Permit A - CITY OF TIGARD
6 1 DEVELOPMENT SERVICES PLUMBING PERMIT
X1 j PE RM I T # • PLM97 -0352
-Nfr — 13125 SW Hall Blvd., Tigard, OR 97223 (503)6394171 DATE ISSUED: 08/28/97
PARCEL: 2S1O2AA -00602
SITE ADDRESS...: 11960 SW PACIFIC HWY
SUBDIVISION • TIGARD HIGHWAY TRACTS ZONING: CBD
BLOCK • LOT :10 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:M FLOOR DRAINS • 0 TRAPS : 0
STORIES • 0 WATER HEATERS • 1 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0
SINKS • 1 URINALS • 1 GREASE TRAPS • 0
LAVATORIES • 2 OTHER FIXTURES • 0
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 2 WATER LINE (ft)...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Aman Enterprises Inc tenant improvement.
Owner: FEES
MAN ENTERPRISES INC type amount by date recpt
PO BOX 230849 PRMT $ 63.00 JSD 08/28/97 97- 298740
TIGARD OR 97281 5PCT $ 3.15 JSD 08/28/97 97- 298740
Phone #:
Contractor
CROWN PLUMBING
23172 SW STAFFORD RD
TUALATIN OR 97062
Phone #: 771 -9449 $ 66.15 TOTAL
Reg #..: 004267
REQUIRED INSPECTIONS
This per.it 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 per.it will expire if work is not started Misc. Inspection
within 180 days of issuance, or if work is suspended for sore Insp existing /ca
than 180 days. ATTENTION: Oregon law requires you to follow rules Final Inspection
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 9524001-0010 through OAR 9524001-0080. You nay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By: Permittee Signat e:
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + ++ + + + + + + + + + + + + + + + ++ + + +++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
. _ - - - -- -
:ITV OF TIGARD Plumbing Application Recd By----- 9 P P Date Recd
3125 SW HALL BLVD. Commercial and Residential C
- 1GARD, OR 97223 Oats to P.E.
503) 639 -4171 Date to Os,.
Permit i l G - • ' + / r'/'7 c 35 e
Print or\Type V A R - E
Incomplete or illegible applications will not be accepted Called OS 9 c7 S,,- -
-9 - 0 1 ,/'fit , !
Name of uProlec . FIX[URE§ArtAleldual) 4.1104. pp it
Job AMA-A) fa aioari 13C , I 9.00 f
Address Street Address r f Suite
Lava
�► �` 9.00 /c
I VI y hn f_ta C I to C RW y , Tub or TublShower Comb. 9.00 Bldg i CGty /State // Zip Shower Only 9.00 �� ,n A n� C � ( iL-N(? fC 17z Z Water Closet &00 / b
t e pu �1JT iopp i-S Dishwasher 9.00
Owner Address r 9 Gasbags DlsPoaal 9.00
(1 1 4 0 0 �/ W (t1C y Washing Machine 9.00
/S nndb 9.00
�
City/State 17 Floor Drain 9.00
4 " 9.00
Occupant 1AaiBng Address Suite Water heater - + 9 L?
-
Laundry Room Tray 9.00 '/
City/State Zip Phone Urinal - / 9.00 7
, , 1 r G
n Other Fixtures (Specify) 9.00
JWN PIlltt44 t r Zsx. 9.00
Contractor Aas Suits 9.00
, � S,W r r rAiv i.t
(Prior to issuance � 9.00
aPPOcant must 4 1 ) pT Q '7 zo 1 7( 7//41 9.00
provide all Oregon Cant. Board Lime Ex p. a 9.00
contractors en 7) /DZ7c" 9.00
Owns. information c; 7 R L* J' 1 ; ri d Sewer _ 1st 100' 25.00
tl Sewer _ each additional 100' 23.00
for COT COT Business Tax or Metro i /� r Date - fat 100'
database,. a � � � �,p 1 1 Water Water Service - each additional 200' 25. 0
Architect Storm & Rain Drain - 1st 100' '• 30.00
or Malang Address - Suite Storm & Rain Oran - each additional 100' 25.00
Mobile Home Space - 25.00
Engineer City /sus Zip Phone Back Flow Prevention Device or Mb- 25.00
Pollution Device
escibe worts New 0 Addition 0 Alteration 0 Repair 0 Residential Bacicflow Prevention Device' 15.00
be done: Residential 0 Non - residential 0 My Trap or Waste Not Connected to a Figure 9.00
:ditional description of work
Catch Basin 9.00
Insp. of Existing Plumbing 40
per/hr
ting use of Specially Requested Inspections 40.00
ling or property pertly
Rain Drain single family dwelling 30.00 .00
, hosed use of Grease Traps 9.00
ding or property
QUANTITY TOTAL 1•� . -_ :_�
capping , moving or Isometric or rater { r ` s " `• '
J you ca replacing an fixtures? Y No p � is teeuired if t7uenly Tow is > 9��..� �,,.,� .. -r. .
yes see back of forrn) 'SUBTOTAL -- 1-- / 0�
scree /
acknowled a that I have read this a , . , ' i ' - C
Y 9 application. that the information
:n is correct, that I am the owner or authorized agent of the owner. and 5% SURCHARGE _..:` i C
t Mans submitted are in corn• :, -- Oregon State taws. - h /
;nab of • • NA: - pate PLAN REVIEW 25% OF SUBTOTAL . - _ •s: V-
Reputed only it 16cese qty. total is a 9
TOTAL j l L
matt • Orson - j - -
Phone
'Minimum permit fee is S25 + 5% surcharge, except Residential Backflow
Prevention Device. which is $15 + 5% surcharge
1: \plmapp.doc 12/96 (dst)
. di S
'LEASE COMPLETE AS APPROPRIATE TO PROJECT:
I Fixtures to be capped, moved . or replaced Qty
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher -
Garbage Disposal
Washing Machine
Floor Drain 2
3 "
4°
Water Heater V
Laundry Room Tray
Urinal f
Other Fixtures (Specify)
J /opQ i`i) f - `` '7
:OMMENTS REGARDING ABOVE:
I:\plmapp.doc 12/96 (dst)
Page No. 1 CASE HISTORY FOR CASE NO.: PLM97 -0352
AMAN ENTERPRISES INC
11960 SW PACIFIC HWY
02/17/99
Action Description Retry Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
- - -- - -- -- - ----- ---
PLMC003 Application received / / / / 08/22/97 PASS JSD 08/26/97 JD
PLMC005 Permit Created / / / / 08/22/97 PASS JSD 08/26/97 JD
PLMC040 (F) Ready to issue / / / / 08/26/97 Needs BusTax /Metro. Hand out sewer PASS JSD 08/26/97 JD
card.
PLMCO50 (F) Issue permit / / / / 08/28/97 PASS JSD 08/28/97 JD
PLMC725 Top -out Insp 08/26/97 / / 09/04/97 No more inspections until address is PASS RAB 09/04/97 RAB
posted.
PLMC760 Insp existing /capped fixtures 08/26/97 / / 02/23/98 PASS WA 02/25/98 J *H
PLMC799 Final Inspection / / / / 02/23/98 PASS WA 02/25/98 J *H
PLMC800 Case Finaled / / / / 02/25/98 PASS WA 02/25/98 J *H