Permit CITY OF T SEWER CONNECTION
�xaa q DEVELOPMENT SERVICES PERMIT
11: �I� � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639°4171 PERMIT # • SW R96 -0464
DATE ISSUED: 10/24/96
PARCEL: 2S110DB -00700
SITE ADDRESS...: 15520 SW PACIFIC HWY #D
SUBDIVISION • WILLOW BROOK /TIGARD PROMENADE ZONING: C —G
BLOCK • LOT :10
TENANT NAME °CARL'S JR
USA NO FIXTURE UNITS...: 117
CLASS OF WORK...: NEW DWELLING UNITS..: 7
TYPE OF USE •COM NO. OF BUILDINGS: 0
INSTALL TYPE :LTP IMPERV SURFACE: 0 sf
Remarks: Plumbing permit for a 3,035 square foot Carl's Junior restaurant
i Owner: FEES
CARL KARCHER ENTERPRISES type amount by date recpt
800 MELLON AVENUE PRMT $ 15400.00 JSD 10/24/96 96- 285690
INSP $ 45.00 JSD 10/24/96 96- 285690
MANTECA CA 95337 ll
Phone #: 823 -9251
Contractor: - -- — A4 A - - - ---
CONTRACTOR NOT ON FILE
Phone #: $ 15445.00 TOTAL
Reg #...
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspect ion
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the i taller shall purchase •
a °Tap and Side Sewer° Permit and the f /install a lateral.
Permittee Si •.fate e: � 4
Issued .
0
Call for inspection — 639 -4175
•
. Commercial Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639 -4171
Jobsite Address: (5g 2-0 .) FA.C,(-t-4 t-
.r
se:
Tenant: l IA � 5 L.S r = .. .
Onl
Suite # . .
.:.....:::.:..:.:::. ........
Valuation:
PlancWRec #
Owner:
IMP & TL #
Address:
Aaarovals>Required ;... ::...
Planning
Phone:
one•
rt rr
:Other
Contractor:
Address:
Type of const:
Occupancy class:
Phone:
Sprinklered? Yes No
Contractors License #
(attach copy of current Oregon license) Sq. ft of project
Contact name & phone: Story (1st, 2nd, etc.)
Proposed use:
Architect/Engineer:
Previous use:
Address:
Note: Plumbing & mechanical plans
must be submitted at time of
Phone: building permit application.
JOB DESCRIPTION:
®v )- '• Y/ �� , Mok-11e Z2'4 -1s it0
Applicant Signature & Phone number
Received by: Date Received:
Permit * Account Description Amount Amt. Pd. - Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
6Kq(a L t Sewer Connection (SWUSA) 6 L IDD I S 400
_ l
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF -R)
Mass Transit TIF (TIF -MT)
Commercial TIF (TIF -C)
Industrial TIF (TIF -l)
Institutional TIF (TIF -IS)
Office TIF (TIF -0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS: _ 4 \ S l -1
Tenant Name: f 1(k. J , Accumulative Sewer Tally This SR #: `f
, Ifo bgto
Address : 155 ?, , a.G 41 G I n W
. This PLM #: qro 0a(°
Fixture Value Previous # Previous Credits Capped Fixtures Fixtures New New
\ Value Capped off value added # added total #s total
N Eu3 Count off #s count value values
Baptistry/Font 4
Bath - Tub/Shower 4
- Jacuz/Whpl 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commer 4
- Domest 2
Drinking Fountain 1
Eye Wash 1
Floor Drain /sink - 2 inch 2
- 3 inch 5 � . ? Lo 7 j 0
- a inch 6 1-1-z-
Lt Z
- Car Wash Drain 6
Garbage Disposal 16
- Dom (to 3/4 HP)
- Comm (to 5 HP) 32 '
i
- Ind (over 5 HP) 48
Ice Machine /Refrigerator Drains 1
Oil Sep (Gas Station) 6
Recreational Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2
. Sink - Bar/Lavatory 2
I -- 3 (.Q Co
- Bradley 5
- Commercial 3 ' .p..- Co Z LP
- Service 3 / -27 1 3
4 Swimming Pool Filter 1
Washer, Clothes 6
•
Water Extractor 6
Water Closet, Toilet 6 Z 1 .4 - 2-
Urinal 6 " / L I (
TOTALS • / 11
Total fixture values: 111 divided by 16 = .73 V.- EDU — 1 1�' S eitandt
HISTORY +, ` ! ..- • A. 1.l .
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
:uo
■
Page No. 1 CASE HISTORY FOR CASE NO.: SWR96 -0464
CARL KARCHER ENTERPRISES
15520 SW PACIFIC HWY Unit: D '
. 09/16/97
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
SWRA007 Application received / / / / 09/24/96 RECD B 10/14/96 BON
SWRA010 Plan check by / / / / 09/24/96 09/27/96 BON
SWRA070 Ready to issue / / / ,/ 10/14/96 PASS B 10/14/96 BON
SWRA080 (F) Issue permit / / / / 10/24/96 PASS JSD 10/24/96 DST
SWRA705 Sewer Inspection / / / / 11/18/96 PASS TLP 12/26/96 BT2
SWRA720 Case Finaled / / / / 11/19/96 PASS TL 02/24/97 MRS
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