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Permit • CITY OF TIGARD PLUMBING PERMIT l DEVELOPMENT SERVICES PERMIT #: PLM2006 -00034 - �� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1 5135 06 PARCEL: 1S135 SITE ADDRESS: 11945 SW PACIFIC HWY 228 ZONING: C -G SUBDIVISION: HOFFARBER TRACTS NO.1 LOT: 002 JURISDICTION: TIG Project Description: Replace existing Ice machine, 3 sinks, add grease trap and 2" drain. Cap 1 sink. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: 1 TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 4 URINALS: GREASE TRAPS: 1 LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES • TIGARD PROPERTIES INC 2106 SE OCHOCO ST Description Date Amount MILWAUKIE, OR 97222 [PLUMB] Permit Fee 1/26/2006 $116.20 [TAX] 8% State Surcharl 1/26/2006 $9.30 Phone : Total $125.50 Contractor: DP PLUMBING(USE D P PLUMBING) 904 S. CHEHALEM REQUIRED ITEMS AND REPORTS NEWBERG, OR 97132 Contact # : PRI 503 -537 -9492 FAX 503 -538 -4306 Reg #: PLM 110612 LIC 36 - 70PB 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 s or direct • - 'ons to OUNC by calling 503 - 246 -6p or 1- 800 - 332 -2344. Issued By: Permittee Signatur . Call 503-639-4175 by 7:00 a.m. for an inspection that b iness day. This permit card shall be kept in a conspicuous place on the job • ntil completion of the project. Approved plans are required on the job site at the time of each inspection. iO 00° Building Fixtures . RECEIVED ,tt--Aditto e4"4pA;tek:;,•-\ Plumnbin2 Permit Application soli of Flee HSI Ol City of Tigard l JAN 26201 i R � / _ -tOG J56 Permit N j .� D/ _ 0Q�gse . 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review N � �! J/ Phone: 503.639.4171 Fax: 503.598.19 'CITY OF "T1 ' ' .� it � Dan Review Other Permit No.: 24- Hour Inspection Line: 503.639.41 i Date Ready/By. L""': RI See Page 2 for Internet: www.ci.tigard.or.us IUILDING I ` _. , �1 Notified/Method _ Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total • ddition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 249.20 ❑ 1- and 2 -family dwelling Cmmercial /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: (' q .7 S S W pa c H w mug Catch basin o r area drain 16.60 City / State/ZIP: t a Drywell, leach line, or trench drain 16.60 T O R �'1 Z2.3 Suite/bldg./apt. no.: Project name: r Footing drain (no. linear ft.: ) Page 2 Z7 - T � pizza Ie,.k.., Cross street/directions to job site: Q Manufactured home utilities 110.00 • l Manholes 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 • Fixture or item Tax map /parcel no.: Absorption valve 16.60 , DESCRIPTION OF WORK Backflow preventer Page 2 ,e 1'4(..411 a- 1°C ■ -1-C- t -4.tJu W i }e... e , 3 Backwater valve 16.60 C-0 St 64ti r /44C1 1 NI I 7a `� arm �� Clothes washer 16.60 Dishwasher 16.60 rae 1°u¢-• 1N1 Z a H Al cal 10 t �p-�i t i nc ii I i; /. Drinking fountain 9 16.60 ❑ PROPERTY OWNER I TENANT Ejectors/sump 16.60 Name: k yi w.s-t- 1 W[!, S 1 r Expansion tank 16.60 Address: x ilcks Cixture/ wel ) 16.60 City/State/ZIP: e ��/� p (�R Gl` } b F oor drain floor sink/hub 'L t r i 16.60 (5o3) g G O - Z Z t 9 Phone: Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ZrCONTACT PERSON Hose bib 16.60 • Ice maleer I 16.60 1 4 Business name: ■ ; e' ev..ct e 1 22.x. 4e t 4 �h Interceptor ease trap 1 16.60 4 Contact name: 1 v S te . e r Medical gas (value: $ ) Page 2 Address: r d "?:"IC. 1 t 9 Primer 16.60 City /State/ZIP: ��Q V,F�� , OR ct C6-4 Roof drain (commercial) 16.60 Phone: (503) g b p - 2 19 Fax:: ( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 • Business name: b e p I � b1 Water heater 16.60\ Address: /382.5 if/� (S iiem/4. QoO,. ,Q,b . Other: �/' ` � / � it/,3 ai ' e. O `7 7/,32 { subtotal City / State/ZIP: Minimum permit fee: $72.50 Phone: (503) 571_ 79c, G G Fax: (b o3) s ,1 N3 Oe./ Residential backflow minimum permit fee: $36.25 / . CCB Lic.: //a& 4 %•∎ bing Lic. no.: ..U, ..--7, „03 Plan review (25% of permit fee) Authorized signature: State surcharge (8% of permit fee) �'. TOTAL PERMIT FEE ha 5. !gyp Print name: j , ' /bo y s Date: jt C, ego 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 \Permits\PLMF- PrnnitApp.doc 06/05 440.4616T(10/02/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' 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 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 (-'._. --"-- permit fee $3G.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. • Quantity by (Fixture) Work Performed ❑ Any new commercial building. Fixture Type: Replace ❑ Any new exterior plumbing site utilities. Previous Capped Added Existing ❑ 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 facilities where new plumbing fixtures, including interceptors, Cuspidor/Water Aspirator. are being installed for the food service area. Dishwasher - Commercial ❑ Any new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain Eye Wash ❑ Any NFPA 13 - D multipurpose fire sprinkler system. Floor Drain /sink - 2" / - 3" Submit 2 sets of plans with any of the above. -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. - Industrial Ice Mach./Refrig. Drains ( i Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley -Commercial I 1 • - Service 3 I Z Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this permit results in an Water Extractor p Water Closet - Toilet 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: G,resj,c. 1 plumbing permit can be issued. •tom i:\ Building \Permits\PLM- PermitApp.doc 07/06/05 • Accumulative Sewer Tally Parcel # 251'i'3�Ch-1'700 Tenant Nme: Tigard Pizza Kitchen This SWRA NA " CREDITS Site Address: 11945 SW Pacific Hwy #228 w ., ., This PLM# PLM2006 -00034 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off #s count # value #s values tiser /Font 4 Ba 0 Baptisery/Font 0 0 0 0 Bath Tub /Shower 4 r'� 0 0 0 0 0 - Jacuzzi /Whirlpool 4,,; 0 '. 0 0 0 0 Car Wash - Each Stall 6 = 0 s ,i.` '� . 0 0 0 0 - Drive through 16 0 0 0 0 0 Cuspidor /Water Aspirator 1 0 0 0 0 0 Dishwasher - Commercial 4 0 0 0 0 0 - Domestic 2 0 0 0 0 0 Drinking Fountain 1 0 0 0 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain /Sink - 2 inch 2 0 0 1 2 1 2 - 3 inch 5 0 0 0 0 0 - 4 inch 6 0 0 0 0 0 - Car Wash Drr 6 0 0 0 0 0 Garbage Disposal - Domestic (to 3/4 HP) 16 0 0 0 0 0 - Commercial (to 5 HP) 32 0 0 0 0 0 - Industrial (over 5 HP) 42 0 0 0 0 0 Ice Machine /Refrigerator Drain 1 0 0 0 0 0 Oil Sep (Gas Station) 6 0 0 0 0 0 Rec. Vehicle Dump station 16 0 0 0 0 0 Shower - Gang (per head) 1 0 0 0 0 0 - Stall 2 0 0 0 0 0 Sink - Bar /Lavatory 2 0 0 0 0 0 - Bradley 5 0 0 0 0 0 - Commercial 3 0 0 0 0 0 - Service 3 0 1 3 0 -1 -3 Swimming Pool Filter 1 0 0 0 0 0 Washer - Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet - Toilet 6 0 0 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 1 3 1 2 0 - Current Fixture Value -1 divided by 16 = -0.1 Current EDU 1 EDU = $ 2,600 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change -1 divided by 16 = -0.1 over (under) $ (260.00) Enter EDU Change Here -0.1 Notes: Authorized Name /Signature: Barbara Butler Date: 1/26/2006 Building Division Note. The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. i:\Building\Sewer Tally \SewerTallySheet.xls 7/1/05 CITY OF TIGARD . BUILDING DIVISION ` PERMIT #• 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1l`IE�I�(1 6- Phone: (503) 639- 4171 ,a 1i i l � Inspection Requests (24 Hrs.): (503) 639 -4175 : -!+� _.. INSPECTION WORKSHEET FOR DATE: 2/17/2006 TIME: 7:06AM PAGE: 15 SITE ADDRESS: 1 1946 ,>W PACIFIC HWY 228 CLASS OF WORK: SUBDIVISION: HOFFARBER TRACTS NO.1 LOT #: 002 TYPE OF USE: PROJECT NAME: - fIGARD PI 71A KITCHEN DESCRIPTION: Replace existing Ice machine, 3 sinks, add grease trap and 2" drain. Cap 1 sink. OWNER: TIGARD PROPERTIES INC, PHONE #: CONTRACTOR: {• P HONE #: 503_537_94,p DP PI_UMt31N �(U5E D P PLUMBING) Inspection Request Scheduled For: Date 2/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 027116 -01 503-860.2219 N The plumbing Installation defects noted Corrections /Comments /Instructions: on this report shall be corrected and an inspection request made within 30 calendar days per OAR 918- 785 -0230 i 6 1 , 5 ii,/ /' AIW ...p_x_.:,...A.V<MILI ,_. L.-"AirriP - - • OF/ efhW -- _ //, :. , .0■1 i % & Allr,-As/ 0 D / t , 3 ) __________ ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS Eti—PAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 0. V-"\ Date: 0 1 I 15J Phone #: (503) 718 - CITY OF TIGARD . BUILDING DIVISION W PERMIT # : PI.M:3006- 000: >4 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: .1 /2E0006 Phone: (503) 639 -4171 f il •Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 2/17/2006 TIME: 7:06AM PAGE: 14 SITE ADDRESS: 11945 SW PACIFIC HWY 228 CLASS OF WORK: SUBDIVISION: I IOFFARBER TRACTS NO.1 LOT #: 002 TYPE OF USE: PROJECT NAME: TIGARD PIRA KITCHEN DESCRIPTION: Replace existing Ice machine, 3 sinks, add grease trap and 2" drain. Cap 1 sink. OWNER: TIGARD PROPERTIES INC, PHONE #: CONTRACTOR: DP PLUML3ING(USE L) P PLUMBING) PHONE #: 603 Inspection Request Scheduled For: Date 2/17/7006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 027117 -01 503.860 -2213 Y Corrections /Comments /Instructions: c a / S ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: `� %v � L / Date: Phone #: (503) 718 - �— . 11( • CITY OF TIGARD , BUILDING DIVISION PERMIT #: PLM200S•000%s•4 iii 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . i0612.006 Phone: (503) 639 -4171 A , ° 11@ "wl1 i Inspection Requests (24 Hrs.): (503) 639 -4175 _..' .. `'I I.. A INSPECTION WORKSHEET FOR DATE: 2/21/200G TIME: 7 :02AM PAGE: 21 SITE ADDRESS: •1 SW PACIFIC HWY 228 CLASS OF WORK: SUBDIVISION: HOFFARBF TRACTS NO.1 LOT #: 002 TYPE OF USE: PROJECT NAME: TIGARD PIZZA KITCHEN DESCRIPTION: Replace existing Ice machine, 3 sinks, add grease trap and 2" drain. Cap 1 sink. OWNER: TIGARD PROPERTIES INC, PHONE #: CONTRACTOR: DP PLUMB!NG(USE D P PLUMBING) PHONE #: 503- 63.1- 9,1y2 Inspection Request Scheduled For: Date: 2/21/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 027230 -02 50: -060 -2218 N Corrections/Comments/Instructions: 3.7 3 2 / i 7 pe-0 ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL 4 4 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 Date: }} ° / ill Date. l r7 6 Phone #: (503) 718 - f G 1 CITY OF TIGARD - BUILDING DIVISION PERMIT #• PLM200 -00034 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 1/26/2006 Phone: (503) 639- 4171sce Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7121/2006 TIME: 7:02AM PAGE: 22 SITE ADDRESS: 11915 SW PACIFIC HWY 229 CLASS OF WORK: SUBDIVISION: HOFFARBER TRACTS NO.1 LOT #: 002 TYPE OF USE: PROJECT NAME: TIGARD PI77A KITCHEN DESCRIPTION: Replace existing Ice machine, 3 sinks, add grease trap and 2" drain. Cap 1 sink. OWNER: TIGARD PROPERTIES INC, PHONE #: CONTRACTOR: DP PLUMBING(USE D P PLUMBING) PHONE #: 503537 -9492 Inspection Request Scheduled For: Date: 2/21/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 027238 -01 603.960 -2219 N Corrections /Comments/ Instructions: ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- ice.. CITY OF TIGARD • iir , BUILDING DIVISION PERMIT # : PI M2006 -00034 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: .1/26/ d- Phone: (503) 639 -4171 � X Inspection Requests (24 Hrs.): (503) 639 -4175 F: INSPECTION WORKSHEET FOR DATE: 2/22/2006 TIME: 7 : 02AM PAGE: 11 SITE ADDRESS: 11945 SW PACIFIC HWY 228 CLASS OF WORK: SUBDIVISION: HOFFARBER TRACTS NO.1 LOT #: 002 TYPE OF USE: PROJECT NAME: TIG;ARD PIZZA KITCHEN DESCRIPTION: OWNER: TIc ARC) PROPERTIES INC, PHONE #: CONTRACTOR: DP PLUMBING(USE L) P PLUMBING) PHONE #: 503_537_9,192 Inspection Request Scheduled For: Date: 2/22/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 027330-02 50:- 860.2218 N Corrections /Comments /Instructions: t - . . - iii` /�� _ _ _ _ _Z ,e /. /Pr_ -1- -...e -.../—... / / roar..., alM` % / i 0,... &A S S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 1 Date: ° i/ " /l Phone #: (503) 718 - r CITY OF TIGARD . BUILDING DIVISION PERMIT #: PLM2006-00034 13125 SW Hall Blvd., Tigard, OR 97223 " DATE ISSUED: 1/26/2m i Phone: (503) 639 -4171 aAi;' .4110 Inspection Requests (24 Hrs.): (503) 639 -4175 F: _.. INSPECTION WORKSHEET FOR DATE: 2/72/7006 TIME: 7:02AM PAGE: 12 SITE ADDRESS: 11945 SW PACIFIC HWY 228 CLASS OF WORK: SUBDIVISION: HOFFARBER TRACTS NO.1 LOT #: 002 TYPE OF USE: PROJECT NAME: TIGARD PIZZA KITCHEN DESCRIPTION: umusuomminatimmansmusaiiminv OWNER: TIGARD PROPERTIES INC, PHONE #: CONTRACTOR: OP PLUMBING(USE D P PLUMBING) PHONE #: 603 1,37 -9492 Inspection Request Scheduled For: Date: 2/22/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 027330 01 603.860 -2219 Y Corrections /Comments /Instructions: I:: - . SS 111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: \/ C) Date: v Phone #: (503) 718 -