Permit S AS' / - - �tJ
_chW CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2010 -00087
r.n�J Date Issued: 03/25/2010
T (GARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S110DB00500
Jurisdiction: Tigard
Site address: 15336 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Sonic Drive -In Restaurant
Project Description: Interior plumbing for new drive -in restaurant. Less than 2" water service. 5/28/10, adding (2)
additional backflow preventors.
Owner: FEES
MWF TIGARD LLC Quantity Description Date Amount
2123 NW ALOCLEK DR #1203
HILLSBORO, OR 97124 1 ea Backflow Preventer 03/25/2010 $31.27
PHONE: 503 617 -0175 1 ea Expansion Tank 03/25/2010 $12.51
15 ea Floor Drain /Floor Sink/Hub 03/25/2010 $375.30
3 ea Hose Bib 03/25/2010 $75.06
Contractor: 1 ea Ice Maker 03/25/2010 $12.51
AL'S PLUMBING 2 ea Primer 03/25/2010 $25.02
5655 CROSSLER CT. S. 1 ea Roof Drain (Commercial) 03/25/2010 $12.51
SALEM, OR 97306 3 ea Sink 03/25/2010 $75.06
PHONE: 503-375-3449 5 ea Lavatories 03/25/2010 $125.10
FAX: 503-375-3444 1 ea Urinal 03/25/2010 $25.02
2 ea Water Closet 03/25/2010 $50.04
1 12% State Surcharge - 03/25/2010 $102.83
Plumbing
Type of Use: COM 1 ea Water Heater 03/25/2010 $37.52
Class of Work; NEW Type of Const: 2 ea Backflow Preventer 05/28/2010 $62.54
0 12% State Surcharge - 05/28/2010 $7.51
Occupancy Grp:
Plumbing
Stories:
Total $1,029.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct que OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued ( ; /` /1 Perm ittee Signatu
a/c
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
"' PLUMBING PERMIT
1 ,., 1 ,,, CITY OF TIGARD ' 0 - COMMUNITY DEVELOPMENT Permit #: PLM2010 -00087
r ,, Date Issued: 03/25/2010
T t G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S 110DB00500
Jurisdiction: Tigard
Site address: 15336 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Sonic Drive -In Restaurant
Project Description: Interior plumbing for new drive -in restaurant. Less than 2" water service.
Owner: FEES
MWF TIGARD LLC Quantity Description Date Amount
2123 NW ALOCLEK DR #1203
HILLSBORO, OR 97124 1 ea Backflow Preventer 03/25/2010 $31.27
PHONE: 503-617-0175 1 ea Expansion Tank 03/25/2010 $12.51
15 ea Floor Drain/Floor Sink/Hub 03/25/2010 $375.30
3 ea Hose Bib 03/25/2010 $75.06
Contractor: 1 ea Ice Maker 03/25/2010 $12.51
AL'S PLUMBING 2 ea Primer 03/25/2010 $25.02
5655 CROSSLER CT. S. 1 ea Roof Drain (Commercial) 03/25/2010 $12.51
SALEM, OR 97306 3 ea Sink 03/25/2010 $75.06
PHONE: 503 - 375 -3449 5 ea Lavatories 03/25/2010 $125.10
FAX: 503-375-3444 1 ea Urinal 03/25/2010 $25.02
2 ea Water Closet 03/25/2010 $50.04
1 12% State Surcharge - 03/25/2010 $102.83
Plumbing
Type of Use: COM 1 ea Water Heater 03/25/2010 $37.52
Class of Work: NEW Type of Const:
Occupancy Grp:
Stories:
Total $959.75
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: J / Permittee Si gnature'
•1_ /j ti
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mar 23 10 10:32a Chip 503 - 375 -3444 p.1
Plumbing Permit ADo ' ' IVED ,(�(,(%a2oto- o00/9 u
:
1d$it< i d 1 t .�, 1 l I; : 1.i( , �1. ( l'�11 n -} ' ,' 4
i1
6 (3 �r { Received ` Op I permit `to.: 1 AO /0 ` �o a
. : :g,, ;; City of Tigard MAR 2 3 C u Receive, a 4 !0 . 7
e t 3125 SW Hall Blvd., Tigard, OR 97223 plan Review www.ti Interne gard _
Other Permit No,: �OlD
Ka,' Photr. 503.679.4171 F�lq•�q� rilitARD Dstdey: N I ��
O mriz t o 9 eeP a g e Z 6tr
,.t:a.�x Itupcction Line: 503,639 199 t VIS ION DecRczrQr/BY 3' e f t QO I
0„4,' , 16 ,,,4
t t: o f _ i DI Notified / Method, l [ ( 9 kmrnal 4formrttoa
r. J• "?:•r "7S:;Iya?r'�,• : , a , •.� 1 +� AL• `^' 1 +' r . t, rT
J' r . T I it+ • ` dh 7 1F -1 r y e .F J 7S ?' Y ' : Y + •� .: tuc1 }- 4k ' h � -*: r , r.._ . .,141, •t ..,� . .:
V i,Jx,, -, ti" s;.: . . a .cr.
Demotiiion Fors c d is ormarlon me tbeekllR
P. ew construction ❑ Description Qty. Ea Total
C Addition/alieratlon/replacement f ❑ dther. • New 1- Z- Qtmily dwellings (includes 100 R. for each utility connection)
n' �' ?t,r ; ,r� ' :x SFR (I.) bath 312,70 I
~ P fy '" °: M� rn • n �:n) 'r>•'1 tY G,.; t•o. r 7 ' ', f,�. t4 t 1 :J�:'t.
�`.n•s�a� fwh �;:5•t +�. ;ti.: wa• sa - • f�.�•n..k.�'...�. ..rc SFR(2)hath 437.78
❑ 1- and 2- family dwelling NrEommercial /industrial 500.32
SFR 0) bath
�1 ❑ /�ceedcory building ❑ Multi-family ^ E a c h additional bath/kitchen 25.02
1 ❑ Master builder ❑ Other: Fire sprinkler ( sq. R) Page 2
r ., l•�'1 :site utilities:
■ d ' u . C , , � NfiiY „: ,o.i•- i: "1 ` ,•1 v 1: r n 1 r ^ ,!'r �, « y r Via!,•
7 •
' ' K <, " ° �` '' C � \ ' ^Y Catch basin or area drain 18.76
,„ Site address: 153 3 ( S.Luz . ? tact c-iC- �-\`-"-. 7 prywcll, teach Ilne, or trench drain 18.76 •
Cily /5tate/l11?, ; ( pvCa O , (. Cy 7 2.23 Footing drain (no. linear R.: __) Page 2
Suite/bldgfapt. no.: Project name: 5 Gam, L Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 13.76
Rain drain connector 18.76
' Sanitary sewer (no. linear ft : Page 2
Sturm sewer (no. linear R.: _ 1 Page 2
Water service (no. linear ft'.: _) Page 2
Subdivision: Lot no.: Fixture or Item:
iY� , i O CO Backflow pravenler 1 - 3L27 31 • 21 �`„ Tax / rued no.: ♦ •
�P P � 1 �, �'.- �� d , : ,. 1 Backwater valve 12.51
^ • h . ,`'fF �f n ._ � *t• t e i'' . ; : A:.. 7 ,, ...,, , , I .,-,. ; ,:: : ,,.,,,::,... .J
V ' !s;;.V - f.... AF . +.'t?i« , , - .>+.,� {� ;: ',' " s^: � :- ...f'•� Y "'* 25.02
F�L :•� �. ty. 'y Clothas wailer
a- Cr 2_ T PL,),.. , -. - I5 ,3 . Dishwasher 25.02
V.1
l I 3ATf n - ' t i 2 t ) t. < a II Drinking fountain 25,02
1.4)A 1e Electors/sump 25,02
,; "w � fw r 12.51 f;. 51
5 t �C'-.�,f �ar , . � : -r "tlry ...• '•,'r`;,'' : ,. Expansion lank ( .
,
.4�1�', .. , , r.tr�k .>r;., �.'..a i•':''r.• 25.02
' •• FixtulteJSewercap
Name: Floor drainifloor sink/hub / i 5 25.02 37613a
so Address:
1 Garbage disposal 25.02
City /State/ZIP: _ - 3 _ 25.02 .. 75.04,
Phone; ( ) Fax: ( ) lee maker ► 1151 /A.6?
n c m Na 4 r" iKf'. ip Intarccptnr /greoselnlp 25.02
,.J' Medical gas (value: S ` )
Business name: page 2
Primer Z
• 1.2.51 q 4 9.
Contact name; Roof drain (commercial) 12.51 / i d a , 5/
Address: Sink/basin/lavatory i S 25.02 aetb•
City /State /Z1P: Solar unit (potable water) 62.54
Phone: ( ) 1 Fax: : ( ) Tublshower /shnwar pan 12.71
Urinal . 25.02 ,25,07
E -mail: J L� .o
.. * s, >�; ':; water closet i 25. .
erg.: ;i ce �i it,, l an y ;"0 ;t'a4 . 'ri... i; 1' r . ,
c:d:5%: i Ax 4 .'; : * k Jr'�t.; ?r i ': r ,� t:,e �•,.a' Water heater t 37.52 - 3 7• it
Business name: Ns. y 4 in -crA, i.--16. r awe- • water piping/DW V 1 56.29
4 - Address: S1 S C 12 c '5%.- +```Q- c . <'.. . Other i 25
cicy/slaterZlP: „,+ G�
--i 73GL. Subtotal
-- Mir imam milli: too: $72,50 a .
Phone: ( 5) '573% - Colt t F ax; (�S5) 3 - 1 i - 3 a
Plan review (25%of permit foe)
. 1•• CCD Lic.: • - ■ c6, a -" ' if Plumbing Lic. no.: 21 • • 21 1'3 3 z________ 7/r // I State surcharge(12 %of permit Fee) /0, .8 ii
Authorized signature: TOTAL PERMIT FEE e? . T - • - ) v t t t 1 This permit application expires I a pennk is not obtntnos .itbin IRO dnyrr
Print name: -� x t.77 C v..e L.:Q Dat 3 - 2. 1,, I lntril has ban accepted of enmptelc
'Foe metbodolagy 9ci by Tri-Cooney Bnitding Intlterry 50v+ee I3.ntd.
tVl Utdfnglrertnitai tvtu- nenmininp,dea tem'rao 4dea416TtlOfeZ!COMfwb87
Mar 23 10 10:32a Chip 503 - 375 -3444 p.2
plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Residential Fire Sur •cession Systems:
Fee Schedule: ;�1 rt4 1 , ,.,.� , -......1...4.-4.,-%-.1.41.wvv,.., � - ', -,
r. \IU - ',1 IJ: ;. '1r.1rt t '�j'�Mw Wi �+:: :.� _M
' " �•''�"� 5121.90
t _ + .:. X11 r r fr> "rdd 1:,�..,.. 0 to 2.0
Footing drain - I" 100' 50,03 _2,001 to 3,600 - 5169.69
Footing drain • each additional 100' 37.52 3.601 to 7,200 5233.20
Sewer -1st 100' 62.54 7201 and greater 5327.54
Sewer -each additional 100' 37.52
ice -1st 300' 62.54 Medical Gas Systems:
Water 5ery � ., .., _ ��y�,� -��: r:a . �''; -.
Water Service - each additional 100' 37.52 Nina} i �• 1° .:" ; 4, y '' ;.J�;. d'afr -�e.R ? v: i,+a;'•: •'
storm & Rein Dram • lit 100' 62.54 51.00 to 55.000.00 Minimum fee 572.50
Storm & Rain Drain - each additional 100' r 37,52 55.001.00 to 510.00 572.50 for the first 55.000.00 and SI.52 fbr
�,�Q� and each additional SI00.00 or fraction thereof, to
r'.K% t9C4 i ! "tea -.nciuding510.000.00.
r Z p .'!. n ' in` p1 I E i �
or f � : r Y T .
2rspection of existing plumbing or for 610.001.00 to S25.000.00 5148.50 tribe first 510,000.00 and $1.54 for
which no fee is specifically indicated 90.00/ hr each additional 1100.00 or friction thereof. to
and including S25.000.00.
minimum charge- I!2 how) 00 �•r 525.001.00 to 550,000.00 S379.50 for the first $25.000.00 and 51.45 for
hours Inspections
min imuu m m charytc - ( c rgc -gal Z hours) business each additional 5100.00 or fraction thereof, to
Roars (min and including S50,000.00, Reirapectittn Fees 90.00/hr
550.001,00 and up 5742.00 far the first 550.000.00 and 51.2C for Additional plan review for revisions 90.00/hr each additional 5100.00 or fraction thereof.
minimumchar_e- 1121tour
Subtotal:
Commercial Fixture Work: ,,� �.. �� ., ;'
nlm c tr " t w i 0,..,.1.: rl '` i Il:: ..- ':
Arc you capping, adding or replacing .fixtures? 0 'ycs . � :} - ' : ;i -:;+ . �x:...s - ,.zn
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees * . Please cheek all that apply.
. ' • Flxtati ?►V.ar �Perlbrinett. ❑ Any new commercial building with water service 2" and
'' ;' 1 ' ; e , greater, except systems designed and Stamped by licensed
3fl�i(%,yLft: .: ti _ •
.r r,. a; _ •: � : ' .� �� °:.Erc9ieus �.'•'rceoi3ae...� :Adbea' � 1Eslsetats engineer.
Baptistry/Font . ❑ New exterior plumbing site utilities for any complex structure
Bath -Tub/5'1°w= as defined in OAR91 g- 780.0040.
recuazilWhiripool 1 0 Medical gas and vacuum systems for health care facilities.
- Car wash -Each Stall ❑ Any multipurpose fire sptinkler syste rn.
Drive Iltry - ❑ Any complex structure 0S defined in OAR918 -7110 -0040.
Cuspidor/WaterAspirator ,
a ahwxsher -Commercial Submit a sets of plans with any of the above.
- Domestic -
prfnkin�Founttin " .' t
1
Eye Wash : .:`ff,= 1 a9v � �+�+ riser diagram is required for new
Floor Drain/sink 2' Isome os buildzltgs
- 3- that meet the qualifications above.
4"
Car Wash Drain - .
Clarbege - Dnnmertie
Oisposol -Commercial ualnl ; , Comments regarding fixture work:
- Industrial •
Ice Mach./Refrig. Drain 1
Oil Separator (Gas Station) I .
Rec. Vehicle Dunip Station
Shower Gang
Stall _
Sink - Bar/Lavatory _ 5
- Bradley '
- Commercial '2-*# "Note: if tie fixture work under this permit results in an
-Service 1 increase of sewer EDU., a sewer permit will be issued and
Swimming pool Filter
washer - Clothes
7 tees assessed for the sewer increase must be paid before the
plumbing permit can he issued.
Water Ext►aetor Z
Wa cr Closet - Toilet
i 2 . Urinal •
Ocher Fixtures: _ .P 1
1:\ Building \Permits1PLMF- PcrrrtitApp.doe 2