Permit CITY OF TIGARD
PLUMBING PERMIT
DEVELOPMENT SERVICES PE SUED: 10 /3 PLM96 -0486
PARCEL: 2511ODB -00700
SITE ADDRESS...: 15520 SW PACIFIC HWY #D
SUBDIVISION • WILLOW BROOK /TIGARD PROMENADE ZONING: C —G
BLOCK • LOT •10
CLASS OF WORK..:NEW GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE °COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 2
OCCUPANCY GRP..:M FLOOR DRAINS 13 TRAPS : 0
STORIES • 0 WATER HEATERS • 0 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS : 0
SINKS : 2 URINALS : 1 GREASE TRAPS • 1
LAVATORIES • 3 OTHER FIXTURES • 7
TUB /SHOWERS • 0 SEWER LINE (ft)...: 100
WATER CLOSETS..: 4 WATER LINE (ft)...: 100
DISHWASHERS • 0 RAIN DRAIN (ft)...: 100
Remarks: Plumbing permit for a 3,035 square foot Carl's Junior restaurant
Owner: FEES
CARL KARCHER ENTERPRISES type amount by date recpt
800 MELLON AVENUE PRMT $ 396.00 JSD 10/24/96 96- 285691
PLCK $ 99.00 JSD 10/24/96 96- 285691
MANTECA CA 95337 5PCT $ 19.80 JSD 10/24/96 96- 285691
Phone #: 823 -9251
Contractor:
AL'S PLUMBING
665 GREENCREST STREET NE
SALEM OR 97031
Phone #: 503 - 370 -7820 $ 514.80 TOTAL
Reg #..: 095618
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Sewer Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Line Insp
applicable laws. All work will be done in accordance with Top—out Insp
approved plans. This permit will expire if work is not started Storm Drain Insp
within 180 days of issuance, or if work is suspended for sore Rain Drain Insp
than 180 days. Misc. Inspection
RP /Backflow Prey
Final Inspection
Permittee Signature: 49L P9
Issued By: >- (I J &LfJj(4__
Call for inspection — 639 -4175
"Tn ? f_ `(- z7-94, o e'l', 63
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # / ' C
(f
13125 SW Hall Blvd. 0 Permit # MAl(0 OZ$6(,
Tigard, OR 97223 96- pi-i (�
\ Z\e' (503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name of 0avwnem r New Single Family Residences Only
A- 9rs
/ ft /zv
(j' ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
f
Job �'QG/ ❑ 3 BATH HOUSE $225.00
Address cnrsmm s an / Fee includes all plumbing fixtures in the dwelling and the first 100 feet
!�,i ' 7 / g C2,ifj� �, ' of water service, sanitary sewer and storm sewer. See fees below.
Name (« name w Balinese) rf FIXTURES QTY PRICE AMT
-/ 2. ! //r , / /' /'j viA2 -% 74- Sink / 9.00 /23.--
Man Mena
Lavatory . 3 9.00 27 -
Owner ,J r "7 4j�2(d (�T Tub or Tub /Shower Comb. 9.00
f� / no Shower Only 9.00
/ /y� . C� lZ�l, Water Closet , 4 9.00 .
Name c me er bmmlas) . Dishwasher 9.00
�Q', / '/is .L Garbage Disposal 9.00
Occupant ,,,,,,, gym,„ 7� f - �9/ _ � Washing M achine �� 9.00
P O Rey( f� 4 1 9 _ 5 6 " 3 V Floor Drain () T a p 9.00 * a f t " 5 1
aly1Stato L,� �/�JJ lJ Water Heater TT / 9.00 ct -
/1./7a2i1. CA /Zg3.3 Laundry Room Tray 9.00
•
7 t 5 LAM 417 i 1 N� Urinal �' / 9.00 d' -
Other Fixtures (Specify)P66 F Ltrh . .S' 9.00 27
hieing Address Phase ' oo S /r7
Contractor K ��
rl/f eit 9.00 e l-
� d �S(o ( ylo 9f� e s 0 0' ��� 30.00 30
l��
State Registration No. City Ekes. Tax Ne. Sewer - ea. Addit. 100' 25.00
P 0- g? - 106 Water Service 1st 100' / 30.00 -
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authorized agent of
-
the owner, that plans submitted are in compliance with State laws, that Storm & Rain Drain 1st 100' / 30.00 , k)
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit 100' 25.00
number given is correct. (If exempt from State registration, please
' " -- give reason below.) Mobile Home Space 25.00 •
,/ Back Flow Prevention /�
17��C� ���, Device or Anti - Pollution Device .. 9.00
i • nut owner o< agog) , e Any Trap or Waste Not
� y / �i ✓ `, � Connected to a Fixture 9.00
` °scribe work nefrit addition 0 alteration 0 repair 0 Catch Basin 9.00
to be done resi ed l 0 non - residential Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr
Existing use of
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
,�. devices 15.00
Proposed use of
building or property i`e jj'(/ Y ° Pi Ails 3 q a7.0
*(Except residential back low
prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL ?ft BD
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 1 11 ,
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE / C�D
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED I
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK ISi
,,� COOMME � NCED. ,� DI ,, , PLAN REVIEW 25% OF SUBTOTAL .00
CC'V v . G`�✓�W'� c�e ZLl ,l p ISM X 35 TOTAL 51 q AD 10:A .
Special Conditions
Date issued by
Page No. 1 CASE HISTORY FOR CASE NO.: PLM96 -0286
CARL KARCHER ENTERPRISES
15520 SW PACIFIC HWY Unit: D
09/16/97
Action Description Reg/ Scbd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
---- --- -- ------ ---
PLMC003 Application received / / -/ / 09/24/96 RECD JD 09/27/96 BON
PLMC005 Permit Created / / / / 09/27/96 PEND B 09/27/96 BON
PLMC007 Plans routed to Plans Examiner / / / / 09/27/96 PASS B 09/27/96 BON
PLMC008 Plans Approved /Routed to DST / / / / 10/07/96 PASS MS 10/07/96 MRS
PLMC015 DST Post Review Complete / / / / 10/14/96 PASS B 10/14/96 BON
PLMCO50 (F) Ready to issue / / / / 10/14/96 Do not issue until SWR96 -0464 is paid. MEMO B 10/29/96 PHN
SWR96 -0464 issued.
Also need contractor info. Contractor
info rec'd 10- 29 -96.
PLMC060 (F) Issue permit / / / / 10/30/96 PASS B 10/30/96 BON
PLMC120 Plumbing Undersl 10/07/96 / / 11/01/96 yard hydrant not approved FAIL MS 11/04/96 MRS
water service needs to be tested
PLMC710 Water Line Insp 10/07/96 / / 12/12/96 PASS TLP 12/26/96 BT2
PLMC725 Top -out Insp 10/07/96 / / 01/07/97 need to test mop sink FAIL MS 01/08/97 MRS
roof drains need to be tested
req. lateral brazing on vents
PLMC725 Top -out Insp / / / / 01/08/97 PASS MS 01/08/97 MRS
PLMC799 Final Inspection • / / / / 02/10/97 roof drains not approved FAIL MS 02/11/97 MRS
PLMC799 Final Inspection / / / / 02/18/97 coke dispenser piping needs to be PASS MSW 02/18/97 MRS
changed
PLMC800 Case Finaled / / / /. 02/19/97 • PASS MS 02/24/97 MRS
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