Permit (176) CITY OF TIGARD (7 4
r
PLUMBING PERMIT
cmroFnEARU PERMIT N(O. : PI_8820 02
COMMUNITY DEVELOPMENT DEPARTMENT OQEOON
13125 S.W. Hall Blvd., P.O. Box 23397, Tigard, Oregon 97223, (503) 639 -4175 DATE ISSUED: 10/11/BB
PHIM . WM I . NU . utleUO i
JOB ADDRESS: 16200 SW PACIFIC HWY S . ' 0'
TAX MAP/LOT SUB: TIGARD TOWNE SQUARE LT: BK:
LAND USE:
I...OT S I Z E : •
ITEM: NO: NO:
WORK CLASS: ALTERATION WATER CLOSET 1 TRAP
USE TYPE: COMMERCIAL URINAL BKFLOW PRVNTR
CON S•T• . TYPE : I T T N LAVORATORY 1 TRAP PRIMER
OCCUP . (:ARP . : B2 TUB SHOWER GREASE TRAPS
DISHWASHER
GARBAGE DISPOSAL
NO. STORIES : :I. WASHING MACHINE
DWELL . UNITS : LAUNDRY TRAY BLDG. DRAIN (DIA
FLOOR DRAIN 1
SINK SEWER (FT)
WATE :R HEATER 1 STORM /RAIN (FT
OTHER
REMARKS:
Tenant Mod : it's Country
Hold for contractor info
O FEES:
Westwood Corp. PERMIT $30.00
E
R FIXTURES
STATE TAX $1.50
OTHER $7.50
C
0
N COOK JAMES
MILWAUKIE PLUMBING
A pc) BOX 393
T • c1 acicama.s or 97015
O PHONE: (503) 655 -9161
R t :CISTRATION No. 5002 TOTAL: $39.00
This permit is issued subject to the regulations contained in Title 14 RECE T PT NO . /6/
6
of the TMC, State of Oregon Specialty Codes, zoning regulations __---- _ - -_•_ _ • - •• - • - _--- __•• •_ - — / VC cv
and all other applicable codes and ordinances, and it is hereby PE :QUIRED INSPECTIONS
agreed that the work will be done in accordance with the plans and PtB UNIOE:RS1 AG
specifications and in compliance with all applicable codes and
ordinances. The issuance of this permit does not waive restrictive ROUGH IN
covenants. Contractor and subcontractors shall have current city PL.B . TOPOUT
business tax permits. This permit will expire and become null and F' INAI_
void if work is not started within 180 days, or if work is suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required inspections are requested and approved.
Permittee Signature
Issued By:
CALL FOR INSPECTION 639 - •1175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
k •
. • • P.O.Bax 23397
CITY OF T IGARD PLUMBING 31125 �' Hal �v
Applic must hold Oregon Registration to conduct a plumbing PERMIT CR 97223
business a must be property owner/operator not hiring outside help. E 2 --4175
•
Nerve d Development
Plumbing Permit No. 2002-
Address Description
• ORS 814 -21 -610 OUAN. PRICE AMT.
Job Tax Lot Map. No.
Address
FIXTURES •
Lot Block Subdivision
Sink 7.50
Name (or name ofbusiness) lavatory 7.50
Tub or Tub/Shower Comb. 7.50
Mailing Address Shower Only 7.50
Owner City /State zip Water Closet 7.50
Dishwasher 7.5.0
Phone Garbage Disposal 7.50
Name Washing Machine 7.50
Floor Drain 7.50
Mailing Address Phone Water Heater 7.50
Occupant Laundry Room Tray _ 7.50
P City /State Zip
Urinal 7.50
.�, : Other Fixtures (Specify) 7.50
IL # 1 ► %I, :' a 7.50
gni , r•vm ess
/ 4 SA? 7.50
Contractor tlytirte l � �'.� Zip 7
• l /IIY
?City - MISCELLANEOUS
v City Bue. Tax No. . Sewer 1st 100' 30.00
5 V Sewer - ea. Addit. 100' 15.00
• State &dip Boardl�o. State P B us. t ic. No.
(Residential) Water Service 1st 100' 20.00 _
I hereby acknowledge that I have read this application, that the fntormation Water Service ea. Addit.2a)' 15.00
given is correct, that 1 am registered with the State Builders Board. and also Storm & Rain Drain 1st. 100' 30.00
have a State Plumbing license that the numbers given are correct, that all -
. _ .... - plumbing work will be done in accordance with applicable provisions of or -. - ..Storm & P: •in Drain Addl. 100' - t 5-00
gon Revised Statutes Chapters 447 and 693 and applicable codes and that Mobile Home Space 25.00
no help will be employed unless licensed under ORS 693. (If exempt from • - -- -
State registration, please give reason below). Back Flow Prevention
HOMEOWNERS - I hereby certify that I am the owner of the property de Device a Anti F'o+iuiion Device 7.50
scribed above, at which location I propose to make a plumbing Installation for My Trap or Waste Not
my own use and this , • • • . b not being constructed for sale, base or rent- Connected to a Fixture 7.50 • ■
N Catch Basin 7.50
'111 '� ,)' (9 $1 ,1 Insp. of Exist. Plumbing 40.00 Per Hr.
'. - ' . - ir i. Specialty Requested Inspections 40.00 Per Hr.
/ l , 11 ` Q • \ _t Mar. of Plumbing within
,
1�'J't}/` \( r _ p'0 an Existing Bldg. 15.00 min.
A 4 s SI'. Tun o 1t ' • k Date New Bldg. or Build. Addition 26.00 min.
! r 1�.. / 1 `- ' Rain Crain/simile fancily
Describe work repair ❑ p addit; 0 alteration 0 rep dolling 15.00 -
tQ be done residential non - residential fl
•
Existing use of .. or Pr SUB-TOTAL
.bU� use of • 5% ls SURCHARGE
ay TOTAL , I 1
NOTICE
• The permit becomes r and void r worts or oonatrucelon authorized b not corn- _ G
minced withtnn 180 darker It oonstruclkxt or wont is tUapardad or abandoned for
a period of 130 days at any time attar work Is commenced.
I P 7 ."----
fdP(CtlALOONDITIONs
• • Date Issued • by -
CITY OF TIGARD PLUMBING 115 �' t�l' EN
Applic must hold Oregon Registration to conduct a plumbing PERMIT P.O.Bax 23387
i
business or must be property owner /operator not hiring outside help.
Tigard CR 97223
Name of Development
'-- r`c ‘ iew...& ... K - 0aa SR • Plumbing Permit No.
Address Description
\tj %NZ QIN Vtdi k.4 ORS 814 - 21.810 otwi. PRICE AMT.
Job Tax Lot Map. No. ` -
Address FIXTURES •
Lot Block Subdivision '
Sink 7.50
4 ame(or name siness) %t, Lavatory 1 7.50 750
ZT C.IA. kitILL ( Tub or Tub/Shower Comb. 7.50
Mailing Address v
Shower Only 7.50
Owner City /State Zip Water Closet 1 7.50 7 S-
Dishwasher 7 .5
Phone Garbage Disposal _ 7.50
Name Washing Machine 7.50
Floor Drain 7 .50 _
'Mailing Address Phone Water Heater ` _ 7.50 7 s c)
Laundry Room Tray 7.50
Occupant City/state ZIP
Urinal 7
Name Phone Other Fixtures (Specify) ` 7.50
( L i �+ PI bc. LO \A00 ott.`A l ` 7.50 7
Mailing a i�o� 39� ( �11�', 7.50
Contractor City /State Zap 7.50
c.■tacvit..inots CA, g l Q I S MISCELLANEOUS
City Bus. Tax No. Sewer 1st 100' 30.00 •
• 5(Ittrt.- • Sewer-ea. Addit.100' 15.00
• State 84695 :Board No. State Plumbers Bus. Lic. No.
(Residential) 3 -11 Water Service 1st 100' 20.00
I hereby acknowledge that I have read this application. that the information Water Service ea. Addit.' 15.00
given is correct, that I am registered with the State Builders Board. and also Storm & Rain Drain 1st. 100' 30.00
have a State Plumbing license that the numbers given are correct. that all - _ •
__ - _ -_ - - plumbing work wii be done in accordarnce with apPficsbleProvis+ons a Ore- -• - -- Stonn• Prin Drain Addit. 100' - 15 D0 -
gon Revised Statutes Chapters 447 and 693 and applicable codes and that Mobile Home Space 25.00 - - no help will be employed unless licensed under ORS 693. (0 exempt from .
State registration. please give reason below). Back Flow Prevention
HOMEOWNERS - I hereby certify that I am the owner of the property de- Device or And-Pollution Device 7.50
acnbed above. at which location I propose to make a plkrrnbkq installation for Any Trap or Waste Not
my own use and this property is not being constructed for sale. base or rent. Connected to a Fixture 7.50 _
Catch Basin 7.50
Insp. of Exist. Plumbing 40.00 Per Hr. -
Speciaily Requested Irnspedlorns . 40.00 Per Hr.
• Alter. of Plumbing within
• an Existing BIB. 15.00 min.
AUTHORIZED SIGNATUR A r New Bldg. or Build. Addttbn 26.00 min.
AP w eh 1-.03 L 10-3- Rain ,rain /single family
Describe work new 1: addition 0 alteration 0 r ❑ i3 ling 15 _
be done residential - non - residential
Existing use of •
bWdit10 or(xoperty •U5 -TOTAL 30 0
s> +Ai4oe / - 0
uas TOTAL 3 i ` y
.b�i� «poopetty .
NOTICE •
Tit prom* beoomes null and void* work or construction authorised Is not corn-
mimed *Win 180 deli se,sr tf construction or work t, *Impeded or abandoned for
a period of 180 days at any time lifter work b oom n:no.d. .
imam. common .
. Data Issued • by -
•
•
P.o.i3Dx 27
CITY OF TIGARD PLUMBING '�15 X11 Blvd. . Applicants must hold Oregon Registration to conduct a plumbing PERMIT �a al g7223
business or must be property owner /operatornot hiring outside help. 6 39 - 175
Name of • 7 ,Ar.,..n , gh Ate- Plumbing Permit No. gzcoZ
•
Job /6 0Q � Zt Par. 4 1 C / �•✓/ ORS 8
2 14 -21 -610 OUAN. PRICE AMT.
Tax Lot Map. No. /
Address
FIXTURES
Lot Block Subdivision
Sink 7.50
•
Name (or name business) Lavatory / 7.50 7 SU
�� f Tub or Tub/Shower Comb. 7.50
u ig ress
Shower Only 7.50
Owner City/State Zip Water Closet / 7.50 7 . fC)
Dishwasher 7.50
Phone Garbage Disposal _ _ 7.50
f 7L � Washing Machine 7.50
Coo Floor Drain 7.50
ng Address Pie Water Heater 7.50
S1i r /� fU i �/P L 7.10 •
Occupant . � /Stet( / Laundry Room Tray _ 7.50
Urinal 7.50
Name Phone Other Fixtures (Specify) 7.50 {
Mailing Address Phone
7.50
7.50
•
Contractor City /State Dp 7.50
MISCELLANEOUS
City Bus. Tax No. '
Sewer 1st 100'
30.00
State s BoardNo. State Plumbers Bus. Lic. No. Sewer ea. Addit.100' 15.00
(Residential) Water Service 1st 100' 20.00
I hereby acknowledge that I have read this application, that the information Water Service ea. Addit.O' 15.00
given is correct. that 1 am registered with the State Builder's Board. and also Storm & Rain Drain Isl. 100' 30.00
have a State Plumbing hoarse that the numbers given are correct, that all
plumbing work will be done in accordance with applicable provisions of Ore- Storm & PPin Drain Addit. 100' 15.00
gon Revised Statutes Chapters 447 and 693 and applicable codes and that Mobile Home Space. 25.00._
-- no help will be employed unless licensed 693. (If exempt from - .
State registration, please give reason below). Back Flow Prevention
HOMEOWNERS - I hereby certify that I am the owner of the property de- or Mb-Pollution Device 7.50
scribed above, at which location I propose to make aplrnbing Installation for Any Trap or Waste Not
my own use and this property is not being constructed for sale, lease or rent. Connected to a Fixture 7.50
Catch Bash 7.50
insp. of Exist. Plumbing 40.00 Per Hr.
•
Specially Requested Inspections 40.00 Per Hr.
Alter. of Plumbing within
an Existing Bldg. 15.00 min.
AUTHORIZED SIGNATURE Date New Bldg. or Build. Addition 25.00 min.
Fin Crain,airg1e family ,
Describe work new ❑ addition ❑ ahteradon ropalr ❑ dlaellirg 15.00
be ri one residential n non-rea alIN
Existing use of
. WHOM or Property
ugs of • ,,}},, SIJd�TOTAL ZZSO
txpropstty • . 70 . SURCHARGE J. /3
•
2S
NOTICE
Tide tee/ um S, 6.2
This permit baoomss null and midi/ work or construction authorized is not corn - 'Dial / _' _ .1221
aparlod 180 MEM orworkb rd
ttapeadorabendonsdfor
days at an dots attar. work rk Is oonlnmiroid.
SPIOIAL CONIOMONS
Date Issued by
O(;11-4M (It /RS rws.