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Permit 6 CITY OF TIGARD PLUMBING PERMIT ~ 9 :- COMMUNITY DEVELOPMENT Permit #: PLM2011 -00200 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/14/2011 Ft Parcel: 2S110DB01700 Jurisdiction: Site address: 15290 SW PACIFIC HWY Project: Black Rock Coffee Shop Subdivision: 1996 -010 PARTITION PLAT Lot: 2 Project Description: Site utilities for new coffee drive -thru. Contractor: DELTA PLUMBING INC Owner: JESS WETSEL 12205 SE 108TH AVE 10110 SW NIMBUS AVENUS SUITE B -9 HAPPY VALLEY, OR 97086 PORTLAND, OR 97223 PHONE: 503 - 698 -7342 PHONE: FAX: FEES Quantity Description Date Amount 2 ea Catch Basin or Area Drain 07/14/2011 $37.52 Specifics: 1 ea Drywell, Leach Line or Trench 07/14/2011 $18.76 Drain Type of Use: COM 1 ea Rain Drain Connector 07/14/2011 $18.76 Class of Work: NEW 110 If Sewer Service 07/14/2011 $100.06 Type of Const: 160 If Storm and Rain Drain 07/14/2011 $100.06 Occupancy Grp: 80 If Water Service 07/14/2011 $62.54 Stories: 1 ea Backflow Preventer 07/14/2011 $31.27 1 ea Backwater Valve 07/14/2011 $12.51 1 12% State Surcharge - 07/14/2011 $45.78 Plumbing Total $427.26 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /I Issued By: 4i� .� __ Permittee Signature: �' ll�� Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. N Plumbing Permit Application Site Utilities RECEIVED FOR OFFICE USE ONLY City of Tigard DateB ( Q A6 // # ��/aa/ ,, Permit _.,/y1 p yti 13125 SW Hall Blvd., Tigard, OR 97223 JUN 2.8 y' �►f(( rte[ � -c / i 2011 Plan Review Phon 503.718.2439 Fax: 503.598.1960 Other Permit No. :o��4 4/` ?9 I D a t e / By: Inspection Line: 503.639.4175 CITY OF TIGAR.D TIGARD Ready /By: Date Read B • 94 q 4 l ® g S e e Page 2 for Internet: www.tigard- or.gov N / Supplemental Information TYPE OF WORK BUILDING DIVISION - 7 - 11.5 77 FEE* SCHEDULE arNew construction ❑ Demolition For special information use checklist Description I Qty. I Ea. Total ❑ Addition/alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection; CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 ❑ 1 and 2- family dwelling ❑ 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 • JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: /5 2 TD S 4/ eat/ C !�i lj not Catch basin or area drain 18.76 3752 City /Slate /ZIP: T i9U rl/f ® � / 2 2 L/ Drywell, leach line, or trench drain I 18.76 /F 7( / Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt.no.: I Project name: 61 4c R CCIcr:-,6, Manufactured home utilities 50.03 Cross street/directions to job site: 5 v pa C i i G F /igh W g i j R 7 Manholes 18.76 S V /{/ 61 e U e f p t Rain drain connector t 18.76 / y..76- Sanitary sewer (no. linear ft.: _) l /0 Page 2 j00 Storm sewer (no. linear ft.: ) Af O Page 2 (00,06' Water service (no. linear ft.: ) S0 Page 2 C2. s Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: 2 MO 0 D ON 017.00 Backflow preventer I 31.27 DESCRIPT OF WORK Backwater valve 12.51 W "� Clothes washer 25.02 S i h. 1 pi i (lb l ngl I pi? a6 r/ ra e'G{ / Dishwasher 25.02 dr v1° /-A, 14 Co 'ee /7Ui/d69 Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER , I 0 TENANT Expansion tank 12.51 Fixture /sewer cap 25.02 ' Name: r^ r p ai„,‘ ` C Floor drain/floor sink/hub 25.02 Address: MHO 51.J f i,i biu Xve f o /c l3- f Garbage disposal 25.02 City /State /ZIP: /90rI/an/ , 0 1C n 117 97 3 Hose bib 25.02 t Phone: (593 ) 7 L y 7 _ 0) f t Fax: ( ) Ice maker 12.51 0. APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 iness name: /3 /ar k JZOC Co 4 Z"r �3C!/ Medical gas (value: $ ) Page 2 Primer 12.51 12.51 Contact name: -3-ii fin L t' f Ci" f Roof drain (commercial) Address: 7g2�f S� ��YlJO C i Sink/basin / lavatory 25.02 City /State /ZIP: 7- 0 g 722 L/ Solar units (potable water) 62.54 Phone: (S 3 w p O i % O Fax: : ( ), E-mail: ub /shower /shower pan 12.51 l lo t, _ /d / Urinal 25,02 us , lrstitor h f rhal Camel - Water closet 25.02 , cia, %, , CONTRACTORS '" ` i .. , I G Water heater 37.52 Business name: 06Z U L V i 7 l Water piping/DWV 56.29 Q Address: 1 5- S t- 2 7 Q6' Other: 25.02 City /State /ZIP: � /o. I/i t(./ (_9/ Subtotal 337, Phone: rJV Tea? ( 3 ) q e O ©/ Minimum permit fee: $72.50 � �L7 / Fax: ( ) S52_ Plan review (25% of permit fee) CCB Lic.: � Plumbing Lie. no.: i l State surcharge (12% of permit fee) Authorized signature: �!9i7, Q ' _ TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: � -y� / Date: - *Fee methodology set by Tri- County Building Industry Service Board. 1 CA 1'4 1 a /3 // 6 NS, 440- 4616TO 0 /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1'100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 ' 2,001 to.3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 - Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Other I nspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to 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 ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Quantity by Fixture Type Plan Review, for,Plumbing Installations Eixture`Type for Replace/ an Plan review is required for of the following. Work Performed: Capped Added Relocate Q any g• Baptistry/Font Please check all that apply. Bath Tub /Shower ❑ Any new commercial building with water service 2" and Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor /Water Aspirator as defined in OAR918- 780 -0040. Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities. - Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040. Eye Wash Floor Drain/sink - 2" Submit 2 sets of plans with any of the above. -3" Isometric or Riser ram Car Wash Drain g Garbage - Domestic- non -food ❑ Isometric or riser diagram is required for new buildings Disposal - Domestic -food related that meet the qualifications above. - Commercial -food related - Industrial -food related Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink/Lav - Non -food related - Bradley - Commercial- food related - Service Swimming Pool Filter Washer - Clothes - *Note: If the fixture work under this permit results in an Water Extractor increase of sewer EDUs, a sewer permit will be issued and Water Closet- Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: I :\Building\Permits\PLMU- PermitApp.doc 2 r V D Ui 0 Rand Wash Sink u. M/N: DI -1.10 d ADVANCE TABCO w k II 1) 1 D tJ , la fink .. to 1 Floor Sink ., c 1 �— B ; _ g I M /N: PF906K 71, '1 r' I I l -i o I li PRQFLO .'L_J _ - ___A__, '' E Blender Triple Sink € i I o a a i & ( CAt.w�� 7 144 2 ice chin , Floor Sink A • ,____ M/N: PF906K Espresso Grinder ` , _'.,V i PROFLO u�-- LAD/ ��� zt /N: SWIFT tt ; 7 Kno„ k Box MANATowoc 1 4 _ _ 1' i a 1 .1____� LA MARZOCCO 1 64.1.1 z s Water Heater o ' __J _._.°2.1____J ° I i 3I Smoothie Machine 01 PROFLO M /N: 5311 IP' (ELEVATED 9 1 1 , 41,6_____ s 1Espresso Machine CRATHCO ABOVE �O'' FLOOR) i 1 , ,il M /N: LINEA u! S I �1 i �' 1 LA MARZOCCO .t', I ; 'd1' — IEMMIIIIIMIIIS•IIIMINIMIIMII�'�II�I 'e1 ,' - r — Under Counter Reterigerater - - -, 1 ' r- ,.. - 1 = I M /N: TUC48 • m 1 L - - -- - TRUE N j I I 1 Y Mop' �Kno Box ; M /N:6 f � 1 - 2 1 ' NSF Walk In Cooler DURA -�`D F I Floor Sink _ _Water Closet � _ 1 `• M /N: PF906K ,.,.,, Lavatory Sink 0 _ Blender I PROFL M /N: PF5404 = I r.:-.1 ���� „r/ A PPROVED) I a u_ , LL.„__, mu1 = nnMINI � I nl __l_I_,_I_I_I_I I_IE'I_IC_J_I_I_ I I_( _ I II Lu Z W w = I- 0 O w CC u. J J C i CC J u? 5 ,E DTBVnm Scala LAYOUT, — ,- — ,9 ;OQA , . 3/8" = 1' ' DWG type C119,9901 AEt RUNG 4 REVISILI w SEED TO CUP COFFEE SOLUTIONS O9 - J 1 ' 7 14' X 33 PREFABRICATED BUILDING . PLOT DATE: gggggg 00A 04 -09 -11 EDK - PRELIMINARY COPY Apr 00,2D11 EQUIPMENT PLAN - MED OR N WAY REV DATE BY APPROVAL REVISION NOTES a.YMV' A THIS DOCUMEN CON CONFlDENTLTL OR PV000IETARV 4NFORMATK)N Oi CLASSIC TROLLEY. NEITHER T HE DOCUMENT NOR IHE INFOR THEREIN 1 -80u -48 -3934 STORE REPRODUCED. OISTMBUTED, USED OR DISCL EITHER IN WHOLEOR IN PART. EXCEPT AS SPECIFICALLY AUTHORQED BY CLASSIC TROLLEv . wwwstccOR ee.com A CAD DRAWING. NOT TO BE MODIFIED MANUALLY, i J •