11705 SW PACIFIC HIGHWAY STE M ADDRESS:
X10 1a,
i:\,records\rnicroil m\targets\budding.doc
SIGN PERMIT
PERMIT M: SGN93-0189 DATE ISSUED. . . . : 12/03/93
EXPIRATION DATE: 3/? /
PARCEL. . . . . . . .. : 1S13EDC-00100
ZONE. . . . . . . . . . . . R-3.5
pJSINESS NAME. . : RIFE'S MUSIC
SIGN LOCATION. . : 1.1705 SW PACIFIC HWY
APPLLCANT/AGENT: RON BRENNEMAN
BUSINESS TAX NO:
SIGN:
PERMANENT (X) FREESTANDING ( ) FREEWAY { )
TEMPORARY ( ) WALL (X) ELECTRONIC ' )
OTHER ( ) BILLBOARD ( ) BALLOON ( )
SIGN DIMENSIONS. . . . . . 2' X 13'11"
TOTAL SIGN AREA. . . . . . : 2.8 sq.ft.
WALL AREA. . . . . . . . . . . . . 600 sq.ft.
WALL FACE (DIRECTION) : S
SIGN HEIGHT. . . . . . . . . . . £t.
PROJECTION FROM WALL. : 8 in.
ILLUMINATION. . . . . . . . . : INT
DESCRIPTION OF SIGN:
Permanent Wall Sign. Dimensions: 2• X 13'11" = 28 square feet.
MATERIALS. . . . . . . . . . . . . PLEX/METAL
EXISTING SIGNS. . . . . . . :
ELECTRICAL PERMIT REQUIRED.: YES
BUILDING PERN.IT REQUIRED. . : NO
ADMINISTRATIVE EXCEPTIONS. : N/A
13ERMIT FEE: $ 25.00
APPROVED BY: �}�� I ))AAk.
DATE: 32/03/93
Permit No. -, �
CT('Y OF TIGAPT)
SICW PER41T AP,FT ICATION
The applicant hereby applies for a permit for the Werk itdicated or as shawl in the
aoc mpanying plans and specifications.
SI(V 1f)2ATICkl ADDRESS: 11705 SW PACIFIC HWY. TIGARD, OR _ ZON M: COMMERCIAL _
SUITE M
NAM*: OF BUSINESS: RIFE'S MUSIC
APPLICANT/AGENT: RON BRENNEMAN _ COMPANY: BLAZE SIGNS PHONE: 639-3262
The City of TigarC inpose, an annual Bwsiness 'fax whim must Ly� kept cu.-rent on alp
persons doing businc-s in the City. Do you presently have a ci.went busi.ness tax?
YI-1 ( X ) NO ( ) U.L. Label it
PROPOE,ID SIGN: (Check as iteny as apply)
PEI3qMw FREESTANDING ( ) FREEWAY ( )
TEMPORARY { ) VZAIL ( X ) El 1;M- RONIC ( )
OTHER ( ) BILLBOARD ( ) BALUJON ( )
SIGN _IMENS-IONS: 2' X 13'-1I" _ _ T--CpIRATION DATE:
TOTAL SIGN AREA (Sq. Ft.) : 27 S�FT. 3' -31 Q q
WALL AREA (Sq. Ft.) : 20' X
WA30'
30 ,�
LL FACE: 20T X 30 _
H G1T (It) : _ 3 X 15
PRO JECBION FROM WAM: 8 FF
IIIJ14INA`!'ION: YES (X ) No ( ) TYPE: Kq,'%LC7-7
CrjPY: RIFE'S MUSIC
MATERIALS: FLEX, SHEET METAL AND ALUMINUM
EXISTING SIGNS: NO
ADMINISTRATIVE EXCEPTION: N/A ( ) APPROVED ( ) i"q MUCH- _—$
AREA ( ) HEIGYr ( )
CU14ENM:
PLANNING DF.PARINERr All sigh permits mist. be accompanied by a scale
Permit Fee: 9S.QC drawing and plot plan. If. work authorized wider
Receipt No:!QQ3- o- Cc� a sign permit has not been completed within ninety
}1Lyraved Bye L 1V _ _ days after the issuance of the permit, the permit
Date: 1� `3`�. shall beacm hall and void.
ELBCIRI.Al, PERM U I CERT IF Y TMT I AM THE RDODRDFD (Acm, OF 71E
REQL RFD: YES ( ) NO (X PROP O AN AC�*^.' AULNORIZED BY THE CX�NII2.
BUIIDING PERMIT _
'� �^"_ RON RRENNEMAN
RFUJ RM: YES (k) NO t . can t'G Si_grature
P.G. BOX 25357 PORTLAND, OR 97225
cp/BKMPERMr -- Iddre-ss --- — �Telephone
N:\W0PD\C MEV\
11/17/93 15: 26 $503 620 847 i BLAZE SIQN*S CITY OF TIGARD 0004
J
7]11;1T/9� 11:55 '0503 620 8177 BLAZE SIGNS CITY OF TIGARD lei 00.I
Cir
I
TO
I TJ
1
1
i C
I �
C,7 I Y (A I t-ol WO Pitt. 1111 (11 I 'l 1, 011- IJI Ili I I I I Mi I. I-)
.111 f;K filylt'll 11A I IAO
MIAMI 1460 f11'l11)UNI r, 1"1., 1/10
ADOFJ: PIO BOX PIMI- 1\11 DMI -- 1 .
Ib I V f.',.I.I II I
I-It I RP(ji.if, (11- F 4:11Y11i Nt AM(AINV PWO Iff t1ttY111141 HM(11 IN I Pi 0 1,
!:i:l k--iN PI RMI I F !-A iW:4,•o 189 01/1
T 0 1 K. 101 OJN r f-,wt o 00
�+B
TUALATIN VALLEY FIRE & RESCUE
AND
REA✓ERTON FIRE DEPARTMENT
4755 S.W. Griffith Drive• P.O. Box 4755 • Beaverton, OR 97076• (503) 526-2469• FAX 52G-2538
r
August 3, 1993
Mahlum & Nordfors
50 S.W. 2nd Street, Suite 600
Portland, Oregon 97204
Re: Rife's Music Center
Pacific. Crossroads
11705 S.W. Pacific Hwy.
5990C-103-009
Gentlemen:
This is a Fire and .Life Safety Plan Review and is based
on the 1991 editions of the Uniform Fire Code (UFC) and
those sections of the Uniform Building Code (UBC) and
Uniform Mechanical Code (UMC) specifically referencing
the fire department, and other- local ordinances and
regulations.
Plans are conditionally approved subject to Tigard
Building Department requirements and the following
Items:
1 . The tenant space number most be prominently
displayed on the street front where it is readily
visible to drivers and officers of responding fire
apparatus and other emergency vehicles. UFC Sec.
10.208
2 . Not less than one (1) apprnvP3 fire
extinguisher(s) with a rating of not less than (*)
shall be provided for each (**) square foot of
Boor area or fraction thereof. The travel
distance to an extinguisher from any portion of
the building, shall not exceed 75 feet. UFC Sec.
10 .303
(*) 2A10B:C - Light and Ordinary Hazard
4A10B:C - Extra Hazard
Working"Smoke Detectors Save Lives
Mahlum & Nordfors
August 3, 1993
Page 2
(**) 3, 000 - Light Hazard
1,500 - Ordinary Hazard
1, 000 - Extra Hazard
Note: Where flammable or combustible liquids are
used, "B" ratings of extinguishers may need to be
higher and travel distances shorte_. See
requirements in National Fire Protection
Association Standard 10-1 .
3 . If Lhis building is protected by an automatic fire
protection or required fire or smoke detection
system, not addressed on these plans, contact this
office before proceeding. Demolition, new
construction, or changes in HVAC could alter or
eliminate protection from these life safety
systems.
Approval of su,-mitted plans is not an approval of
omissions or oversights by this office or of non-
compliance with any applicable regulations of local
government.
If I can be of any further assistance to you, please
feel i'ree to contact me at 5224609.
Sincerely,
Bradley .. Wanamaker
Deputy Fire Marshal
BNW:kw
cc: Tigard Building Department
LF.RTIFICATE UP
CITY OF TIGARD PFnM I T 1I'. . . . . .OCCUPAI.4cy SUP93-01,
COMMUNITY DEVELOPMENT DEPARTMENT DATE' ISSUEDc 07/29/1-$3
13125 SW Hr.H Blvd.Tigard,Oregon 9722348190 (503)6619.41711
,ITE AUURF-St:. . . c 1 ! i 0*j ',iW I.-IAL",I IL. 'IWY
SUBDIVISION. . . . a FRIJITLAND ACF--FS ZONINGeR-3. !;
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . 116
CLASS Of WORK. :NEW
TYPE OF USE. . . :COM
OCC(JPnNCY ORP. :B2
OCCUP(INCY LOAD160
I ENA19T NAME. . :RIFE" S MUSIC CENTER
Reimavks.- Tenant 11,1provpment- partittun walls and toilet I-OOM.
Owner
WESTWOOD CORP.
3030 �3W MOODY
PORTLAND OR 977201
Phone #t
Lontracturs -------
WESTWOOD CONSTRUCTION
3030 SW MUODY AVENUE
POKTLFIND OR 97i-201
Phoiie #3 222-2000
Reg #. . - 03339
19-crupancy of the a..)ove referenced t-iLtildinq :is lipreby given, And certifies
the, compliance with the State Of Oregon Speu.,ialty Gor -?s for the 9)-OuP,
ocuupAr)c,y, and cse under which the reFerenced permit was trislied.
IRF -r MF-.'r\l T (3
Ell
b �,, l NO ISPEL I up
POST IN PLACE
INSFECTON NOTICB
City or Tigard Building Department 'j
13125 M Hall Blvd_ Tigard, Oregon 9722
Inspection Lina (Rec-O-Phone)t 639-4175 Business Phone: 639-4171
Innpactlon:
Footing Plbg. Underslab Mach. Rough-in Appr/8dwlk
Found. Plbg. Top Out Gas Line PINALs
Post/Beam Struct. San. Sewer Framing
Post/Beam Mech. Rain Drain. Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Ed. -loch.
Date Requesteds `7 -.1- � Times AM Q PM
Address:
r Ue Permit #4 �c/)/ Z 7
sr is
Hullders
TM POLLOMMO CCRMCTIt XMIRMs
e �
Ins. ctort !:.tat
r
`__APPROVED SAPPROVED _ APPROVED SUBJEC.'T TO ABOVE
C For Rainap.
JP�P,11N 1,,, 4 ) 6 TUALATIN VALLEY FIRT & RESCUE
AND
BEAVERTON FIRE DEPARTMENT
� ► FIRE MARSHALS OFFICE
T r: v� (503) 526-2469 POSTED`n
OCCUPANT '�: �� C
CONTRACTOR BLDG. PERMIT 0
PROJECT NAME PLAN REVIEW 0
LOCATION
JURISDICTION: 1= Be. 2= Du, 3= r•C.(4= Ti) 5= Tu. 6= Sh. 7= Wi, 8= CC 9= WC 0= MC
COVER F NAV SPECIAL FOLLOW-UP/REINSPECTION ATTEMPTED FINAL
❑ Framing ❑ Separation Walls ❑ Sprinkler System
❑ Shaft ❑ Fire Dampers (Overhead/Underground)
❑ A] , *m System ❑ Hood' Extng Systems ❑ Conference
❑ bpray Booth ❑ Ceiling Cover ❑ Other
r
DateInspector-,
����� f
H PBCf U NOTICF
City of Tiqard Building Departmeznt
13125 Be Ball Blvd. Tigard. Oregon 97223
Inspection Line (Rev 4-Phone)s 639. 4175 Businesa Phone 4 �^
Inep►.ctionx _.__� --- --
Footing Plbg. Underelab Hach. Rough-in Appr/S4.A k
Found. Plbg. Top Out G&W Line FINALx
Toot/Beam Struct. San. Sawar Framing -Bldg.
Poet/Ream Hoch. Rain Drain Zneulatlon ._Plumb.
Plbg. Underfloor �7 Watnr Line Gyp. Rd. -Hoch.
Data RaQuestedt / _ Times AH PH
Address: Z 05- tt —� L
Builders
L�
THE FOLLOWING CORRECTIONS ARE REQtTIREDt
i
✓.........
Inspector
APPROV$D DISAPPROVED APPROVED AU IM! To
Call For Reinsp.
CITY CSF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13126$W Mall Blvd.Tigard,Orvjon 07223.6100 (503)630.4171
i
FR Cj I
t t.;
,��(�1t�3'r,X�14°J. , » (���� I . r1 �1: r- �i�'viia•:t:: _.
b L 9:..:
.�YtV �� � � � �� .... -.. ....._.. .w.....,nw
c
' ..- ,-�'i ,ir a.:.is+b"r:i. .7" :'i i,:':•�, .i{9�,'._n• i LI+<ita � r, ^:-_.'�;: L..i t' _. .: ...,. ... _.�....._......,
13125 SW H91 DN4 PLNCK/RECf HCI 1 1T�'(j OF TICARD PERMIT # �UP V3- 0)"19
COMMUNITY DEVELOPMENT DEPARTMENT Tigm-4 Oregon 9M3
(503)639A171 DATE ISSUED _
JOB ADDRESS: JV 72-5- TAX MAP/LOT
SUB: LOT: P` _ LAND USE:
** APP.
VALUATION: /7t,���� 6vl - i
VE **
BY:
OWNER SPECIAL N
NAME: . , �t«x __CC�� REISSUE OF:
ADDRESS: ` LAST REISSUE:
FLOOD PLAIN/
PHONE: ��Z-c'�=LTJ SENSITiVE LAND:
CONTRACTOR APPPOVALS REQUIRED
NAME: //1"S�Z_��. ). PLANNING:
ADDRESS: ENGINEERING:
FIRE DEPT:
PHONE: _ OTHER: NO �i�)��._:—tZi
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: _ — LIST/SUBCONTRACTORS:
MECH: BUS TAX:
ARCH/ENGINEER r CALCULATIONS:
NAME: 11 ��':��/K{��� TRUSS DETAILS:
ADDRESS: i`Y�� LLJ Zn <`'�lr cic r' OTHER:
/-,l�`i/
PHONE: 1
PROPOSED BLDG. USE: ,5 a-) US 1fr, C r-
COMMENTS: V"l�r �?��5T I '�y '
APPLICANT SIGNATURF
Received By: �___ Date Received: ¢ ,
PERMIT # ACCT a DESCRIPTION M10UNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees Q0
V/)r }� �`FpF10-431 00 Plumbing Permit Fees
174,rfZ_ r 10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building
Plumbing
Mechanical
10-433 00 Plans Check fee
Building
Pl umb i rg
Mechanical
10-230
10-230 06 Fire -
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees _
25-443-04 Industrial TIF Fp-s ^_ _
25-448-06 Institutional TIF I-gcs
25-448-03 Office TIF Fees
2.5-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 Parks System Dev Charge (PDC)
31-450 Ou Sto►7n Pr-ainage Syst Dev Chrg
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
2.4-445-02 Water Quantity (Fee in lieu of)
TOTAI - ----- ---- - ���-'
nm/3587P.WP'-
. . .. ....... ..
10' 5" -
EXISTING BATHROOM '
STORAGE SIXBATH DIMENSIONS TO REMIAN
Q ROOM hOoM TffrDOOR TO MEET MIN 32"CLI
w11alY OPNG REO. (ADA
................
PLUG STRIP
G4"A, F 12'O.C.
(10 L.F. )
PLUG STRIP .1
12"O.C. ELECTONE
o (10 L.F. EA) CLASSROOM
N
CLAVINOVA X (S
CLASSROOM
6'-3" �• o nm O�t�'
�p0� a zvz� SALES
CLOSING
��•Ylyi,r�>rf�if};y�°%'Y i;3 r> Ys s}, � k ?Yl�
s
Nip.
;> DESK
ISPLAY
�. .. R EA
PLUG STRIP
POWER FEED
FROM CEILING ' (10 L.F. )
;<!tt<iii•'•rii:'i.:iL�;tfi,:::1�. 3i:
PLUG STRIP '' f «fi.g; f .; - i• t }
12'0.C. 4ti..•yr 1 k, t ,"�;
(10 L.F.
�£� : .a(%.�. fi •to-:
"S,YVf•:•i•YiFiY:,', •�'` +b• i5^: :;<.. •:SSE€�e "�fiK::S•:5:�:
<eS:,
i;;:i:. :}�ii•. 'S}: i`.3 k:
�:$ir;�F:if•{:{:::f.y4 ,';y� }.:..; :f1iF:::i::R;:i.:;`:F':: '�::::}vS1:i'FF%�'•..:.;�::�•.
r 4i>YYtr moi" �,YP'yM \FSO i +, .• {
Pk
Gj out,
,�•F.kri �+ 1 iF°3}4' >k.r. ?i-k <. is}L�y�s.:'
>, i S }SAX,•' 1 � r ;�i��; �
RIFE S MUSIC CENTER
FLUOR PLAN PACIFIC CROSSROADS CENT!
TIGARD, OREGON
33'-3"
I
-- O
r-
o �
o
\`/_STORAGE 00
ROOMS
DRESSING "6
ROOMS -- -
LEASE SPACE
STATISTICS:
GROSS SO.FTG:
1.970Ln
O
PERIMETER: ,
185' 01
HEIGHT:
59.25'
WIDTH:
23.25'
MAIN Sly
f I ENTI iY j
r0avo r s /
EXISTING I_E&GE SPACE r
1-1993 1-110.4 FP0II MAHLUM t10PLIFORS TO UESTWOOD -ORF F.04 X15
tMrg7�ltaiONl �
yj
p•.� a �I
Y
O
0 �I
L�
N
- $
h
W"II Y`l'40► O LU
n
L-L, vi
K
�>
u U �
U
I V �
L
4 � �
CITY OF TIGARD REC171PT OF PAYMENT RECEIPT NO. 9,3-241 .852
C HEr.K AMOUNT s 134. 93
AIIE : WEs,rWOOD CORP CASH AMOUNT 0. 01
DDRESS 4 PAYMENT DATE a 06/30/93
3030 9W MOODY AVE SUBDTUTRION
PORTLAND OR 97201--
'(UkPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
UILDING PEM 128. 50 SY. BUILD PER 6. 43
11705 SW PACIFIC HWY
'UITE M
FOT*AL AMOUNT PAIL) 134. 93
CITY OF TIGARD RECEIPT OF PAYMENT r":ECEIPT No. t 93-c_'41678
CHECK AMOUNT 83. 53
IAMF : WESTWOOD CORPORATION CASH AMOUNT t 01. 00
DDRFSS : 3030 SW MOODY AVE PPYMENT DATF i 06/iF-4/93
PORTLAND, OR SUBDIVISION
97201-
1URPOSE OF PAYMENT AMOUNT PAIL) PURPOSE OF' PAYMENT AMOUNT POI D
"'LWN CHECK FE 6--68C 83. 53
(0101.. OMOUNT rnio
191s. 51-1
t�
City of Tigard MECHANICAL PERMIT Planck/Rec. # _
13125 SW Hall Blvd. APPLICATION Permit # �IPi I3 .CTIN
Tigard, OR 97223
(503) r,',')-4171 _
escription
5 &t� Table 3A Mechanical Code QTY PRICE AMT
`1tt
Job n 1 n, 1) Permit Fee -0- -0- 10.00
Address Aly
/"r J _ q 7.2-z,;; 2) Supplemental Permit 3.00
"•"• -4Furnace to 100.000 BTU
(A,Xp fi t,,� (�,) t,%W jar 1) ind.duds 3 vent; 6.00
o •••
Furnace 100,555 M+ —^
Own_ C .i f YJ Cori 2) ind.duds d vents 7.50
''• AP Floor Furnance
3) incl.vent 6.00
�^•�^•^� Suspended heater.w Iheater ,
4) or floor mounted beater 6.00
•� "•• Vent not I .In
Occupant j l^ s r, tf i Fit 5) appliance permit 3.00
Repair of heating,ro ng.
2,05 6) cooling,absorption unit 6.00
�^• 'moiler or comp, heat pump,air cond.
7) to 3 HP absorp whit to 100K BTU 6.00
"''''a°k••• -- - Boder or camp,cheat pump,air cond.
Contractor 8) 3-15 HP absorp unit to 500K BTU 11.00
"• Boiler or comp,beat pump,air cond,
9) 1530 HP absorp unit.5-1 mil BTU 15.00
r' ••"°^"^ --�'+ ""° oder or comp,beat pump,air Gond.
10) 30-50 HP absorp unit 1-1.75 mil BTU 22.50
_TTWre y acknowledge that I have read is ap ication,that die I or or comp,boat pump,air Co .
information given is correct,that 1 am the owner or authorited went 11) >50 HP absorp unit 1.75 mil BTU 31.50
of the owner,that plans submitted are in compliance with StateAir handling unit to
laws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is contact. (II exempt from State registration, Air handing unit —
please give reason below.) 13) 10,000 CTM a 7.50
Non portable —
14) evaporate cooler 4.50
Vent fan connect _
_ 15) to a single dud 3.00
anti-tion system not
16) included in appliance permit 4.50
17) mechanical exhaust 4.50
osTcneo w�c new addition altorat-10—
?5;mmercial or 6&stdal
to be done rosldential O non-residential G 18) type incinerator 30.00
x—"hng use o Oi5er i.e.,woodstove,water
building or property_ 19) heater,solar,clothes dryers,etc. 4.50
Proposed use of 20) Gas piping one k four outlets 2.00
building or property _ —
A -
Tvpe of fuel-oil O natural gas O LPC=O electric:O 21) More thin 4 per outlet
—�E ---- -
Minimum Fee$25.00 SUBTOTAL
PERMITS BECOME VOItj it-WORK OR CONSTRUCTION
AUTHORIZED(`i NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
IF CON;, R!.fCTION OR WORK IS SUSPENDED OR _
411ANCK)NED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25'X.OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL
Special Coruirtions
Data issued by
WWII~
reiCe•nvMr
City of Tigard PLUMBING PERMIT Planck/Rec. #
13125 SW ♦-lull Blvd. APPLICATION Permit # f-11—rL,
Tigard, OR 97223
(503) 639-4171-4-4 Descn P4 on
_
k r f- /�1, _^ LL FSA ORS 81421.610 OTY PRICE AMT
.lob •Y-,_,T�/ rC'. � >�r�•M FIXTURES
Addre ysw -Sink5t1
Lavatory 7.50 L
,/ ^^•• Tub or Tub/Shown(Comb,
lJV ap Jt` �o'r do Slower Only 7.50
�• stet closet T 7.50
OwnerDishwa- or T50
--Garbage Disposal
Macliine 7.50
n•^•^• 1 kwr rain 7.50'
p7x Water eater 7.50
'�' ^"' Laundry Room ray
Occupant ---
�'cJ 7 ' r Urinal 7.50
Other Fixtures(Specify) .50
7t� rlY" Clf- �l7 0.71 7.50
7.50
• 7.50
Contractor ,,, MISCELLANEOUS 4
`fewer 1st 100' 30.00
'"^ ""° — u N. Sewer-ea.Ad& 100' 1T0-0
alar _tutee 1st100' 20.00
derey acknawledge that I have read this ap ication,thal the Water Serrice ea.Addit.200' 15.00
infonration 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 3 Rain Drain 1st 100' 30.00
am registered with the Construction Contractors Board,that the number Storm d rla:i Drain Addil. 100' 15.00
given is coned (If exempt from State registration,please give reason _
below.) Mobile Home Space 25.00
Back Flow Prevention
Device or Anti-Pollution Device 7.50
any Trap or Waste I TT
Connected to a Fixture 7.50
�escn wnew addition alteration repair Ca- assn W
to be done resideal
O non-residential(Jf -- — -
'C 40.00
Insp.of Exist. Plumbing per hr
40.00
Specially Requested Inspections per hr
Existng use of -6 rain,single family
build ng or property dwelling 15.00
Residential backflow prevention
devices 15.00
Proposed use of ----- -
building or property _
'("xcep(►esrdenrral backflow
prevention devices)
NOTICE 'Minimum Fee$25.00 SUBTOTAL
PEPMITS BECOME VOID IF WORK,OR CONSTRUCTION 5%SURCHARGE r
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF J
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25%OF SUBTOTAL I��
COMMENCED,
TOTAL
Special
Date issued by