Permit 1 a CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2006 -00514
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/9/2006
PARCEL: 2S 102AC -01101
SITE ADDRESS: 12562 SW MAIN ST ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: TI - change of use from retail to eating and drinking establishment. Other fixtures: (1) expansion
tank, (2) hose bibs, (2) ice makers and (4) primers.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 3
OCCUPANCY GRP: A3 FLOOR DRAINS; 14 TRAPS:
STORIES: 1 WATER HEATERS: 2 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 6 URINALS: 2 GREASE TRAPS: 1
LAVATORIES: 4 OTHER FIXTURES: 9
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 4 WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
BANKERS INVESTMENT Description Date Amount
16325 SW BOONES FERRY STE 200
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 11/9/2006 $952.60
[TAX] 8% State Surcha 11/9/2006 $76.21
Phone : 503- 636 -0388 Total $1,028.81
Contractor:
CASCADE MECHANICAL SYSTEMS INC
PO BOX 399
ESTACADA, OR 97023 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 630 -4492
FAX 503- 630 -5510
Reg #: LIC 127012
PLM 3 -324PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ,6G.t,Ltc.4...- Permittee Signatur / r`1
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 Application Yi)-(-1,. 0,06 -( 00ing
Building Fixtures RECEIVE
City of Tigard 5 2006 Received /o 0 25/ - .,,e_ PermitNo.: L� �p } '4/
• O CT 2 Y (o
III v 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Pe A 4
• Phone: 503.639.4171 Fax: 503.598.1960 /J/� Permit No .-
i Line: 503
Inspection ne: .639.4175 CITY OF TIGAR D a t e /B y.
T 1 c n li t� BUILD DIVISION Date ReadyiBy: r Supplemental See Page for
Internet: www.tigard- or.gov Notified/Method Supplemental informat
TYPE OF WORK FEE *HEDULE
❑ New construction ❑ Demolition For special information use checklist
. Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 249.20
❑ 1- and 2- famtiy dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building El Multi-family SFR (3) bath 399.00
1:1 Master budder Each additional bath/kitchen 45.00
❑ O ther: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: ( J 4 . .S (,..4..i 4 ,:a..:4/1. s-4- _ Catch basin or area drain 16.60
City/State/ZIP: ! t a f Yom- c 7 3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: ' " Project name: Fa_ Cr K 6» Footing drain (no. linear ft.: Page 2
wvt.
elAb o �2
Manufactured home utilities ' 1 10.00
Cross street/directions to job site: Manholes J 16.60
Rain drain connector ( 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: _) Page 2
0/ 6 / on �t ' Q Fixture or item
( Tax map/parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Back flow preventer 3 Page 2 /37, '
'VC-40 py1/4,4, P ( Backwater valve 16.60
1F� Clothes washer 16.60
. Dishwasher / 16.60 /6.
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Expansion tank j 16.60 16 • (co
Address: Fixture/sewer cap & 16.60 97, 69
. . City /State/ZIP: Floor drain/floor sink/hub / 'Y 16.60 a ff,„7, Yd
Phone: ( ) I Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON
Hose bib 2 16.60 33 • 10
Ice maker 16.60 33 .aO
Business name: Interceptor /grease trap / 16.60 /(p. (00
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 1 16.60 lolv
City/State/ZIP: Roof drain (commercial) 16.60
Sink/basin/lavatory /Q 16.60 /64. ae
Phone: ( ) I Fax::( ) -
Tub /shower /shower pan 16.60
E-mail: Urinal 2. 16.60 1,0..90
CONTRACTOR Water closet 16.60 (p(p•4'
Business name: C "WA & 4 ( S y . 5 f.G..� Water heater ( 16.60 3.3 ,s,20
Address: pr9 ieX 9? Other:
City / State/ZIP: � Subtotal
�ff' Minimum permit fee: $72.50 9s�,k'
Phone: ( ) & 3p ^ �l�?�- Fax: ( ) 6 30 -S','(0 Residential backflow minimum permit fee: $36.25 • �t
CCB Lic.: a - hp 12 Plumbing Lic. no.: '3 -3yP Z Plan review (25% of permit fee)
c / State surcharge (8% of permit fee) 74'
fi
Authorized signature: e On TOTAL PERMIT FEE ( A
Print name: �i✓Ao•n C. 4 I Date: /ey„) 1 I This permit application expires if 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.
. . I:\ Building \Permita\PLMP- PmmitApp.doc 04/06/06 440-4616T(I0/02/COM/WEB)
PlumbinE 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' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40 -
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof to and
including $10,000.00.
. • Commercial Back Flow Prevention Device . 2 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof to
(minimum permit fee $36.25) 27.55 , and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
each additional $100.00 or fraction thereof to
Inspection of existing plumbing or
and including 00 ot e first $ .00.
specially requested inspections - per hour 72.50 $50,001.00 and up. $742.00 for the first $50,000.00 and $1.20 for
Subtotal:
each additional $100.00 or fraction thereof
Fixture Work: Plan Review for Plumbing Installations
Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees *. ye Any new commercial building with water service 2" and
Qaantit by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped Added Existing ❑ Any new exterior plumbing site utilities.
• • Baptistry/Font ❑ Medical gas and vacuum systems for health care facilities.
Bath - Tub /Shower ❑ Any multipurpose fire sprinkler system.
- Jacuzzi/Whirlpool ❑ Any complex structure as defined in OAR918 780 - 0040.
Car Wash -Each Stall
- Drive Thru Submit 2 sets of plans with any of the above.
Cuspidor/Water Aspirator
Dishwasher - Commercial
Isometric or Riser Diagram
- Domestic
❑ I sometric or riser diagram is required for new buildings
Drinking Fountain >',� �l s g
Eye Wash that meet the qualifications above.
Floor Drain /sink -2 " ,
-3" lit
-4"
Car Wash Drain Comments regarding fixture work:
• Garbage - Domestic
Disposal - Commercial
- Industrial '
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
• -Stall
• Sink - Bar/Lavatory t *Note: If the fixture work under this permit results in an
- Bradley increase of sewer EDUs, a sewer permit will be issued and
-Commercial ( fees assessed for the sewer increase must be paid before the
- Service plumbing permit can be issued.
Swimming Pool Filter
Washer - Clothes
• Water Extractor
Water Closet - Toilet A
Urinal
Other Fixtures:
is\ Building \Pamits\PLM- PennitApp.doc 0924/06
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: PLM200600514
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 _..
INSPECTION WORKSHEET FOR DATE: 5/1/2007 TIME: 7:00AM PAGE: 44
SITE ADDRESS: 12562 SW MAIN ST CLASS OF WORK: •
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MAX'S FANNO CREEK BREW PUB
DESCRIPTION: TI - change of use from retail to eating and drinking establishment. Other fixtures: (1) expansion
tank, (2) hose bibs, (2) ice makers and (4) primers.
OWNER: BANKERS INVESTMENT, PHONE #: 503 - 636-0388
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 503.630 -4492
Inspection Request Scheduled For: Date: 5/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 047397 -01 503-572-8246 N
Corrections/Comments/Instructions:
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[ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C7 Date: / / 16 ? Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006-00514
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1119/2006
Phone: (503) 639 -4171 Am° I
Inspection Requests (24 Hrs.): (503) 639- 4175
INSPECTION WORKSHEET FOR DATE: 4/19/2007 TIME: 7:01AM PAGE: 46 •
SITE ADDRESS: 12562 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MAX'S FANNO CREEK BREW PUB
DESCRIPTION: TI - change of use from retail to eating and drinking establishment. Other fixtures: (1) expansion
tank, (2) hose bibs, (2) ice makers and (4) primers.
OWNER: BANKERS INVESTMENT, PHONE #: 503-636 -0388
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 503 - 630 - 4492
Inspection Request Scheduled For: Date: 4/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 046776 -01 503 -572 -8246 N
Corrections /Comments /Instructions:
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
X FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: WM/0 7 Phone #: (503) 718-
CITY OF TIGARD . . 1
BUILDING DIVISION PERMIT #: PLM200Ei.00514
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2006
Phone: (503) 639 -4171 pti I
Inspection Requests (24 Hrs.): (503) 639 -4175 ° °" I. .
INSPECTION WORKSHEET FOR DATE: 3/22/2007 TIME: 7 :00AM PAGE: i
SITE ADDRESS: 12562 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MAX'S FANNO CREEK BREW PUB
DESCRIPTION: TI - change of use from retail to eating and drinking establishment. Other fixtures: (1) expansion
tank, (2) hose bibs, (2) ice makers and (4) primers.
OWNER: BANKERS INVESTMENT, PHONE #: 50363E-0388
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 503 - 4492
Inspection Request Scheduled For: Date: 3/22/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 045242 -01 503.572 -8246 Y
Corrections /Comments /Instructions:
0 i� (/
! Q PASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
y . , Inspector: 1 Date Phone #: (503) 718- L
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006•00514
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2006
Phone: (503) 639- 4171 1
Inspection Requests (24 Hrs.): (503) 639 -4175 _..' Wy, I�
INSPECTION WORKSHEET FOR DATE: 2/6/2007 TIME: 7 :02AM PAGE: 23
SITE ADDRESS: 12562 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MAX'S FANNO CREEK BREW PUB
DESCRIPTION: lay change of use from retail to eating and drinlding establishment. Other fixtures: (1) expansion
tank, (2) hose bibs, (2) ice makers and (4) primers.
OWNER: BANKERS INVESTMENT, PHONE #: 503 - 636.0388
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 503-630-4492
Inspection Request Scheduled For: Date: 2/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 043012 -01 503-572 -8246 N
Corrections /Comments /Instructions:
Di
eAjed 044441/ / 0 il
•
i tk,)414(--e4/ / 4/ / S
❑ PASS ❑ PARTIAL APPROVAL XCANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: PLM2006.00514
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2006
Phone: (503) 639 -4171 ;;�y, +�
Inspection Requests (24 Hrs.): (503) 639 -4175 " I..
INSPECTION WORKSHEET FOR DATE: 1//612007 TIME: 7 :09AM PAGE: 5
SITE ADDRESS: 12562 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MAX'S FANNO CREEK BREW PUB
DESCRIPTION: TO - change of use from retail to eating and drinking establishment. Other fixtures: (1) expansion
tank, (2) hose bibs, (2) ice makers and (4) primers.
OWNER: BANKERS INVESTMENT, PHONE #: 503 - 636 -0388
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 503 - 630 -4492
Inspection Request Scheduled For: Date: 1/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 042178 -01 572 -824 -6503 N
Corrections /Comments/ Instructions:
2� • aL � S 4(c
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL \ LL FOR IN • CTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N Lv Date: I On Phone #: (503) 718 - 1 -04L -
___
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: PLM2006_00614
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2006
Phone: (503) 639 -4171 46,440,1 r
Inspection Requests (24 Hrs.): (503) 639 -4175 `'
INSPECTION WORKSHEET FOR DATE: 11116/2006 TIME: 7 :00AM PAGE: 47
SITE ADDRESS: 12562 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MAX'S FANNO CREEK BREW PUB
DESCRIPTION: TI - change of use from retail to eating and drinking establishment. Other fixtures: (1) expansion
tank, (2) hose bibs, (2) ice makers and (4) primers.
OWNER: BANKERS INVESTMENT, PHONE #: 503.636_0368
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 503-630-4492
Inspection Request Scheduled For: Date: 11/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Plumbing 039867 -01 503 - 572 -8246 N
345" * 7 UNte.R. 6LAc
Corrections /Comments/ Instructions:
CO tv v.ig sSNR.tvi c MV(Lov<b FbI c.xluFR.
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PASS El PARTIAL APPROVAL El CANCEL El NO ACCESS
� ❑ ` FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v • VI '‘ Date: w tit 0.10 Phone #: (503) 718- •4 '