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12060 SW MAIN STREET IS NMN MS 09026 — cn z C Q � 3 cn 3 0 0 I C) 0 N u r' 12060 SW MAIN ST CHY OF TIGARD _ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2000-00195 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/12/00 SITE ADDRESS: 12060 SW MAIN ST PARCEL: 2S102AA-00904 SUBDIVISION: PAYLESS SHOPPING CENTER ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG CLASS OF WORK: REP GARBAGE DISPOSALS: MOBILE HOME SPACES: 'TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: M FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 100 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Replace water service meter to building, less than 100'. FEES Owner: -- — `- Type By Date Amount Receipt NORTHWOOP REALTY CO INC BY A[ AE4TSON'S INC #6518 PRMT DEB 6/12/00 $50.00 0002880 PO BOX 20 SPCT DEB 6112/00 $4.00 0002880 E:-ASF, ID 83126 Total $54.00 Phone 1: Contractor: I'ACCOY PLUMBING 2617 NE M.L.K. BLVD PORTLAND, OR 97212 RtQUIRID INSPECTIONS Watei Ser,;;,a Insp — Phone 1: 288-5403 Reg#: LIC 00001756 Final Inspection PLM 26-53PB v;`,` a WThis permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. F3 Specialty Codes and all other applicable laws. All work will be done 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 more than 180 days. ATTENTION: Oregon law requires you to fellow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You obt Inalna copies of these rules or direct questions to OUN� alling (503) 246-1987. Issue By: Perrilttee Signatu "Call (503) 639-4 5 by 7:00 P.M.for an inspectlon neede �nex}bnslwe`ss day CITY OF TIGARD Plumbing Permit Applicatirm Plan Ch eiiiii 13125 SW HALL BLVD. Commercial and Residential Recd E TIGARD, CIR 97223 Date Recd (5()3) 6394171 Date to P.E. Print or Type Date to DST Incomplete or illegible applications will not be accepted Permits Related SWR*� Called------ Job �N me of Development/Projecl FIXTURES (individual) qTY PRICE AMT_ 'W �� WSink 11.50 Address Street Address Suite Lavatory 11.50 Q Tub or TublShower Comb, 11 50 Bldg City/State Zi Shower rinly 11.50 --� T� ,� Water ;Ioset/Urtnal Name (Specify) 11.50 "T,/Z ZI>J(.. Disr Hasher 11.50 Owner Mailing Address Suite C.rrbage Disposal 11.5b P U r76 Dashing Machine/Laundry Tray (SDecity) 11.50 Cky/State Zip Phone 4aa3 a Floor Drain/floor Sink 2" 11.50 -- i 11.50 Name t ac., 4. 11.50 Occupant Mailing Address \ uile Water Heater O conversion O like kind 11.50 c1l�J Gas piping requires a separate mechanical permit. _ City/State 1� rzip Phone MFG Home New Water Service 28.00 ---- t 1 .r LI-'11a COi 1 �� MFG Home New San/S' n Sewer 28.00 Name Hose Bibs y_ 11.50 Contractor Mailing Address Suite -+-{ Rain Drains 11.50 c��Dt 1 M Drinking Fountain 11.50 Prior to permit Citylstate 7ip Phone Other Fixtures(Sr elft') 15.00 issuance,a copy R�91Vo� �'� _ of all licenses are Oregon,_Coonst.Cont.Board Lic.0 P.Date I _ required if expired in COT Plumbing Lic * Exp.Date database I - Name Sewer-1 at 100' 38.00 Architect Sewer-each additional 100' 32.00 Or Mailing Address Suite Water Service-1st 100' 38.00 Water Serviceeach additional 200' 32.00 Engineer City/State Zip Phone Storm R Rain Drain-1st 100' 38.00 [Additional ;tribework to be done Storm&Rain Drain-each additional lOG 32.00 w O Repair O Replace with like kind: Yes No OCommercial Back Flow Prevention Device 32.00 sidential O Commercial O description of work: Residential Backflow Prevention Device' 19.00 cf_gi,_`fa,C.rti. �l.-l{�1`t� `�`Lj�t(,ly CY\4.A Catch Basin 11.50 1_► 2�t�C- Insp.of Existing Plumbing 50.00 Are you capping,moving or replacing any fixtures? per/hr a Yes O No Specially Requested Inspections 50.00 If yes,see back of form to indicate work perform?d by peobr ~ fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain,single family dwelling 45.00 V' _ } WORK GOULD RESULT IN INC EASED 96 ER FEES. Grease Traps 11.50 F,- I hereby acknowledge that I have recd this application,th a information QUANTITY TOTAL -� given is correct,that t am the owner or authorized agent of the wrier,and Isometric ur riser diagram Is required 0 Quantity Tetal Is >9 _m that la 'submitted are in compliance with O op.State Laws. "SUBTOTAL Date J Contact 'l �l 7%SURCHARGE Nene- Phone -1 :z(J(- a J`iC) ­PLAN REVIEW 25%OF SUBTOTAL 1 BATH HOUSE$178.00 r z Required M fixture qty.Ictal is>9 2 BATH HOUSE at-I.00 TOTAL �/ 3 BATH HOUSE$285.00 _ `[ (Thls fee Includes all olumbing fixtures In the dwelling and the first y 100=1 sanitary sw ' " slower and water service) 'Minimum permit tee is 3_50+7%surcharge,except ResMeMlal Backflow Prtvans Device.which Is$25+7%surcharge wom- **All New Cummemlai Buildings require plans with Isometric or riser diagram and plan review I tdstsUormslafumapp doc MEIM9 PLEASE COMPLETE: Fixture Type _ Quantity by Work Performed _ New Moved Replaced Removed/Capped Sink LavatoryTu, ,- or Tub/Shower Combination _ Shower Only Water Closet _ Dishwasher Garbage Disposal _ Washing Machine ~ Floor Drain/Floor Sink, 2" 411 Water Heater Laundry Room Tray _ Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: a Ui J J I lds1slfmm%%P1umepp doc 7119199 LL � 7 � \ / \_ uj / 2 \ \ 7 \ \ \ d \ § \ \ \ � c ; ; @ m / 2 2/ $ 2 g a \ \ § 3 / � .# 2 / 2 \ \ a m 6 \ © \ E 7