Permit CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00423
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/24/2007
PARCEL: 1S135DD-03301
- SITE ADDRESS: 11945 SW PACIFIC HWY 104 ZONING: C -G
SUBDIVISION: TIGARD PLAZA LOT: 002 JURISDICTION: TIG
PROJECT: TAQUERIA 7 ESTRELLAS
Project Description: Fixture: interceptor /grease trap, ice maker.
•
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 2 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 5 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner:
FEES
TIGARD PROPERTIES INC
2106 SE OCHOCO ST Description Date Amount
MILWAUKIE, OR 97222 [PLUMB] Permit Fee 9/24/2007 $215.80
[TAX] 8% State Surcha 9/24/2007 $17.26
Phone :. Total $233.06
Contractor:
BRUNER PLUMBING
PO BOX 23985
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact # :. PRI 503- 624 -4880
FAX 503- 624 -2173
Reg #: LIC 81837
PLM 26 -445PB
•
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: Atjeto Permittee Signatu �sy-•� �—�
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.
Building Fixtures � ECElVED P P -03 •
mbin2 Permit Application FOR OFFICE. USE oNI..l'
City of Tigard 5 ` , 1 2007 Receives/ 070-7 ��..Q
B Permit No.. L I f4L3
2
13125 SW Hall Blvd., Tigard, OR 9 OF TIGARD Plan Re ew /
Phone: 503.639.4171 Fax: 5035 DIRC DIVISIO • / n r � `III I � Date/By. Other Permit No t
ea .-b
24- Hour Inspection Line: 503.6 ■ _ Date ReadylBy:� tuns El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method:�( 0, - 7 ao Supplemental Information
'TYPE OF WORK / FEE* SCHEDULE SCH ED U L ES PejtaitypeZ 15
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
Wr Addition /alteration/replacement ❑ Other: New 1- 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY! OF CONSTRUCTION SFR (I) bath 249.20
❑ I - and 2- family dwelling 2Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family
SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft.) Page 2
. . JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 1/R � j / S (� p ( , , Catch basin or area drain 16.60
City /State /ZIP: 7 o� Drywell, leach line, or trench drain 16.60
-
Suite/bldg. /apt. no.: ` / IA Project name: Footing drain (no. linear ft.: ) Page 2
��Q���'�,,,�,,,,��_� Manufactured home utilities 110.00
,,,,,gggg
Cross street /directions to job site: �' d 4-.4 Manholes 16.60
Rain drain connector 16.60
TQ ,...„ led- Sanitary sewer (no. linear ft.: ) Page 2
to Storm sewer (no. linear ft.: ) Page 2
Subdivision: (((/// I Lot no.:
Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK ' Back flow preventer Page 2
Backwater valve 16.60
(9 /1/-44) Ff t MP,. Clothes washer 16.60
Dishwasher 1 16.60 / ( i,„(.. 0
❑ PROPERTY OWNER I ❑ EN ANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: 6F, -A-P-4:9 -3 6 yy < Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink /hub 2 4, 16.60 /(0.(.00
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 1 16.60 6.(0
Business name: Interceptor /grease trap 1 16.60 /(' Co O
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( ) Sink/basin/lavatory 5 16.60 83
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 2, 16.60 3, t Lo
Business name: rUil &Y Pr U�� � /14 �, Water 1 tot 16.60 i 6 • (ofl
Address: P O i bye 2 - A9 SJ Other:
City/State/ZIP:
/r /5 Subtotal X3 v,
T��
t f Minimum permit fee: $72.50
Phone: ( 5 6 Z'-f. L g '1 Fax: (5t)3) 62,4 Z 03 �/( g Residential backflow minimum permit fee: $36.25
CCB Lic.: O g Plumbin g Lic. no.: I ).'1 2 ( - (4 5 Q. Plan review (25% of permit fee)
State surcharge (8% of permit fee) / T. a (o ,
Authorized signature:
TOTAL PERMIT FEE a 3 .Ofp
Print name: w 6 t rue' ei/ Date: A /� This permit application expires if a permit is not obt within
` 180 days after it has been accepted as complete.
•Fee methodology set by Tri -County Building Industry Service Board.
i.\ Building \Permiu\PLMF- PerrnitApp.doe 06/05 44 0-4616T( 10/02/COM/WEB)
Plumbing Permit Application - City of Tigard - c• tom.
Page 2 - Supplemental Information �'�•
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities : ' ". "::": '. L . , .. Qtr• , 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 L - • Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Back flow 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
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: Plan Review for Complex Structures
Are you capping, adding or replacing fixtures? If "yes ", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
• _ QuantltY by (Fixture) Work Performed ❑ Any new commercial building.
Future Type: . • • I . , Replace ❑ Any new exterior plumbing site utilities.
• - — - . • - • • - Previous • Capped Added Fasting ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool providing services to human beings.
-
Car Wash -Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru fac ilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food service area.
Dishwasher - Commercial / ❑ An new residential building containing three (3) or more
- Domestic dwelling units.
• Drinking Fountain ❑ Any NFPA 13 -D multipurpose fire sprinkler system.
i Eye Wash
Floor Drain /sink - 2" $, 7,... Submit 2 sets of plans with any of the above.
-3"
-4"
Car Wash Drain . . Isometric or Riser Diagram .
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial three (3) or more stories in height.
- I ndustrial
Ice Mach./Refrig. Drains /
Oil Separator (Gas Station) / Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory 9 /
-Bra e�y —
-Commercial. 1 5f
- Service me ,,- f
Swimming Pool Filter
Washer - Clothes
Water Extractor *Note: If the fixture work under this permit results in an
Water Closet - Toilet L I increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
i \ BuildingTcnni&PLM- PenniUpp.dot 07 /06/05 iir")
CITY OF TIGARD
BUILDING DIVISION PERMIT #: P1..M2007 -00423
I l 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/24/2007
Phone: (503) 639 -4171 'l
Inspection Requests (24 Hrs.): (503) 639 -4175 -' �'I
INSPECTION WORKSHEET FOR DATE: 10/25/2007 TIME: 7:01AM PAGE: 32
SITE ADDRESS: 11945 SW PACIFIC HWY 104 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: UO2 TYPE OF USE:
PROJECT NAME: TAQUERIA 7 ESTRELLAS
DESCRIPTION: Fixture: interceptor /grease trap, ice maker.
OWNER: TIGARD PROPERTIES INC, PHONE #:
CONTRACTOR: BRUNER PLUMBING PHONE #: 503 -624 -4880
Inspection Request Scheduled For: Date: 1012512007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 058338.01 503 624 -4880 N
Corrections/Comments/Instructions:
egi PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 1/ -4.— ` \1 � Date: JD 12,1 ? Phone #: (503) 718-
7
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PI._M2007 -00423
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/24/2007
Phone: (503) 639
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 21712008 TIME: 7 PAGE: 18
SITE ADDRESS: 11945 SW PACIFIC HWY 104 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: TAQUERIA 7 ESTRELLAS
DESCRIPTION:
Fixture: rnteireptor /grease trap, ice maker.
OWNER: TIGARD PROPERTIES INC, PHONE #:
CONTRACTOR: EBRUNER PLUMBING PHONE #: 503 - 624 - 4680
Inspection Request Scheduled For: Date: 2/7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 064687 -01 503. 624.4880 Y
Corrections/Comments/Instructions:
1 rO V i AL Li J v4 rt-zA Ti-Jr L eLh 'a v.44-iwd v✓1
e eSG.
Pro roIPy C + Rc
C r -- 1, - „.) i ) Go w�, -h.. �"'�` s;,./L( ) ra,.,� cZ 7✓ Pvt,p
V t 1., . i - Iii �� • - • low J�'�:� fC .�.� rM 0
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CD ‘41..A.-;) Vim..._. Date: '2, \'7\r' Phone #: (503) 718-
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: PLM2007 -00423
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9J2412007
Phone: (503) 639-4171 %1C I I
Inspection Requests (24 Hrs.): (503) 639 -4175 -- F 'I I..
INSPECTION WORKSHEET FOR DATE: 11/14 /2007 TIME: 7 :42AM PAGE: 55
SITE ADDRESS: 11945 SW PACIFIC HWVY 104 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: TAQUERIA 7 ESTRELLAS
DESCRIPTION: Fixture: interceptor /grease trap, ice maker.
OWNER: TIGARD PROPERTIES INC, PHONE #:
CONTRACTOR: BRUNER PLUMBING PHONE #: 503. 6244800
Inspection Request Scheduled For: Date: 11/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 059564 -01 503 -624 -4880 V
Corrections /Comments/ Instructions:
g PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (ThLv ,/i`l 1)444-4— - Date: ) / f / !' /o 7 Phone #: (503) 718-
CITY OF TIGARD
1, BUILDING DIVISION PERMIT #: PLM2007.00423
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 904 /2007
Phone: (503) 639 -4171 ifts.44 � .�Ii
Inspection Requests (24 Hrs.): (503) 639 -4175 ` __
INSPECTION WORKSHEET FOR DATE: 4 /11/2008 TIME: 7:01AM PAGE: 15
SITE ADDRESS: 11945 SW PACIFIC HWY 104 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: TAQUERIA 7 ESTRELLAS
DESCRIPTION: Fixture: interceptor /grease trap, ice maker.
OWNER: TIGARD PROPERTIES INC, PHONE #:
CONTRACTOR: BRUNER PLUMBING PHONE #: 503 - 4600
Inspection Request Scheduled For: Date: 4/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 068255-01 503 624 -4880 N
Corrections/Comments/Instructions:
C a f<.��v�
A PASS ❑ PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 u \' \ N„.„- Date: y Pi DZ Phone #: (503) 718 -