Permit CITY OF TIGARD PLUMBING PERMIT
a COMMUNITY DEVELOPMENT Permit #: PLM2010 -00090
Date Issued: 03/25/2010
T i G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
w•. Parcel: 2S110DB00500
Jurisdiction: Tigard
Site address: 15336 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Sonic Drive -In Restaurant
Project Description: Site utility work for new restaurant; sanitary and storm sewer. 04/16/2010: Add 200' water _
service.
Owner: FEES
MWF TIGARD LLC Quantity Description Date Amount
2123 NW ALOCLEK DR #1203
HILLSBORO, OR 97124 8 ea Catch Basin or Area Drain 03/25/2010 $150.08
4 ea Manholes 03/25/2010 $75.04
PHONE: 503-617-0175 1 ea Rain Drain Connector 03/25/2010 $18.76
100 If Sewer Service 03/25/2010 $62.54
Contractor: 635 If Storm and Rain Drain 03/25/2010 $287.66
LUNDEEN EXCAVATION 1NC. 1 12% State Surcharge - 03/25/2010 $71.29
17046 SE KELLY Plumbing
PORTLAND, OR 97236 200 If Water Service 04/16/2010 $100.06
PHONE: 503-761-0072 12 da 12% State Surcharge 04/16/2010 $12.01
FAX: 503- 761 -0113
Type of Use: COM
Class of Work: NEW Type of Const:
Occupancy Grp:
Stories:
Total $777.44
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 -0 etyma . btain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
' Permittee Signature:
s
Issued By: ` ��
Call 503.639.4175 by 7:00 a.m. for an inspection that busi ' . ss day.
This permit card shall be kept in a conspicuous place on the job site unt c • .. • n of the project.
Approved plans are required on the job site at the time of each inspection.
PLUMBING PERMIT
�('��V ��„r CITY OF PLUMBING
' q
` r 2 : ..'.,,- COMMUNITY DEVELOPMENT Permit #: PLM2010 -00090
∎ ,,T I CARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/25/2010
Parcel: 2S 110D600500
Jurisdiction: Tigard
Site address: 15336 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Sonic Drive -In Restaurant
Project Description: Site utility work for new restaurant; sanitary and storm sewer.
Owner: FEES
MWF TIGARD LLC Qua ntity Description Date Amount
2123 NW ALOCLEK DR #1203
HILLSBORO, OR 97124 8 ea Catch Basin or Area Drain 03/25/2010 $150.08
PHONE: 503 4 ea Manholes 03/25/2010 $75.04
1 ea Rain Drain Connector 03/25/2010 $18.76
100 If Sewer Service 03/25/2010 $62.54
Contractor: 635 If Storm and Rain Drain 03/25/2010 $287.66
LUNDEEN EXCAVATION INC. 1 12% State Surcharge - 03/25/2010 $71.29
17046 SE KELLY Plumbing
PORTLAND, OR 97236
PHONE: 503 - 761 -0072
FAX: 503 - 761 -0113
Type of Use: COM
Class of Work: NEW Type of Const:
Occupancy Grp:
Stories:
Total $665.37
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: �� Permittee Signature:
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.
CITY OF TIGARD TH1VA/1)- 606
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 .I!+r °`_I_
INSPECTION WORKSHEET FOR DATE: 4/7/ 1 t TIME: PAGE:
SITE ADDRESS: 1 33 (P CLASS OF WORK:
SUBDIVISION: c)(e;;AL-C....... ° LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: �.Poe�
OWNER: PHONE #: q 3 - b 4
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: ED I ng o Z _ a k Pour Time: 1,q(5--o
Code # Inspection Description Confir ele Contact #essag- ?) cl-6c.'
' 346 S
Corrections /Comments/ Instructions:
■
is I ��
. 1- 1 / /
;
d t
I
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL ❑ A LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: iv Phone #: (503) 718 -2
Plumbing Permit ApplicationRECEIVED
OIt 0 1 I(1 - 1Itil O I 1
,,,�• -,.. �; ; :_
IN f City of Tigard D us SAS /0 r Permit No. : wyad/O '000 0
9 u 1 3125 SW Hall Blvd., Tigard, OR 9724,, ,. ®F TIGA D Plan Review
Phone: 503.639.4171 Fax: 503.598. ' Date/By: Other Permit No. B ' /� 4 J 2 / 6
inspection Line: 503.639.4175 B UILDING D[V[ )IC�iN
4 - 1 , .
[ 11.‘','''',t R ' : Date R eady l e y ; J!uia: !a See Page 2 for
Internet: www.tigard- or.gov NotifedMeihod:
i/ Supental nfora
t mdo n
; +� y�lnit u i! clt n.7�{ - y },._ tiri� 7 ] g4(t J 3 2. t 4 3(.. 406A, otif i / x+ 14 tr rft° y h r s7 ix a t S J plemE ten n n 4 ' 4 1 1 � , •
# idit i Y tiM 'rI • .20.1V��O' �� Via: l S i .. M ' r 1 -h '! {{! . '-,, � . ..�.. J J ` 188I1 k I . , t i : 4 1 J� 3 i f ,i 11 . 1. •.
t S t tr dK.. • t IJ, 1 ' ' . LP!'"*";" t 1. _� • . i' ! ! .i S ._ '�*:':ff .t t .4? i� jj { idi '43
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►i New construction ❑ Demolition For s, eclat t ormallou use checklist
Description Qty. Ea. Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2 -famil dwellings (includes 100 ft. for each utility connection)
' ,, .... %r6''j d
.,: y • . .
'cr. ,y6 ti k r o r o % A .. o -, 1 '4,. gg 4rd, , i , . A tt'.,. �•.� .. x • kc a ea r.a.,} } a,,.✓ S��`,I r �} 1 SFR (l) bath 312.70
,S
❑ I- and 2- family dwelling N Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi- family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
1 " ;r >l r r ( 0 X+, Ii�yg B A (�1 d ry ✓t t or qtr }�;� ,�
v )} !l'€• : , +(? � 17 , ,I• at �
1 t* Ok ,a ` ' 14.1, ,� t ! {p l. ; . Site utilities:
Job site address: ( 5 35 (' S w , pat. ,t Lc_. 1-11.0 1` Catch basin or area drain ��� 18.76 /$0 , 0,
1 Drywall, leach line, or trench drain 18.76
City /State/ZIP: Ti 4\6.44 , b 12 Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: 5, Jul C. 'PEA Uf....- �1
� Manufactured home utilities 50.03
Cross street/directions to job site: Manholes Li 18.76 1 7S,' p y
s` Yv e.k ay Rain drain connector i I 18.76 / 76
Sanitary sewer (Ito. linear fl. :/)C Page 2 to a , Sy
Storm sewer (no. linear ft.: (23.5 Page 2 a P f (o •.
Water service (no. linear ft.: ____) Page 2
Subdivision: I Lot no.: _ Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
A� ? �. ‘ , X1 • r • - t t 4t k /j 01 �. r
. (r �y5�c > ! I . * 1 r „ ?:,; Backwater valve 12.51
',.. ( u
A'4' "ar�•�' 1:
-' i �a. .4�. ,,,, l ®) Fe{1 .,L ` ;,... ci°•J`,", .
'.41))1 .s )k
t �' a Y (� 1i +0.% `•`' 4 Clothes washer 25.02
' 11 r r � ( T/L 1 Ty W CJ2,� P AT& Dishwasher 25.02
/ KS %71 GC'V Drinking fountain 25.02
Ejectors/sump 25.02
t •' r•'• 1't T" r is aY
,�rt , {`(}{��{ ( ? �t h� & +F A ae 12.51
r�i ltii' }it ndtt ?!.?"t�s _ . �','•-oues4; . �`�, MEI • `i� +, 11�'�'k �s 'rl ( t o. +1.'i6
Expansion tank
p
Name: 114E tic <A• Fixture /sewer cap 25.02
Address: 21 2 r$, L..3 , . A ( '.L_Ex ke, 5 , 112,z) Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City /State/ZIP: .0 iii.jtriej5 E),e , 9 71 2, Li. Hose bib 25.02
Phone: (5 3) (p ( 1 e) 1 Fax: ( ) Ice maker 12.51
k,:1 arka n �`' a t6A4 ``fy " ' ' IS 404. `s Interceptor /grease trap 25.02
Business name:
e� '' Medical gas (value: $ ) Page 2
Primer 12.51
Contact name:
E- Roof drain (commercial) 12.51
Address: Sink/basin/lavatory avatory 25.02
City /State/Z1P: Solar units (potable water) 62.54
Phone: ( ) I Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: 3) 7 Urinal 25.02
FNS, Y(a k , r t' y + t�! f ^j}'+ 1�, C y i } 1 j
„ T 1: r ; { � T � r � S t i ;{„t y L�� y ��' , Water closet 25.02
.,., i� <; 0 .1,, (( ff'jj���� s �lifiP tt i i C �1f j� ( t �� �{_) ,�` , i, y � � t ,� , �+ v ; .� it . t .
r i o t'tl .,;:irI S'tf.`�di� o.',-0 �;�, i k , :fIfA u •' ,, „ir,. PF at`Nc' i,, P ry q h.,..,, -;at it ,iig.,,, N: Water heater 37.52
Business name: L�vt LJ �.ez �e l t-lJ kJ -L oz. . Water piping/DWV 56.29
Address: I 7014 6 , KILL / , Other: 25.02
City /State/ZIP: 7 f O Z 2a g Co Subtotal
Phone: ( ) ,{ 3 7 r7772 Fax: ( 3 7t / 01 1 3 Minimum permit fee: $72.50 � a
1 (,F S " CCB Lie.: Si- / 0 ',49/p Plumbing Lic. no.: F8 mg Plan review (25% of permit fee)
l° State surcharge (12% of permit tee) ?/, �
Authorized signature -r,�(,� TOTAL PERMIT FEE 6S 2
I Print name: ER_ (L L (du L FL I Date: 3 -Z </- / This permit application expires it a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri- County Building industry Service Board.
1:\ BuildingTennitsWPLMU- PamiIApp.doe 10/01/9 440- 4616T(IO/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential
t Residential Fire Su • • r #' S stems: Q�
L La d '=t 6 . . ri �i ` �� i e: • j M. ' 7i t 5 . i r, rt `i�; • � Jul r k do . ,� r PJ _ ` `� S�
Footing drain - 50.03 0 to 2,000 $121.90
Footin • • - in - each additional 100' 37.52 2,001 to 3,600 $169.6
62.54 3,601 to 7,200 5233.20
Sewer - 1st 100'
S� (p,�, 7,201 and greater $327.54
Sewer - each additional 100` ' 37.52
Water Service - 1st 100' 62.54 Medical Gas S stems:
Water Service - each additional 100' 37.52 d • r yl l 1 ` , r s
in Drain 1st 100' / p p 62.54 6� , S , `" ' u ' s� �"' ft, ,
Storm &Ra
y $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 53 �' 37.52 a� s, /� $5,001.00 to $10,000 $72.50 for the first $5,000.00 and $1.52 for
O v i � ' ,
. amm %gik l , o };i c t e 1 , each additional $100.00 or fraction thereof, to
:dR l f . '. 7 and including $10,000.00.
Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to
(minimum charge - 1/2 hour) and including $25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
hours (minimum charge -2 hours) each additional $100.00 or fraction thereof, to
Reinspection Fees 90.00/hr and including $50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum charge -1/2 hour) each additional $100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes", kV i; !;�`, , , •.v g ;' ; I t . f ' , L ; `t >�;
please indicate work performed by fixture. Failure to �
P p Y Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
❑ Any new commercial building with water service 2" and
yl, ievlbu6` ` C�4pped %;, . Qded � i �,Firtis(inaf' greater, except systems designed and stamped by licensed
Baptistry/Font T engineer.
Tub/Shower ❑ New exterior plumbing site utilities for any complex structure
Bath Font
--Jacuzzi/Whirlpool Tub /S ow as defined in OAR918- 780 -0040.
Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities.
- Drive Thrtt ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR9I 8- 780 -0040.
Dishwasher - Commercial
- Domestic Submit / sets of plans with any of the above.
Drinking Fountain
t � J j tyr�:,*Z�, � � : J i Cl" e�n�� t�A � ♦, i "! e y ` �,� . ry ✓,, ��',�4 f . � �'fi }
Eye Wash 1 i ' ;' e?'�i V V , t :, ;i x` .. s' r
Floor Drain /sink - 2" Isometric or riser diagram is required for new buildings
3.. that meet the qualifications above.
-4"
Car Wash Drain
Garbage - Domestic
Disposal - Commercial
Industrial Comments regarding fixture work:
Ice MachfRefrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar /Lavatory
- Bradley
- Commercial *Note: If the fixture work under this permit results in an
- Service increase of sewer EDUs, a sewer permit will be issued and
Swimming Pool Filter fees assessed for the sewer increase must be paid before the
Washer - Clothes
Water Extractor plumbing permit can be issued.
Water Closet - Toilet
Urinal
Other Fixtures:
I:lBui IdinglPermits \PLMF- PermitApp.doc 2