Permit CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13f25 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PLUMBING PERMIT
PERMIT # PLM93 -0242
639 -4171 DATE ISSUED: 11/30/93
PARCEL: 1S1260C -01403
SITE ADDRESS...: 09300 SW WASHINGTON SQUARE RD
SUBDIVISION ZONING: C —G
BLOCK • LOT °
CLASS OF WORK..:ADD GARBAGE DISPOSALS..: MOBILE HOME SPACES.:
TYPE OF USE °COM WASHING MACH BACKFLOW PREVNTRS..:
OCCUPANCY GRP..:B2 FLOOR DRAINS :5 TRAPS •
STORIES •2 WATER HEATERS °3 CATCH BASINS
FIXTURES LAUNDRY TRAYS . SF RAIN DRAINS •
SINKS °3 URINALS °5 GREASE TRAPS •
LAVATORIES °12 OTHER FIXTURES :7 •
TUB /SHOWERS SEWER LINE (ft)
WATER CLOSETS..:19 WATER LINE (ft)
DISHWASHERS RAIN DRAIN (ft)
Remarks: Meier and Frank interior permit. Note: Type of Const. 5N, allowed as OS
SC
Sec. 106 Modification. See file.
Owner: FEES
MAY DEPARTMENT STORES type amount by date recpt
611 OLIVE ST PRMT $ 565.00 PLL 11/30/93 —
PLCK $ 141.25 PLL 11/30/93 —
ST. LOUIS MO 63101 5PCT $ 28.25 PLL 11/30/93 —
Phone #:
Contractor:
MARKMAN, INC.
9955 SE ASH
•
PORTLAND OR 97216
Phone #: 503- 255 -9923 $ 734.50 TOTAL
Reg #..: 12857
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 Rain Drain Insp
approved plans. This permit will expire if work is not started Misc. Inspection
within 180 days of issuance, or if work is suspended for more Drinking F o un t a i
than 180 days. Final Inspection
Permittee Signature: - -�
Issued By:
Call for inspection — 639 -4175
City of Tigard PLUMBING PERMIT Planck/Rec. #
13125 SW.HalI Blvd. APPLICATION Permit # P 73-0A)..
Tigard, OR 97223
(503) 639 -4171
Description
Yi-ee,"//:. .. . ..
(z. k. ORS 814 - 21-610 I OTY I PRICE I AMT
Job FIXTURES
Address o c S�✓ -We (5)h i, 4.
Sink 11/ 7.50 20,so
Lavatory fj o. 00
Norm (or nano a 0.4410141 0.4410141 Tub or Tub/Shower Comb. / J 7.50
t / ' �-bys Shower Only 7.50
l �! Water Closet I I IV I 1 7.50 / ta;;o
Owner e/ OL5Y , Ye'd Dishwasher 7.50
4 Garbage Disposal 7.50
' S ' , LUrs /) ° ,3i61 Washing Machine 7.50
Wm. cc mow a °i"..4 Floor Drain trff 7 37 5
A tTev and fa--k Water Heater / 7.50 /s, S O
Phone Laundry Room Tray 7.50
Occupant `°l g 3oG SP,/ ( 7r. Ss Urinal
7'44 7.50 °; 7,..5 0
am r � z. Other Fixes = (Specify) / 7.50 7- S o
N / %9 a re ) 6 R 9/P,3 f' .19 - ice • 7.50
� r
R� sty - � ti _ _/� �is . ..lift.,
. -! /II / �l ,f4. '-,-x- nil 7.50 _ 0 ^ ec
Maimg Ada... Pt, n. _ _ f
Contractor c,,,,.,... MISCELLANEOUS ��
Sewer 1st 100' 30.00
Sow amPa.00n No. Coy &.. T.. No. Sewer - ea. Addt 100' 15.00
Water Service 1st 100' 20.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addrt 200' 15.00
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 I Storm & Rain Drain 1st 100' 30.00
am registered with the Construction Contractor's Board, that the number Storm & Rain Drain Addrt 100' 15.00
given is correct (If exempt from State registration. please give reason
below.) Mobile Home Space 25.00
Back Flow Prevention
Device or Anti- Pollution Device 7.50
Sg w. (owner Of gwW Dr
Any Trap or Waste Not
Connected to a Fixture 7.50
Describe work new 0 addition (13 alteration ® repair 0 Catch Basin 7.50
L
to be done residential 0 non - residential rat
40.00
•
. Insp. of Exist. Plumbing . per hr /6 a O
40.00
Existing use of Specially Requested Inspections per hr
n9 Rain Drain, single family
building or property 7/ dwelling 15.00
Residential backflow prevention
devices 15.00
Proposed use of ��
building or property /' e 4Y
'(Except residential backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL 5k:5' 60
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5% SURCHARGE ,a ,j
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS. OR IF -
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED / �
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25% OF SUBTOTAL / # / " J'
COMMENCED. 7j -�
TOTAL ;` -w_
�
Special Conditions
Date issued ll/, &30 1Q'3 by kite
lutPLWASPIAT