Permit (99) A CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
ij PERMIT # • PLM98 -0001
13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 DATE ISSUED: 01/05/98
PARCEL: 25115AB -01900
SITE ADDRESS...: 16200 SW PACIFIC HWY #B -2
SUBDIVISION • ZONING: C —G
BLOCK • LOT • JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 2
OCCUPANCY GRP..:M FLOOR DRAINS • 1 TRAPS • 0
STORIES • 0 WATER HEATERS • 1 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0
SINKS • 1 URINALS • 0 GREASE TRAPS • 0
LAVATORIES • 0 OTHER FIXTURES • 0
TUB /SHOWERS...: 1 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Animal House Pet Shop TI
Owner: FEES
BIT HOLDINGS type amount by date recpt
444 MARKET ST PRMT $ 86.00 B 01/05/98 98- 302267
SUITE 2100 5PCT $ 4.30 B 01/05/98 98- 302267
SAN FRANCISCO CA 94111
Phone #:
Contract or
ASSOCIATED PLUMBING CO
P 0 BOX 301362
PORTLAND OR 97230
Phone #: 331 -0582 $ 90.30 TOTAL
Reg #..: 000578
REQUIRED INSPECTIONS
This persit is issued subject to the regulations contained in the Rough —in Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM /Underfloor
applicable laws. All work will be done in accordance with Top —out Insp
approved plans. This permit will expire if work is not started RP /Backflow Prey
within 180 days of issuance, or if work is suspended for more Final Inspection
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 w through OAR 952 " You say
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By : Permittee Signature:
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + ++ + + + + + + + + ++ + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + ++ + + + + + + + + + + + + + + + + ++
t " ` R
CITY OF TIGARD Plumbing Application Rec'd By 1U Ot•-) i
13125 SWHALL BLVD. Commercial and Residential Date Rec'd i - LI
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TIGARD, OR 97223 Date to P.E.
(503) 6394171 Date it DST
Permit # ft-1 9 ` '-oozy/
Print or Type Related SWR # C"
Incomplete or illegible applications will not be accepted Called 0/ 920
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Name of Development/Project On back Indicate Work Performed by fixture.
Job Tigard 7bAm C S9yare� FIXTURES (Individual) • QTY PRICE AMT
Address St et Address ✓ �3 Lavatory 9.00
Suite Sink 9.00
1040S S a Pae.; w 2- Lavato 9 ��� '
Bldg # City /State Zip Tub or Tub /Shower Comb. 9.00
Name T/ aro(l d r Shower Only / 9.00
q. ��
t■kilAt atjl Water Closet 9.00
Own er Mailing Address Suite Dishwasher
9.00
Garbage Disposal 9.00
City /State Zip Phone Washing Machine 9.00
Name Floor Drain 12' tr. 9.00 cl oa
Pr) m ? t *Are fir £4 p 3 " 9.00
Occupant Mailing Address Suite 4" 9.00 •
City /State Zip Phone Water Heater 0 conversion 0 like kind ' 9.00 di- 7,00
Laundry Room Tray 9.00
I Name - Urinal 9.00
Si S 5 0 C i attd Plwm i"ba Co. Other Fixtures (Specify) 9.00
Contractor Mailing Address Suite 9.00
015DX G 2-
Prior to permit City /State Zip Phone 9.00
issuance, a copy P rY - /a►J.i 4r, 97294 33I -O5R2 9.00
of all licenses are Oregon Const. C ont. Board Lic.# Exp. ate 9.00
required if 3 9V 4 , Q5 /0a Sewer - 1st 100' 30.00
expired in COT Plumbing Lic. # Exp. Date
database AG-4/2. Pa /0/ /9 ' Sewer - each additional 100' 25.00
Name Water Service -1st 100' 30.00
A rchitect Water Service - each additional 200' 25.00
Or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00
Storm & Rain Drain - each additional 100' 25.00
Engineer City/State Zip Phone Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00 SD OJ
Describe work New 0 Addition 0 Alteration Repair 0 Pollution Device OL
to be done: Residential 0 Non - residential 60•* Residential Backflow Prevention Device* 15.00
Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00
r•Ci7 Re? IH1 VCH/ / -rte Catch Basin 9.00
Insp. of Existing Plumbing 40.00
per/hr
Existing use of Specially Requested Inspections 40.00
building or property _ per/hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL •
I hereby acknowledge that I have read this application, that the information isometric or riser diagram is required if Quanity Total Is > 9 .
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given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL
that plans submitted are in compliance with Oregon State Laws. ' .WD
Signature of Owner /Agent Date 5% SURCHARGE
Contserson Name Phone PLAN REVIEW 25% OF SUBTOTAL
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Required only if fixture qty. total is > 9 i • J
2 L� ? /G!" .-7 3J-Org2 TOTAL
*Minimum permit fee is $25 + 5% surcharge, except Residential Backp � 1
Prevention Device, which is 515 + 5% surcharge 0
� j v V '
lAdstslplmapp.doe 5197
0 61/1) 7 _
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PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I:batslplmapp.doc 5197
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4 5 A Sewer Tally
Tenant Name: j This SWR# ��-
Address: /re' C' (- Z This PLM#:
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
Value Capped off value added # added #s total
Count off #s count value values
Baptistry/Font 4
Bath - Tub /Shower 4 - 1 4 7'
- Jacuzzi/Whirlpool 4
Car Wash - Each Stall 6
- Drive Through 16
CuspidodWater Aspirator 1
Dishwasher - Commercial 4
- Domestic 2
Drinking Fountain 1
Eye Wash 1
Floor Drain/sink - 2 inch 2
- 3 inch 5
- 4 inch 6
- Car Wash Dm 6
Garbage Disposal 16
- Domestic (to 3/4 HP)
- Commercial (to 5 HP) 32
- Industrial (over 5 HP) 48
Ice Machine/Refrigerator Drains 1
Oil Sep (Gas Station) 6
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2
Sink - Bar/Lavatory 2
- Bradley 5
- Commercial 3 1
- Service 3
Swimming Pool Filter 1
Washer - Clothes 6
Water Extractor 6
Water Closet - Toilet 6
Urinal 6
TOTALS T Y9
Total fixture values: divided by 16 = 2 I EDU / u C ee
HISTORY j7z6),A
PLM# ° r ' x EDU# SWR# /? - ° 3S"S PLM# EDU# SWR#
PLM# 1'7 - c' ° `f r EDU# zz SWR# PLM# EDU# SWR#
PLM# EDU# ; a. .SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
is dstslswrtaly.doc
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Page No. 1 CASE HISTORY FOR CASE NO.: PLM98 -0001
BIT HOLDINGS
16200 SW PACIFIC HWY Unit: B -2
06/16/98
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
---- --- -- - ----- - --
PLMC003 Application received / / / / 01/02/98 PASS BON 01/05/98 JSD
PLMC005 Permit Created / / / / 01/05/98 PASS JSD 01/05/98 JSD
PLMC040 (F) Ready to issue / / / / 01/05/98 PASS JSD 01/05/98 JSD
PLMCO50 (F) Issue permit / / / / 01/05/98 PASS B 01/05/98 DST
PLMC720 PLM /Underfloor 01/05/98 / / 01/06/98 door locked FAIL MS 01/06/98 MRS
PLMC720'PLM /Underfloor / / / / 01/07/98 PASS MS 01/07/98 MRS
PLMC725 Top -out insp 01/05/98 / / 01/07/98 PASS MS 01/07/98 MRS.
PLMC750 RP /Backflow Preventer 01/05/98 / / 01/21/98 PASS TLP 01/21/98 J *H
PLMC799 Final Inspection / / / / 01/21/98 PASS TLP 01/21/98 J *H
PLMC800 Case Finaled / / / / 01/21/98 PASS TLP 01/21/98 J *H
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