Permit �
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COMMUNITY DEVELOPMENT DEPARTMENT
1o125nW Hall Blvdr/*mm Oregon 97223.8199 (503) Blvd. Tigard, PLUMBING PERMIT
PERMIT #.......: PLM94-0163
639-4171 DATE ISSUED: 08/10/94
PARCEL: 2S112AC-01600
SITE ADDRESS...: 14975 SW 74TH AVE
SUBDIVISION....: FANNO CREEK ACRE TRACTS ZONING: I—P
BLOCK..........: LOT....... ..... .:17
_____
CLASS OF WORK..:NEW GARBAGE DISPOSALS..: MOBILE HOME SPACES.:
TYPE OF USE....:COM WASHING MACH.......: BACKFLOW PREVNTRS..:
OCCUPANCY GRP.. :B2 FLOOR DRAINS. . .. . .. : TRAPS. .. ..... .. .... :
STORIES........:1 WATER HEATERS......:1 CATCH BASINS ^
FIXTURES---- ---- LAUNDRY TRAYS ^ SF RAIN DRAINS.....:
SINKS..........: URINALS ^ GREASE TRAPS.......:
LAVATORIES.....:2 OTHER FIXTURES :
TUB/SHOWERS ^ SEWER LINE (ft) ^
WATER CLOSETS..:2 WATER LINE (ft)....:
DISHWASHERS....: RAIN DRAIN (ft) ^
Remarks: Skoutes Warehouse SDR 93-0009: Applicant request Site Development Revi
ew
approval to allow construction of a 12,000 square foot warehouse building. ZON
E:
I—P (Industrial Park). WCTM 2S1 12AC, tax lot 1600 (SHELL ONLY!) ONSITE WATER
QUALITY FACILITY!!
Owner: — — FEES
JOHN SKOURTES type amount by date recpt
17010 SW WEIR ROAD PRMT $ 45.00 SW 08/10/94 —
PLCK $ 11.25 SW 08/10/94 —
BEAVERTON OR 97007 5PCT $ 2.25 SW 08/10/94 —
Phone #:
Contractor:
MICHAEL AND CO.
P 0 BOX 23008
TIGARD OR 97281 — -- ---
Phone #: $ 58.50 TOTAL
Reg #.. : 67877
REQUI RED INSPECTIONS
This pernit is issued subject to the regulations contained in the Rough—in Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Top—out Insp
applicable laws. All work will be done in accordance with Misc. Inspection
approved plans. This peruit will expire if work is not started 1",/ri n'yi-ng Fcunt li
within 180 days of issuance, or if work is suspended for more Final Inspect ion
than 180 days.
-
Permittee Signature: x2-rw��'ra~,'
Issued By: ---
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Call for inspection — 639-4175
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Gitif of'Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name of Deveyr ryent - New Single Family Residences OnIy
l `1 q 7�
Address . 0 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job {,c c re w 7/- .4 / ❑ 3 BATH HOUSE $225.00
Address Cit zip Fee includes all plumbing fixtures in the dwelling and the first 100 feet
-71eo p•t 6 iG x,'2'2 a c( of water service, sanitary sewer and storm sewer. See fees below.
Name (o name of Business) FIXTURES QTY PRICE AMT
Jai -Leo 4/(7-C Sink 9.00
Mailing Address Phone Lavatory a 9.00
Owner /76)/0 f lit , "e - - . dc"/ / Tub or Tub /Shower Comb. 9.00
City/State ZIP Shower Only 9.00
Water Closet 9.00
Name (or name of business) / Dishwasher 9.00
Garbage Disposal 9.00
Occupant Mailin Address Phone Washing Machine 9.00
Floor Drain 9.00
ary/State ZiP Water Heater / 9.00
Laundry Room Tray 9.00
Name Urinal 9.00
i ',411..6-e. s1 KU 1 i Other Fixtures (Specify) 9.00
Mailing Address f Phone 9.00
Contractor
r d s ri k -'�_, G L ; (- 9.00
City /State / ZIP 9.00
l 'Cn /4-�, -! (//c . -7. Sewer 1st 100' 30.00 •
State Registration No. / City Bus. Tax No. Sewer - ea. Addit. 100' 25.00
aP(a Jf 4 (,p 7t7 7 Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please
give reason elow.) Mobile Home Space 25.00
Back Flow Prevention
e j ,-- :Y Device or Anti - Pollution Device 9.00
Signatur er or. agent) Data Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new addition 0 alteration 0 repair 0 Catch Basin 9.00
to be done residential 0 non - residential Ar Insp. of Exist. Plumbing • 40.00 /hr
Specially Requested Inspections 40.00 /hr
Existing use of
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of
building or property
'(Except residential backtiow
prevention devices)
NOTICE "Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL 533
Special Conditions
Date issued by