Permit _,- CITY OF TIGARD
PLUMPING PERMIT
�,L
DEVELOPMENT SERVI PERMI ISSUED: 04/10/98 -0081
PARCEL: 25112DD -00701
SITE ADDRESS...: 15820 SW UPPER BOONES FERRY RD #BLD.
SUBDIVISION ZONING: I —P
BLOCK LOT • 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..:B FLOOR DRAINS • 0 TRAPS • 0
STORIES • 0 WATER HEATERS • 0 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS : 0
SINKS • 1 URINALS 0 GREASE TRAPS • 0
LAVATORIES • 1 OTHER FIXTURES • 0
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Installation of 1 sink and 1 lavatory.
Owner: FEES
JOHN ROMISH type amount by date recpt
2276 SE 24TH AVE PRMT $ 25.00 GEO 04/10/98 98- 304855
PORTLAND OR 97214 5PCT $ 1.25 GEO 04/10/98 98- 304855
PRMT $ 6.25 GEO 04/10/98 98- 304855
Phone #: PRMT $ 18.75 GEO 04/10/98 98- 304855
5PCT $ 1.25 GEO 04/10/98 98- 304855
Contract or
POWER PLUMBING CO
P 0 BOX 23144
TIGARD OR 97281
Phone #: 244 -1900 $ 52.50 TOTAL
Reg #..: 000523
REQUIRED INSPECTIONS ■
This permit 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 Insp existing / ca
approved plans. This permit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for more
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 9524001 -0010 through OAR 952 '.''.q-9080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By / v / " Permittee Signature: J ■ / `
+++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
MAR -20 -1998 11:18 POWER PLUMBING CO. 244 +8825 P.01
"v "' "°rI..1 PLUMBING PERMIT APPLICATION Planck/Re � �.
1312TSW Hall Blvd. •.
Tigard, OR 97223 Permit # G 9 1 �
(503) 639-4171 6U P,44AR 7 - 60q 7
MINIMUM $25.00 PERMIT
Egttl§T,;.,,,SURCHARGE
Narns of x.n.a.n.n
0 IS P New Single Family Residences Only -
Job ` C ggv C ` 0 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Address en rs� , 4J 0 3 BATH HOUSE $225.00
( Fee includes all plumbing futures in the dwelling and the first 100 feet
Q/ of water service, sanitary sewer and stnrrn sewer. See fees below.
Mae. (or norm r
FIXTURES QTY PRICE AMT -
.... .esY Sink = /
9.00 o f
Phone
Lavatory
/ 9.00 r
Owner Tub or Tub /Shower Comb. r '
cwilim• a , 9.00
Shower Only 9 00
Water Closet 9,00
Nam. (s name w !mines.?
Dishwasher
9.00
Occupant Garbage Disposal 9.00
„,,,,,c .sL... R+m.
-
Washing Machine 9.00
- ee Floor Drain
9.00
zo Water Heater
9.00
H.... Laundry Room Tray 9.00
1 e�'' ueiL � I v l �, J Other 9.00 4 0 e Marc �� 1..t Other Fixtures (Specify) 9.00
Contractor �� ,
9.00
� ra, 9.00
6x 3 140 � 1'� 9.00
Sewer 1st 100' 30.00
8tat• q.pRtraGm N.. C2, Ss. Ta M.
2 I _ _ P 1 4 Sewer - ea. 100' 30.00
` r r�itY11 �J Water Service a 1st 1st 100' 30.00
I hereby acknowledge that I have read this application, that the
Information given Is correct, that I am the owner or authorized agent of Water Service ea. Addit. 200' 25 DD
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
number given is correct. (If exempt from State registration, please Storm & Rain Drain Addit. 100' 25.00
give reason below.) Mobile Home Space
25.00
R&1t: l ! Back Flow Prevention
�1 �� I 4I■ Device or Anti - Pollution Device 9,00
....•
7;6x e k [� ` A vtn b Any Trap or Waste Not
� Connected to a Fixture 9.00
Describe work new 0 addition 0 altera repair 0 Catch Basin
to be done residential 0 non - residential 9.00
Insp. of Exist Plumbing 40.00Mr
-
Existing use of Specially Requested Inspections 40.00/hr
building or property `) [ Rain Drain, single family dwelling 30.00
Residential backflow prevention
Proposed use of AeK, evice s 15.09
building or property '`(w[ ( jL
SC ��I
' (Except residential backlfow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL C
PERMITS BECOME VOID IF WORK OR CONSTRUCTION _ o�
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED _ / g
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL .
c�� I �
ipecial Conditions
TOTAL � ' �•°
- & so
Date issued by
TOT .01
3-PG -9i
Accumulative Sewer Tally
Tenant Name 1 'G )f 14 T0, This SWR# • 2 q g —004/7
Address: /51 PO o,) u PP€t PacoNE / 2' 20 This PLM#: ii 0 6 1 SS U()
Fixture Value Previous Previous Credits Capped Fuctures 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
- JacuuWVhirlpool 4
Car Wash - Each Stall 6
- Drive Throu • h 16
Cuspidor/Water 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
4
Ice Machine/Refri • erator Drains 1
Oil Se • (Gas Station) 6
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2
Sink - Bar/Lavatory 2 I
- Bradley 5
- Commercial 3 1
- Service 3
Swimming Pool Filter 1
Washer - Clothes 6
Water Extractor 6
Water Closet - Toilet 6
Urinal 6
TOTALS I 11D 0 5 lCac
/ ' '" 6 �u ' S
Total fixture values: i CD 5 divided by 16 = /Q 3 / EDU
11
I � � l / , I
HISTORY ��ji(phg � Ltd -U/1. /b - I - DLL' �d CCT� IV e----
PLM# EDU# SWR# " PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
i:ldstslswrtay.doe