Permit CITY OF TIGARD ,
PLUMBING PERMIT
^,i re l ii DEVELOPMENT SERVICES DATE ISSUED: 07/30/97 7 -016`
PARCEL: 1S136DB -02600
SITE ADDRESS...: 11201 SW 72ND AVE
SUBDIVISION • ZONING: C —G
BLOCK • LOT .............: JURISDICTION: TIG
CLASS OF WORK..:NEW GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE °COM WASHING MACH 1 BACKFLOW PREVNTRS..: 2
OCCUPANCY GRP..:A3 FLOOR DRAINS......: 14 TRAPS..... ........ .: 0
STORIES • 0 WATER HEATERS • 1 CATCH BASINS • 6
FIXTURES LAUNDRY TRAYS.....: 0 SF RAIN DRAINS.....: 0
SINKS • 2 URINALS • 1 GREASE TRAPS • 1
LAVATORIES • 2 OTHER FIXTURES.°..: 5
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 200
WATER CLOSETS.. : 3 WATER LINE (ft)...: 300
DISHWASHERS • 1 RAIN DRAIN (ft)...: 500
Remarks: A quick serve restaurant with a drive— through service lane.
Owner: FEES
MCDONALDS CORPORATION type amount by date recpt
5000 SW MEADOWS ROAD, SUITE 230 PRMT $ 623.00 B 07/30/97 97- 297740
LAKE OSWEGO OR 07035 PLCK $ 155.75 B 07/30/97 97- 297740
SPCT $ 31.15 B 07/30/97 97- 297740
Phone #:
Contract or
ASSOCIATED PLUMBING CO
P 0 BOX 301362
PORTLAND OR 97230 -- — Phone #: 331 -0582 $ 809.90 TOTAL
Reg #..: 000578
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Sewer Inspect i o n
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Line Insp
applicable laws. All work will be done in accordance with Water Service In
approved plans. This permit will expire if work is not started P L M /Underfloor^
within 180 days of issuance, or if work is suspended for more Top—out Insp
than 180 days. ATTENTION: Oregon law requires you to follow rules Storm Drain Ins p
adopted by the Oregon Utility Notification Center. Those rules are Rain Drain Ins p
set forth in OAR 952- 0001 -0010 through OAR 952- 0'A1 -0080. You may Final Inspect ion
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By: `� Permittee Signature: L.ea 64
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
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;LTY OF TIGARD Plumbing Application Recd By J s'" 0
3125 SW HALL BLVD. Commercial and Residential Date Rec'd S rt -9
'!GARB, OR 97223 oats to P.E. - -'
Date to DST -.SRN
503) 639 -4171 Permit* ' _ L 1 ? / / L
Print or Type Related SWR s 7-(7( Lin
Incomplete or illegible applications will not be accepted called
Name of Development/Project . FIXIURE3 ;'3,45fit: V't) QT1 ' `FACE: Alai)
Job CDo�q{,{�S Sink V 2 9.00 1 S
Address ri p sues « Tub/Shower Comb. Z 9.00 18
I ltp ' Bldg • City /State ZIP Shower Only 9
Tit er * 7AV•3 Water Closet V 3 9.00 21
Name
AALCO►3 At.fp°' e, Dishwasher ✓ i 9.00 q
Owner Mailwq Address _ - Suite Garbage � 9.00
o gut Ewa l , ercim 2dC Washing Machine / I 9.00 9
City /State Zip Phone Floor Drawn r r/ G 9.00 g4-
Name
atylleGii0 /C512.. 4'1° _ C434--934 g• ✓ 5 9.00 4, 5
•
l 5 `` 4 ' 9.00
Occupant I'"a Adatess � Suite Water Heater '---- 3 q�
9.00
� ova...e.... Laundry Room Tray , 9.00
City /State Zip Phone Urinal d 1 9.00 ef
Name �-; , nQ / � i
' Other Factures (Specify) . 9.00 '
- 1 - 11 . 7 1 slum I t& f lu44 Ihl ,c.. _` " re / 2- 9.00 1P
Contractor Mailing Address Suite ., J 3 , ,..2) .._-- 3 9.00 el .
9.00
(Prior to issuance City/State Zip Phone
9.00
applicant must
provide all Oregon Exp. Date • 9.00
p regon Conet Cont. Board Lies
contractors 9.00
license Plumbing Lie * Exp. Date Sewer - 1st 100' . I 30.00 ¢61
information Sewer - each additional 100' .9. 25.00 1,0.
da or�b ) COT Business Tax or Metro al Exp. Date Water Service - 1st 100' 1 30.00 so /
Name Water Service - each additional 200' . . fo 25.00 re `e7
Architect -3of+lU Alt Ot pbpg Storm & Rain Dram - 1st 100' I • 30.00 'X)
Or Mailing Address Suite Stain & Rain Drain - each addition 100' 6. g 25.00 J 1 _...A
711 3beie Pablo »>cp1-4 0j Mobile Home Space 25.00
Engineer coy/state Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00
So
.csmosea0k. r TL (0621 63b - (23-31:13 Pollution Device 'L
Oesaibe work New X Addition 0 Alteration 0 Repair O Residential Baddlow Prevention Device' 15.00
:o pe done: Residential 0 Non - residential 0 Any Trap or Waste Not Connected to a Fixture 9.00
.+ceitional cesaiption of work Caton Basin b 9.00 64.
Quick- Insp. of Existing Plumbing 40.00
pert hr
,sting use of Specially Requested Inspections 40.00
ou,Wing or property Nike--0 per hr
Rain Drain. single family dwelling • 30.00
Proposed use of c Grease Traps 1 9.00
:u,iding or property
QUANTITY TOTAL •
•are you capping . moving or replacing any fixtures? Yes ❑ No
isometric orn diagram is bruise 1 Ouaniry To is > 9 �j 70 ;, . ::..
If yes see back of form) 'SUBTOTAL . i O
• I hereby acknowledge that I have read this application. that the information � CO'
liven is correct. that I am the owner or authorized agent of the owner. and 5% SURCHARGE •
mat plans submitted are in compliance with Oregon State Laws. • " 7j'I
Sag re t e Date PLAN REVIEW 25% OF SUBTOTAL 1 !
-
Rommel ow A fixture cry. total is 3. 9 / _
/ w�cl,� CV, 6 -61 - 7 TOTAL cgb - -,=4
et Person ktige Phone
I •Minimum permit fee is 525 • 5% surcharge. except Reside - ow
I Aa•�,j e,/)_ �$�4 - -�I Prevention Device. which is S15 • 5% surcharge
1
I: \plmapp.doc 12/96 (dst)
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'LEASE COMPLETE AS APPROPRIATE TO PROJECT:
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 "
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
:OMMENTS REGARDING ABOVE:
l:! plmapp.doc 12 :96 (dst)
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: A — v - / -7 A.M. P.M. MST:
Location: .....0 ...,,, , _ M�Li-4 : d 0 BUP:
Tenant: / Suite: Bldg: MEC:
Contractor: Phone: 33 / - 05 (9-- PLM: 9' 7-0/ 0 r —
Owner: Phone: ELC:
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL
Site Post/Beam I' osuBeam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing To Out Gas Line Rough -In UG Spriner
Foundation Insulation ew 3 kl
� Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC. tai
Masonry Ceiling Rain Drain A/C UG Slab iljAzetae
Shear /Sheath Fire Spklr /Alm � ved nd Dr Heat Pump Low Volt
Approved ppro Approved Approved
A r /Sdwlk Not Approved Not Approved Not Approved • of Approved
PP PP PPr PP PP
FINAL FINAL FINAL FINAL FINAL
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O Call for reinspection O Reinspection fee of $ Ao required before next inspection 0 Unable to inspect
Inspector: Q/ Date: (J ) Z /, " �_ Page
� � L of I