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Permit CITY TIGARQO PLUMBING PERMIT ".�"*- �`'I DEVELOPMENT SERVICES � / PERMIT #: PLM1999 -00351 - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 DATE ISSUED: 11/02/1999 SITE ADDRESS: 13050 SW PACIFIC HWY " PARCEL: 2S102CB -02700 SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: C -G BLOCK: LOT: 020 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS: 1 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 4 URINALS: GREASE TRAPS: 1 LAVATORIES: OTHER FIXTURES: 0 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft • Remarks: Plumbing TI - restaurant FEES Owner: Type By Date Amount Receipt ANTONIO CAPONE PLCK DEB 11/02/199c $28.13 99- 319497 13050 SW PACIFIC HWY 5PCT DEB 11/02/199 $9.00 99- 319497 TIGARD, OR 97223 PRMT DEB 11/02/199c, $112.50 99- 319497 Phone 1: Total $149.63 Contractor: BCS PLUMBING 6165 SW 190TH AVE ALOHA, OR 97007 REQUIRED INSPECTIONS Top -out Insp Phone 1: Reg RP /Backflow Preventer eg #: LIC 00094079 PLM 34 -259P6 Final Inspection 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 -0080. You obtains opies of these rules or direct questions to OUNC by calling (503) 246 -1987. issue y: � _ � i�.d i jab , _/ Permittee Signature�1� pil.4 Call (503) 6 9-4175 by 7 :00 P.M. for an inspection needed the next business day CITY OP TIGARD Plumbinermit Application Plan Check ; 1 /■. 13125 SW HALL BLVD. Commercial and Residential Recd By ii TIGARD, OR 97223 Date Recd i (503) 639 -4171 Date to P.E. tg -21 - q I • Print or Type Date to DST U ' Incomplete or illegible applications will not be accepted Permit# '_v ' 1 Related SWR # ( Called Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job '4)(14E2 `'Ia 0(JKt't`f Sink 11.50 4/4,00 Address Street Address Suite Lavatory 11.50 13650 sw 'Pact �r C IN Tub or Tub /Shower Comb. 11.50 Bldg # City/State Zip Shower Only 11.50 C� 6 AP-bon.. y�u Water Closet/Urinal (Specify) 11.50 / Na_ me �OCi Dishwasher 11.50 r Owner M i AAddress `C� I Suite Urinal 11.50 13OSb 3t» ()kik C14 Garbage Disposal 11.50 City/State Zip Phone Laundry Tray 11.50 i i�O+4r ©n 973 6z Name Washing Machine/Laundry Tray (Specify) 11.50 T 6 )ii hAwl .CAi1 » Z- Floor Drain/Floor Sink 2" i 11.50 / /.3 Occupant Mailing Address Suite 3° 11.50 610 s Lv' ISCO Fit US 51" 4° 11.50 City/State Zip Phone - 1 l 61}a -t (r 97 42) 5q39- Water Heater 0 conversion jB( like kind 11.50 `/ ,,r® me Gas piping requires a separate mechanical permit. Na S MFG Home New Water Service 28.00 MFG Home New San/Storm Sewer 28.00 Contractor Mailing Address Suite (O(a S Sub `C10 Hose Bibs 11.50 Prior to permit Ci /State Zip �J Phone Roof Drains 11.50 issuance, a copy W.. q 1o07 Ck 1,' 712: Drinking Fountain 11.50 of all licenses are Oregon Const. Cont. Dua,.: L;...� I F �� "'are if 540 bC.,t' `?COD Other Fixtures (Specify) 15.00 expired in COT Plumbing Lic Exp. Date"?- _ {- Q database '34- -) Name Architect Sewer- 1st 100' 38.00 or Mailing Address Suite Sewer - each additional 100' 32.00 Water Service - 1st 100' 38.00 Engineer City/State Zip Phone Water Service - each additional 200' 32.00 Describe work to be done: Storm & Rain Drain - 1st 100' 38.00 New 0 Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00 Residential 0 Commercial 0 Additional description of work: Commercial Back Flow Prevention Device ' 1 32.00 32' Residential Backflow Prevention Device* 19.00 Catch Basin 11.50 Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00 Yes, No 0 Inspections per/hr If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps i 11.50 `®,S") WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL • I hereby ackir ayvledge that I have read this application, that the information Isometric or riser diagram is required if Quantity Total is > 9 given is correct, that I am the owner or authorized agent of the owner, and , �� /O� •SUBTOTAL / n that plans submitted are in compliance with Oregon State Laws. Ignature of Owner /Agent Date 1I l 1 ; _ 0-2-1-7, 0"/ q o SURCHARGE ?, ®0 Contact arson Name Phone , 3S,OWi l \t jh 0 CAC _ 50#-340 ""PLAN REVIEW 25% OF SUBTOTAL a g ,) 3 71 BATHHOUSE $178. Required only if fixture qty. total is > 9 � , ; TOTAL M. 2 „BATH HOUSE $250.00 a - . 3 B HOUSE $285.00 This foe all plumbing fixtures in the dwelling and the first 'Minimum 7% ( permit fee is $50 + 7 � surcharge, except Residential Backflow Prevention 100 feet of eanttavy sewer storm sewer and water service) Device, which is $25 + 7% surcharge "All New Commercial Buildings require plans with isometric or riser diagram and . plan review. I:tdstsVormstplumapp.doc 920/99 , , \, q t h, r 1 S ' - PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved I Replaced Removed /Capped Sink 1 3 Lavatory Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Urinal Garbage Disposal Laundry Room Tray — Washing Machine Floor Drain /Floor Sink 2" L • 3" 4" Water Heater Other Fixtures (Specify)G,,,,,,se ¥-D • COMMENTS REGARDING ABOVE: \l pp k yovvt tom_ S cAL (sec. Nil -inns ccX G,c rc cS; vs 2, 't-3 Li ,-e_ w42, i 1I ) , W S f c) tn. l C i v` RooLAA I:ldstsVormslplumapp.doc 9/20/99 — - 12/09/1999 Activities for Case #: PLM1999 -00351 9:56:49 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes PLMC003 Application received 10/21/1999 BON RECD No Hold BON 10/26/1999 PLMC005 Permit Created 10/26/1999 BON DONE No Hold BON 10/26/1999 PLMC007 Plans routed to Plans Examiner 10/27/1999 BON DONE No Hold BON 10/27/1999 PLMC725 Top -out lnsp 10/29/1999 10/29/1999 11/09/1999 TLP PASS No Hold VT 11/12/1999 PLMC799 Final Inspection 10/29/1999 10/29/1999 12/01/1999 TLP PASS No Hold TLP 12/01/1999 PLMA008 Plans Approved /Routed to DST 10/29/1999 10/29/1999 10/29/1999 MS SENT No Hold MRS 10/29/1999 PLMC040 (F) Ready to issue 11/02/1999 DEB DONE No Hold DEB 11/02/1999 PLMCO50 (F) Issue permit 11/02/1999 DEB DONE No Hold DEB 11/02/1999 PLMA055 (F) Reprint Permit 11/02/1999 DST DONE No Hold DST 11/02/1999 PLMC715 Rough -in Insp 11/12/1999 11/12/1999 11/09/1999 TLP PASS No Hold VT 11/12/1999 PLMA800 Case Finaled 12/09/1999 JMT DONE No Hold JMT 12/09/1999 Page 1 of 1 1