
` —�-,I iN c -1:7 T, _rte-< G� �5• •� �5�' /L�1,-vv
O Call for reinspectt 0 Reinspection fee of S required before next inspection O Unable to inspect
Inspector: r _--- I)utc - �Q 7"�? page----of
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Busine,--s phone: 6394171
Date Requested: (.' ' d- 9- L? A.M. M. MST: _
XX_
Location: BUR_
367
Tenant:___ /Suite: _Pldg: MI?C: [_
Contractor: t/�/ Phone: tG - a PI 1 7-n37(
q(honer: L _ Phone: t) EL
�7 7 R:
- SIT:
BUILDING BLDG(con's) ��U � G -�MECHANICA J ELE� SITE
Site Post/13mr! oF' sUl3eam 111*3z-im Cover/Service Sewer/Stonn
Footing Roof UndFl/Slab Rough-In Ceiling Water Line
Slab Framing 'Cup out Gas Line Rough-In i1G Sprinkler
Foundation Insulation :;ewer Hood/Duct Reconnect Vault
lismt Damp D"all Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Shcar/Shea"a I-ire Spkh/Aha Crawl lh Heatun-11 Low Volt
Approved rove Approved Approved
Frp�'Sdwlk Not Approved Not Approved No proved Net Approved Not Approved
FINAL FINIAL FLNAL FINAL FINAL
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❑Call for re4v.q7ec on ) O Reinspection fee of Sreq tied bcfor next inspection C7 Unable to inspect
Inspector._ _ Date: Page of
CITY OF TIGARD El__rCTRTCAL- PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC97-070'
13125 SW Nall Blvd., Tigard,OR 97223 (503)539-4171 DATE ISSUED: 1.0/24/97
PARCEL! 2S 1 1 1 AB.-083,00
SITE ^DDRESS. . . : 14410 5W 94TH CT
GUBDTvISION. . . . :PENROSE TERRACE ZONING-R--4. E
BLOCK,. . . . . . . . . . . LOT. . . . . . . .. . . . . . .028 JURISDICTION: TIG
Project Desc:r^iption : Add fir.. Branch circuit to an existing single family
dwelling.
___-_RESIDENTIAL UNIT.-.---- -_..._TEMr SRVC/FEEDERS.--...__ --
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0+
EACH ADD' 1_ 500SF . . . : r?r 201. - 400 amp. . . . . . . : 0 SIGN/OUT LINE. LTG. . : 171
TM?TED E;NERGN.. . . . . : 0 401 •- 600 amp. . . . . . . : 0 SIGNAL/PnNEL. . . . . . . : 0
ANF, HM/ SVC/F'DR. . 0 601 +amp5--1000 volts. : 0 MINOR I-ABEL ( 10.) . . . : 0
-_----BRANCH CIRCUITS------- ----AAD' L INSPECTIONS---
, .00 amp. . . . . .. : 0 W/SERVIC OR I" :.R: 0 PEP INSPECTION. . . . . : 0
400 amp. . . . . . : 0 1st: W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
'r01 - 600 amp. . . . . . : 0 EA ADD' L. BRNr� H CIRC: 0 Ill r'L.ANT. . . . . . . . . . . : :h.
601 - 1000 Lamp. . . . . s 0 _.._____. ----.__._._______._PLAN REVIEW SECTI07N- -
1000+ amp/volt. . . . . : 0 ) -4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR > - 225 AMPS. . r CLASS AREA/SPEC OCC. :
Owner : ________.. _. ._.__.__-.----__..__ FEES
'_YNN WORTH type amol.rnt by date recpt
4410 SW 94TH CT PRMT $ 35. 00 GEO 10/,24/97 07--300375
7IGARD OR 97223 SPCT $ 1. 75 GED 10/24/97 97-300375
P!,one #: 620 .3748
Cant r,,-irtu;
WESTS I DE ELECTRIC $ 36. 75 TOTAL.
7518 SW MACADAM AVE
__...._.._. REDUIRED INLPr7CTIONS -
r,ORTI..AND OR 77219 Under-groi.rnd Cove Elect' l Final
Phone #: 45--3385
Reg #. . . 000133
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other
applicable laws. Al: work will be done in accordance with approved pars, This permit will expire if work is not started within 180
days of issuance, or it work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center, Those rules are set forth in OAR 952-MI-N.10 through OAR 952-001-1987. You may obtain a copy
of these rules or dirert questions to DINC by calling I '!246-1987. n
Pet-mittee Sign;ai,r.rre : _ _ Iso�_:k�d By• r--'—
r-
-� INSTALLATIOhI
�? The installation is being made an propoi,ty I own which is not intended for
L rsale, lease, or, rent.
—' OWNER' S r I GNATURC DATE:
INSTAILI...ATTON ON1._'r'--._._.__-...__ ....__._._..__..___.._._ _. _..__ _ ............
5 T rh!''17'!JRE OF S 1rIP. EL rCI N: ���� DATC:
1..I.CENSE NO,
4++ +++ t ++ t +++ hF++4 .r A r r-1 F+ r+++.! +-++-r-I +++++++4++-t ++-14+++++++++++++++,•++++•+++ +++-r
rAll C 7 t.. r c
++.-1 +++++++++ F + ++'+++++++++- +++4-++++++4 1 $-+++++++++.+.+ +++++'1
CITY OF TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date RecdDate to P.E.
Phone (503)639-4171, x304 Print cr Type Date to DST G
Inspection (503) 639-4175 Permit#_��
Fax (503) 684-7297 Incomplete or illegible will not be accepted Called_
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) _.�� / � . Service included: Items Cost Sum
AddreSsi/ -j i�L 4a. Residential-per unit
Ci /Slate/Zi� �� �� Woo sq.It.or less $110.00 _, 4
ty I __. f/ ( Eich additional 590 sq.ft.or
Commercial Residential Limitedportion thereof �. $25.00 1
Energy � $25.00
Each Manut'd Home or Modular
Dwelling Service or Feeder $68.00 _
2a. Contractor installation orly-
(Attach copy of all current license 4b.Services or Feeders
Electrical Contractor ( I: Installation,alteration,or relo:ation
Address L✓ �r �i/,' ,s - 200 amps or less $60.00 _ 2
I 201 amps to 400 amps $80.00 2
City /C.• 4i [ State� �e Zip_1 I 401 amps to 600 amps $120.00 2
Phone No. 620 - 37VL
601 amps to 1000 amps $180.00 2
Job No. )t -- Uver 1000 amps or volts $340.00 2
Elec.Cort. Lice. No. L (_ExReconnect only $50.00 2p.Date �-
ON State GCB Reg. No. s _Exp.Date 4c.Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date ___ Installation,alteration,or relocation
200 amps or less $50.00
Signature of Supr. Elec'nJ� _ '--- �___ --- 201 amps to 400 amps $75.00
401 amps to 600 amps $100.00
Over 600 amps to 1000 volts,
License Nr L> S ____Exp.Date see"b"above.
---- 4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations. a)The lee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00
- --- --- u)The fee for branch circuits
City _ StateZip without purchase of
Phone No. serirsvice
h circuit or
fee $35.00 2
The installation is being made on property I owr,which is not I ach additional branch circuit_ $5.00 2.
intended for sale, lease or rent. 4e.Miscellaneous
(Service or feeder not included)
Owner's Signature _ _ Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circult(s)or a limited energy
panel,alteration or extension $40.00
rL Minor Labels(10) $100.00
N Please check appropriate Item and enter fee in section 5B.
4 or more residential units in one structure 4f.Each additional Inspectloo over
Service and feeder 225 amps or more the allowable In any of the above
_System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C.Chapter 5 In Plant $55.00Lli
-j `Submit 2 sets of plans with application where any of the above apply. 5. Fees: r-
Not required for temporary construction services. .5a.Enter total of above fees $
5%Surcharge(.05 X total lees) $
NOTICE Subtotal $
5b.Enter 25%of line So for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if resulted.aec.3) $
NOT COMMENCED WITHIN 160 DAYS,OR IF CONSTRUCTION OR WORK subtotal $ -
IS SUSPENDED OR ABANCONED FOR A PERIOD OF 160 DAYS AT ANY ❑ Trust Account a I� s
TIME AFTER WORK IS COMMENCED.
Total balance Due If
11aSMELr'96.APP Rev W96
CITY O TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : ,EC97-0367
DATE :iSSUEP: 09/30/97
PARCEL: 2G I I I AB-083021
SITE ADDRESS. . . : 14410 SW 94TH CT
SUBDIVISION. . . . : PENROSE TERRACE ZONING: R-4. 5
BLOCK. . . . . . . . . . . L0I . . . . . . . . . . . . . :028 JURISDICTION: TIG
------------------------------------------------------------------------------------------
CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP,. . : Ra VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES-------------- 0-3 HP. . . . : 0 DOMES. I NC I N: 0
:GAS 3--15 HP. . . . : 0 COMML. I NC I N: 0
MAX INPUT: 0 BTU 15--30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS7. . : 30-50 HP. . . . : 0 WOODSTOVF-S. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS----------- ATR HANDLING UNITS OTHER UNITS. : 0
FURN ( 100K BTU: 1 (- 10000 cfm : 0 GAS OUTLETS. : 1
FURN ) -100K BTU: 0 > 10000 cfm : 0
Remarks : Worth
Owner: ---------------------------- ------ -- ----___------ - FEES ----------------
LYNN WORTH type amoi_int by date recpt
14410 SW 94TH CT PRMT $ 25. 00 JSD 09/30/97 97-299640
TIGARD OR 97223 SPCT $ 1. 25 JSD 09/30/97 97-299640
Phone #: 620-3748
Cont Tact or: ---------------------------------
COL_UMBIA HEATING R COOLING INC
PO BOX 230397
$ 26. 25 TOTAL
TIGARD OR 97223
Phone #: 624-2704
Reg #. 000763
--- ---- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechani(7al Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Heating Unt Ins p
applicable laws. All Mork will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started
within IN days of issuance, or if work is suspended for sore _ __....
than 180 days. ATTENTION: Oregon law requires you to follow rules _
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-BI-NIO through OAA 952-01-OW. You may
obtain copies of these rules or direct questions to OLNC by calling
(503)246-9187. -_
Issue By: __, Permittee Signature:
+++++++++++++++++++++-++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 6:00 p. m. for- inspections needed the next business day
+i l ++++++t+-h++.++-F++t+++++.++++++4+t+++t+.++t++++++++.....+++t+t+++tt41....+t-h++..
Plan Check#
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential DateRec'd Or` 4 -
TIGARD, OR 97223 Date to P.E.
(503) 539-4171, x304 Date to DST
Print or Type Permit W&
Called
Incomplete or illegible applications will not ".)e accepted
Nape of Development/Project Description
L YI (A I()C h 1 Table 1 A Mechanical Code CITY PRICE AMT
Job Street Address sudee A) Permit Fee -0- -0• 10.00
Address /- >W `/r✓rl !
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 PERMIT #. . . . . . . : PLM97-0390
DATE ISSUED: 09/30/97
PARCEL: 2S1i1AB-08300
SITE ADDRESS. . . : 14410 SW 94-F!i (-T
SUBDIVISION. . . . : PENROSE TERRACE ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :Q128 JURISDICTION: TIG
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : i CATCH BASINS. . . . . . : 0
FIXTURES---------------. LAUNDRY TRAYS. . . . . - 0 SF RAIN DrAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . .
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0
TUN/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0
WPTER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DISHWA.173HERS. . . . : 0 RAIN DRAIN (ft ) . . . 0
Remarks : Worth
Owner-: ----------------------------------------------------- FEES --------------
LYNN WORTH t',-pe amoi.Ant by date rk-cpt
14410 SW 94TH CT PRMT $ 25. 00 JSD 09/30/9*7 97-299640
TIGARD OR 97223 5PCT $ 1. 25 JSD 09/30/97 97-299640
Phone #: 620-3748
Contractot-----------------------------------
COLUMBIA HEATING & COOLING INC
PO BOX 230397
8900 SW BURNHAM ST STE E-110
TIGARD OR 97281-0397 ---------------------------------------
Phone #: 624-2704 is 26. 25 TOTAL
Reg #. . : 000763
------- REQUIRED INSPECTIONS -------
This permit is issued subject to the regulations contained in the Misc. Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inr-pection
applicable laws. All work will be dont in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for vprt
than 180 days. ATTENTION: Oregon law requires yon follow rules
V1
adopted by the Oregon Utility Notification Center. Those rules are
set forth in DAR 952-000I-08I0 through DAR W. AWI-W. You may
obtain copies of these rules or direct questions to OUNC by calling
(50312~6-1997.
Issi-ted B, : i-t r e
Permittee Signat
T
...........................................4............ ............4++
Call 639-4175 by 6:00 p. m. for An inspection needed the next bi.tsiness day
4•...............................................................4 .........
-ITY OF TIGARD Plumbing Application Recd By_i
3125 Sl;'HALL BLVD. Commercial and Residential `Fate Rscd
,GARD, OR 97223 Data to P E.
r--
M) 639-4171 Date to DST
Permit rtes ! 2
Print or Type Related SWR 0
Incomplete or illegible applications will not be accepted called
kwa of Deveapmenviaro)ea! FIXTURES,Qndlvidual) jw
Job sink 9.00_
Address strillet Address a suite Lawitory 9.00
1 Tub or Tu','Shower Comb. 9 W
Bag r! Gty/Stat ZI Shower Only 800
r Water Closet
Norm .1 9.00
r!UD r f h Dlshwastw _ 9.00
Owner wiiii Adrtreaa �� Suite Garbage�poa� 9.00
nlj
— ^ _ Wshiry Machine 9.00
city/State ZIP Phone Floor Onn
j J 5.00
Name 7
FX .00
9.00
Occupant ma*v Address 3ude Water Heater 1 9.00
_ LAW"Room Tray 9.00 ,
City/state Zip Phone --
Urinal
9.00
NOther FwWres(Specify) 9.00 ea _ 9.43
-ontractor sub
r10r f0 issuance � � `) ZIP` Ptt01N
8.140
applicant must CC _�.7u 9.00
provide all cn Conic.cant.Board Lk.! Exp.Date 9.00
contractors r /
ncense Pkrttlerltp Lk:.• ewer-1 st 100" 9.00
Date S —3,0 0-0
information Ig _ .� !, I ,_,
Sewer-each sdditbnei 10ri '—
for COT COT"Mu Tax or K%tm 0 Earp.Date _ 25.00
(latabase), 1 AiW
c r ater Service-1 si 100 3000
Name Water Service-each additional 200' 25.00
Architect Storm&Kae,Oram-1st 100' 30.00
or Ma'an9 Address Suite Storm d Ran Oran-each adddbnN 1 W 23.00
Mob"Home space 25.00
Engineer City/State Zip Phone Coffvrwtaal Back Flow Prevemion Device or Anti. 2500
Pollution Device
srnbe work New O Addition O Alteration O Repair O Residential Baciflow Prevention Device* 1506—
done., Resrderrtlal O Non+esidential O Any Trap or Waste Not Connected to a Fissure 900
.:odwral le:rnption of won[
Catch Basin 9
,00
insp.of Exisbng Pl mbirig x0.00 —
__ per/hr
�. Specialty Requested Inspections
_vsbnq Lae of 40.00
using or property per/hr
Ram Drain,single family dwelling 30.00
., •000sed use of Grease Traps 9.00
using of property
QUANTITY TOTAL
Are you capping. moving or replacing any flztures? veep No r] Immea,e or riser dowwn is rediised r ousnity toW is 9
'f yes see back of form) SUBTOTAL ;
,en!by acknowledge that 1 have read this appik)bon•that the information
-n is correct.that I am the owner or authorized agent of the owner,and 5%SURCHARGE
it plans submitted are in compliance with Oregon State Laws. '.
nature rlAgent paq PLAN REVIEW 25% OF SUBTOTAL
Qewesd 0"4 rtrsrrsmy toil to>9
TOTAL
Net "frame•---�
i Phone
'Minimum permit fee o$25• 5%surcharge.except Residennal Backflow
i - !� r"1G PrevrnWin Device.which is$15•5%surcharge
1:'ptmapp doe 1296 (dst)
'LEASE COMP :ri, QS APPROPRIATE TO PROJECT;
Fixtures to be capped, moved or replaced Qty
'Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only Y
Water Closet _
Dishwasher
_Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
IOMMENTS REGARDING ABOVE:
w_
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L: pimapp.doc 11�90; (dst)