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Permit Support Document
TIGARD City of Tigard April 3,2020 DP Plumbing Inc. 15825 NE Springbrook Rd Newberg, OR 97132 Re: Permit No. PLM2019-00119 Dear Applicant: The City of Tigard has processed a refund for fees on the above referenced permit(s) as follows: Site Address: 16200 SW Pacific Hwy, Z3 Project Name: Starbucks Job No.: N/A Refund: ® Check#235112 in the amount of$171.39. ❑ Credit card"return" receipt in the amount of$ Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account"deposit"receipt in the amount of$ Comments: Reduced plumbing fixtures resulted in reduced permit fees. Refund difference. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Ornelas Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov 1111 City of Tigard T I G ARD Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: DP Plumbing Inc DATE: 3/20/2020 15825 NE Springbrook Rd Newberg, OR 97132 REQUESTED BY: Dianna Ornelas TRANSACTION INFORMATION: Receipt#: 427732 Case#: PLM2019-00119 Date: 1/14/2020 Address/Parcel: 16200 SW Pacific Hwy, Z3 Pay Method: CreditCard Project Name: Starbucks EXPLANATION: Reduced plumbing fixtures resulted in overpayment. Refund difference. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Cash Over 100-0000-48001 $171.39 j pj 9 TOTAL REFUND: $171.39 APPROVALS: SIGN URE DATE: If under$5,000 Professional Staff #'�.}"tC!Z aC--4--.-) If under$12,500 Division Manager If under$25,000 Department Manager a If under$100,000 City Manager If over$50,000 Local Contract Review Board FOR ACCELA SYSTEM ADMINISTRATION USE ONLY >' Case Refund Processed: Date: '?/'1/ 4;'./ By: We) rj I I:\Building\Refunds\RefundRequest.doc x 09/01/2010 iii4A CITY OF TIGARD RECEIPT l 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TICAR.D Project Name: Starbucks Site Address: 16200 SW PACIFIC HWY Z3 Receipt Number: 436213 - 09/03/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PLM2019-00119 $-171.39 Total: $-171.39 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 235112 DHOWSE 09/03/2021 $-171.39 Payor: DP Plumbing Inc. Total Payments: $-171.39 Balance Due: $171.39 Page 1 of 1 CITY OF TIGARD RECEIPT 711 _ 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TrGi,,P1) Project Name: Starbucks /� Site Address: 16200 SW PACIFIC HWY Z3 / t ' 1 � Receipt Number: 427732 - 01/14/2020 CASE NO, FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PLM2019-00119 Backflow Preventer 230-0000-43101 $62.54 PLM2019-00119 Dishwasher 230-0000-43101 $25.02 PLM2019-00119 Expansion Tank 230-0000-43101 $12.51 PLM2019-00119 Floor Drain/Floor Sink/Hub 230-0000-43101 $150.12 PLM2019-00119 Hose Bib 230-0000-43101 $50.04 PLM2019-00119 Ice Maker 230-0000-43101 $25.02 PLM2019-00119 Interceptor/Grease Trap 230-0000-43101 $25.02 PLM2019-00119 Primer 230-0000-43101 $12.51 PLM2019-00119 Water Closet 230-0000-43101 $50.04 PLM2019-00119 Water Heater 230-0000-43101 $37.52 PLM2019-00119 Misc Other Fee 230-0000-43101 $125.10 PLM2019-00119 Sanitary Sewer 230-0000-43101 $62.54 PLM2019-00119 Fixture/Sewer Cap 230-0000-43101 $25.02 PLM2019-00119 Sink 230-0000-43101 $250.20 PLM2019-00119 Lavatories 230-0000-43101 $50.04 PLM2019-00119 Plan Review 230-0000-43109 $240.81 PLM2019-00119 12%State Surcharge-Plumbing 100-0000-24001 $115.59 PLM2019-00119 Cash Over 100-0000-48001 $171.39 <— Total: $1,491.03 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 5944953 JDRINKWATER 01/14/2020 $1,491.03 Payor: Darren Placek Total Payments: $1,491.03 Balance Due: $0.00 Page 1 of 1 CITY OF TIGARD RECEIPT 71, -; --- y 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 T f(._;;A Tr t) Project Name: Starbucks Site Address: 16200 SW PACIFIC HWY Z3 OA/G/Af Ff—t____ Receipt Number: 427732 - 01/14/2020 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PLM2019-00119 Backflow Preventer 230-0000-43101 $62.54 PLM2019-00119 Dishwasher 230-0000-43101 $25.02 PLM2019-00119 Expansion Tank 230-0000-43101 $12.51 PLM201 9-001 1 9 Floor Drain/Floor Sink/Hub 230-0000-43101 $150.12 PLM2019-00119 Hose Bib 230-0000-43101 $50.04 PLM2019-00119 Ice Maker 230-0000-43101 $25.02 PLM2019-00119 Interceptor/Grease Trap 230-0000-43101 $25.02 PLM2019-00119 Primer 230-0000-43101 $12.51 PLM2019-00119 Sink 230-0000-43101 $425.34 PLM2019-00119 Water Closet 230-0000-43101 $50.04 PLM2019-00119 Water Heater 230-0000-43101 $37.52 PLM2019-00119 Misc Other Fee 230-0000-43101 $125.10 PLM2019-00119 Sanitary Sewer 230-0000-43101 $62.54 PLM2019-00119 Fixture/Sewer Cap 230-0000-43101 $25.02 PLM2019-00119 Plan Review 230-0000-43109 $272.09 PLM2019-00119 12%State Surcharge-Plumbing 100-0000-24001 $130.60 Total: $1,491.03 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 5944953 JDRINKWATER 01/14/2020 $1,491.03 Payor: Darren Placek Total Payments: $1,491.03 Balance Due: $0.00 Page 1 of 1 , II 'r Accumulative Sewer Tally „ ; Tenant Name: STARBUCKS SWR#2019-00138 citronstoN 2L a : Site Address: 16200 SW PACIFIC HWY PLM#2019-00119 Parcel#: 2S115BA02500 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count try ed#s value count added# added value total#s total values lia.tisc (Font 0111111. 0 0 0 0 Bath: -Tub/ShowerMIIIIM 0 11111. 0 0 0 0 -Jacuzzi/Whirl.00l 11311111111111111.11111111111111111 0 0 0 0 :.: ........ Car Wash: -Each StallIIINIIIIIIII 0 IIIII0 0 0 0 -Drive throu 41 16 0 0 0 0 0 Cussidot/\'Water As ir:ator �� 0 0 0 0 Dishwasher: -Commercial 0 IIIIIII 0 1 4 1 4 Domesticmnii 0 0 0 0 0 Drittkin.Fountain 0 0 0 0 0 E e Wash Mal. 0IIIIIII 0 0 0 0 Floor.Drawn/Sank. -2 inchMIMI 0 0 0 0 0 3 inch 5 0 0 6 30 6 30 4 nub 6 0 all 0 0 0 0 -CGar Wash 6INIIIIIIIIIIIIIIIII 0 0 0 0 Garba c Di:sot:sal: Domestic(to 3/41-IP) 16 0 111111111 0 0 0 0 -Commercial'to 5 14 32 0 IIIIIII 0 1 0 0 0 "Industrial{over 5 HIIrlIMI 0 MINI 0 0 0 0 Ice Machine/Refri'erntor Drain NM 0 MN 0 2 2 2 2 1151111111111111 aa:uiup Unit 0 MN 0 0 - 0 0 St..'Gas Station 6 MI 0 MIN 0 0 0 0 Rec.Vehicle Dum s station MIN 0 0 0 0 � Shower -Cram(ter head)head) IM 0 0 IIIIIII1 0 0 0 0 -Stall IIIIIIIIIII 0 0 0 0 0 Sink: -1 av/Bar-Non-Food Related ummmollMIIIIMN 0 1 8 3 6 Br-Ale 0 0 0 0 0 -Corn/Serv/Util-Food Related IEIIIHIIIIIIIIE 0NMI m 6 0 0 Swisnmin;Pool Filter 11111110111 0 1111111 0 0 0 0 Washer-Clothes 6 MIR 0NMI 0 0 0 0 Water Extractor11111111111111111 0 MIN 0 0 0 0 Water Closet-Toilet 6NIIIII 0 6 2 i2 1 6 Urinal 6 1111111 0MI 0 0 0 0 Previous EDU Count IIIII 0 11111 0 Capped EDU Credit I= 0 TOTALS 0 0 62 13 48 Current Fixture Value 48 divided by 16= 3.000 Current EDU 1 EDU= $5,800.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change 48 divided by 16= 3.000 over (under) $ 17,400.00 Enter EDU Change Here 3.000 * *Round EDUs to the nearest 1/100th: a count ending iu.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01. Notes: Authorized Name/Signature: BRAND.EN TAGGART X2449 Date: 2/10/2020 Building Division r-uote: `Die property owner shall retain the:ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be heaairted to the City of Tigaid Building Division to redeem credits towards future system development dial-fits. I:\Building\Sewer Tally\SewerTallyShcer_5800_070119.xlsx CITY OF TIGARD FEE AND PAYMENT HISTORY 13125 SW Hat Blvd.,Tigard OR 97223 503.639.4171 TIGARD SWR2019-00138 - 16200 SW PACIFIC HWY Z3, TIGARD, OR 97224 Starbucks Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Sewer Connection Fee 500-0000-25500 $27,176.50 $27,176.50 $27,176.50 Totals for Fees $27,176.50 $27,176,50 $0.00 $27,176.50 Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount Total Payments: Balance Due: $27,176.50 a Branden Taggart From: Branden Taggart Sent: Wednesday, February 12, 2020 5:33 PM To: 'dplumbingguy@gmail.com' Cc: #Building Permit Technicians Subject: RE: Starbucks Sewer Fees: PLM2019-00119 & SWR2019-00138 - 16200 SW Pacific Hwy Attachments: Branden Taggart2.vcf; SWR2019-00138 Revised Starbucks Sewer Tally.pdf; RegPermitAction_120518.pdf Hi Darren, I have attached a copy of the revised sewer tally above for you. There will be a sewer permit refund of$9,776.50 issued to JHC Commercial LLC in the form of check. Since we do not have the address on file for JHC Commercial LLC, I have attached our Request for Permit Action form above for them to complete and return to us so that they may receive a refund. Regarding your plumbing permit refund,there will be$173.39 refunded to you. Both refunds will be processed in approximately 3-4 weeks, and each refund will be issued in the form of a check. Please ensure that the Request for Permit Action form is completed by JHC Commercial LLC. Thank you for your cooperation and patience while we worked to revise these permits. Please let me know if you have questions or concerns. Thank you, 7sBranden Taggart #k 7 City of Tigard �. Senior Permit Technician TIOAKD Community Development 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449 brandent@tigard-or.gav From: Branden Taggart Sent:Tuesday, February 11, 2020 5:38 PM To: dplumbingguy@gmail.com Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: Starbucks Sewer Fees: PLM2019-00119 &SWR2019-00138- 16200 SW Pacific Hwy Darren, Here is the update regarding the fee changes. I will need to work with Dianna tomorrow to get the refund situation figured out. We will get back to you afterwards. Thanks, 1 IBranden Taggart III Branden of Tigard 4 Senior Permit Technician `e Community Development 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449 brandentr©tigard-or.gov From: Branden Taggart Sent: Monday, February 10, 2020 7:12 PM To: dplumbingguy@gmail.com Cc: #Building Permit Technicians <TigardBuildingPermits@tigard-or.gov> Subject: Starbucks Sewer Fees: PLM2019-00119 & SWR2019-00138 - 16200 SW Pacific Hwy Hi Darren, I have revised the sewer fees for Starbucks. I need to make a few more adjustments to the plumbing and sewer fees before I am finished with this revision. I will have everything finished tomorrow. Thank you for your patience. Thanks, Branden Ta 01 . ggart s City of Tigard Senior Permit Technician ak Community Development 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449 brandent@tigard-or.gov 2 .. _ _ . .. a tiEL;EIVED 1 MAR 1 6 2020 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT CITY OF HUARD N 41 g , Request for Permit Action BUILDING OIVISION • 13125Hall Blvd. •Tiga rd,Oregon 97223 •503-718-2439 •www,tigard,Kyo: tic(ARD SW TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 '.1 Phone: 503-718-2439 Far 503-598-1960 TigardBuildingPemilts@tigard-or.gov ,( FROM: 0 Owner [Si Applicant 0 Contractor El City Staff Cheek(1)uric liS REFUND OR Name: ri-D 1 -f- ' INVOICE TO: 03""T"'"`"1"44"") -1-- tsNw Coii5 (vck ' 0 ' Lt--C- 4. fi Y Mailing Address: --'1-060 4, 3 City/State/Zip: \- . \\SOt 1 0(2— 9-/e r Phone No.: 50--3 - 53 D - /I'll PLEASE.TAKM ACTION FOR THE ITEM(S)CHECKED(1): iii:WCANCE1../VOID PERMIT APPLICATION. REFUND PERMIT FEES(attachco pyoforiginal receipt and provide explanation below). INNcncEFOR ;sDII (attachcasefeeschedule and provide explanation below). Permit#: _ ..... _ (5-i-J&:211(91)—0(5' aS-Te Site Address or Parcel #: I.3 1 2:7 50.) Pac ;-(c.c. 14oc...i sv: .-e 2.0 0 , ft Project Name: "--ROV(1,11 \-e- 1::)177-(C%\cA„. A-H-11:106,A Subdivision Name: •Lot#. _ri‘t, r4 1 Oyu _ es- EXPLANATION: ----1 \\.1,v-e-k.xillS yvo Irl vi%iD15 enck J2 nn (--e_c\ li , v,V\esA;) . -11-e, -5o, uic-r CCW,3e•, ii ar-di- P (4) L•pe. ( c..41,),..1-e- -- - fluv ,..1-e-d- -44.-..a_ uu ar) fi i t• 0. krt.-, ,0 n, I - it- , . V• 0/1 -0-4, tr-d.i-iits 4-D15,41)2_.-1-rove.,y- r * ' __— cid es .0-,Signature: 1)ate: 3 - I 6 - '1_0 5ci-1 i..„D v Print Name: ,/ r/tr-r...--- Jetibt- t, 3111°Id- itc fond Policy 1. The city's Community Development Director,Budding Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected • Not more thrill 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3 Please allow 3-4 weeks for processing refund requests. I OR l/l I ICI. l ;-,1. ONI.) Route to Sys Admin: Date 7ffill; • , By ''Ts Route to Records: Date _ By Refund Pmcessed: Date By invoice Processed: Date Bv Permit Canceled: _Date —By Parcel'lag Added: Date i\thti idu kg\Fo OTI I\ReqPertiut Amon_I 205194ov . 4 . .. . _ -.. - , Plumbing Permit Application Building Fixtures FOR OFFICE USE ONE City of Tigard Received Date/By: Permit No.: a]N/) )0.t s_oo l i q 13125 SW Hall Blvd.,Tigard,OR 97223 l Plan Review „ III C -3-2 oo /'�, Phone: 503.718.2439 Fax: 503.598.1960 D Date Re ,1 tFkJ Other Permit No.: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE D New construction 0 Demolition For special information use checklist Description I Qty. Ea. I Total 1Addition/alteration/replacement E Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)- CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 0 1-and 2-family dwelling *Commercial/industrial SFR(2)bath 437.78 El Accessory buildingSFR(3)bath 500.32 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: r Catch basin or area drain 18.76 Job site address: i a �GCC IL L (.01 Drywell,leach line,or trench drain 18.76 City/State/ZIP: r - V-(1 I OR. C. i t 13[J Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: z 3�U1 Project name: C LL tt, T curD tt C s Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: 1 ) i ✓ Page 2 ( ,2 54 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27t 5e( DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher / ✓ 25.02 d5=02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER 0 TENANT Expansion tank / .; 12.51 ia/5( Name: Fixture/sewer cap / Y 25.02 4.creigiiitt Floor drain/floor sink/hub 6 ✓ 25.02 ISd,it) Address: Garbage disposal 25.02 City/State/ZIP: Hose bib a ✓ 25.02 50 ,04 Phone:( ) Fax:( ) Ice maker ,d- j( 6;kl a ✓ 12.51 62 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap i ✓ 25.02 a 5 02 Medical gas(value:$ ) Page 2 I Business name: g Contact name: Primer / ✓ 12.51 1a,51 Roof drain(commercial) 12.51 Address: s� It Sink/basin/lavatory lea l✓ 25.02 -plot 4 ,j' City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet '/ 25.02 5604 Water heater / V 37.52 39,5.;:t Business name: Water piping/DWV 56.29 Address: Other: S V 25.02 /O9S /0 City/State/ZIP: Subtotal Cii3S,aq Phone:( ) Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) O li()t[, I CCB Lic.: Plumbing Lic.no.: State surcharge(12%of permit fee) i!$` q Authorized signature: TOTAL PERMIT FEE 13 let,itil This permit application expires if a permit is not obtained within 180 days Print name: Date: after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) CO-5 �� ,04yity � 4c. 1.. * /7/, 39 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-1" 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100. 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to I� and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge 1/2 hour) each additional$100.00 or fraction thereof. Subtotal: 1 Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font 0 Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. Jacuzzi/Whirlpool Car Wash: -Each Stall ElNew exterior plumbing site utilities for any complex structure Drive as defined in OAR918-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. Domestic 0 Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" 4, Isometric or Riser Diagram 4„ 0 Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains 4Comments regarding fixture work: Oil Separator(Gas Station) Cy/tki / er-C....%,}r�r i,kvr w..jT�. (ii) Rec.Vehicle Dump Station L:i S•, iZt. zk-S Y, le-‘/ til<fi y,.t. Shower: -Gang u -Stall �>f C4) C`-�/ /Q°C.v ,/J / i/7/ o .?; Sink: -Lav/Bar non-food related I rl -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet i c plumbing permit can be issued. Urinal Other Fixtures: 1:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 tii Ii ,iii a-3--c)oao A k2.<..J i Se(X F i *titre Cc,-(A. o t. 5 :yl(C S ) lJJ� f� 1 p tc I td54`�, t. oleic S; k- direcf cIra;v` iiii P 10 3 I into K .11e+- [40,4. S r'kl k- c(i t-ecf-cfro,tpt _ : 5 ((tarn R _// cf c(ros . 41LAAft- F s `,' 6 3 f.i_ 19656 6;(116-eiY n_! cirojki ! I:OMfi r;t' $.4 �.-- 161 5 .if��5�.)S-.L.,r+Mt4.sk.Ir S +,1'tt , f[ ived-C1,416 l 7 ccwVi-- - te7) l 18743 Sink at 4mty filliKlSta m inGreet P10$ 1 to fls Y►1 o/ 514k cts'recf cita.tiek P to 3 I 14606 Raotti. S;ki k c.(i vicf cdr th edi-ovit- — Ptittott V 13 fitrb 3-c'c,otp .S'ak IPci1reCi ( r'a 't Ell P 1( `k tO L(10 I Au direct ci vi 114-44 delo 1 ;,, 070 lc Leo r a c h,y i, 1, k-i-eid s.hilc 144 rt..e....Sj TAf+-c61.z, _..flair area IA/S at re_ c vv47.- c .,,." . '. f 1 JJJJJJ k 9 1 f t f f 1 i ?;t 7 t t 1 `1 1 c r D rc r t 1 /c ao( S i 1 l<s 3 .a.03.0 Pam.. 7 I 3 '` '�s cider Dram P t03 - 5 F v.cc i erect Was q-af D Pescr:4 R660, F2 liar `? `(Z,in Sei- .C�.�,? Ca) 1 t`1650 S PAL< - 1 J 56 5 thiSer Ai( ( '7 3 5?n.lt cd C.Jcthei- .�'rl[ern SLa(ia 6.-1) ( 131100 3-64D 85 3;n1z at) Pay P 1 O r\ l t-tout- S S . P53a 5) 5�4Nlc cdc (&vUkTtr . -,l(�v� Sk'ccf;cave /5#7 3 3." P 5o . Asprz-sso vnaclta ! 12917 1 :'4 34fr Sink' tcc (34 , 3" P So a 01) �.� P 50 I 3-C w-,ip 5 W & i 3 r1043 3)' P 3-0 a Jr;e fra, P SG uc, v‘f.(1.- R vise.r 5� -,ic � � icQ (�; h d :�. b ,