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Permit y a CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00362 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/8/2008 PARCEL: 1S134BC-00500 SITE ADDRESS: 12388 SW SCHOLLS FERRY RD ZONING: C -G SUBDIVISION: PP1993 -057 LOT: 001 JURISDICTION: TIG PROJECT: MCDONALDS Project Description: Installing floor sinks: adding (1) 3" and replacing (2) 3 ". CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS; 3 TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES MCDONALD'S CORPORATION 036/0002 Description Date Amount PO BOX 66207 [PLUMB] Permit Fee 9/8/2008 $72.50 CHICAGO, IL 60666 [TAX] 12% State Surch 9/8/2008 $8.70 Phone : Total $81.20 Contractor: HENDRICKSON PLUMBING LLC 212 HABERMAN RD WOODLAND, WA 98674 REQUIRED ITEMS AND REPORTS Contact # : PRI 360 - 225 -5087 FAX 360 - 225 -0917 Reg #: LIC 163351 PLM PB213 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 B Permittee Signature: 25 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. %j Se 0 r.4:27a 5 ami `an c'Ks r / 360- 225-0917 p.1 4, 0,r 1 ( . urn i 1' Permit Application I, 3 G Building Fixtures RECEIVED i'oR of t ICI: l'sl: O\l.l City of Tigard Received D°te . _ Permit No.: P -V 13125 SW' Hall Blvd., Tigard, OR 97223 ���`� �� • ( 14 /3125 Review Phone: 503.639.4171 Fax: 503.598.19E P 3 20C1 Date/By Other Permit No. P'n� 1S-.--CO/3/ Inspection Line: 503.639.4175 �'�/`� T I G .A R U Daze Ready/By: Jta c Ea See Page 2 for Internet: www.tigard - or.gov Noti6ed/Mdhod: 6 Supplementallntarmadon TYPE OF t t' TY OF TIGARD DIVIVI ®� FEE* SCHEDULE ;i' � ❑ New construction V em D t t For information use checklist Description i Qty. I Ea. I Total 5(Addition/alterationlreplacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 249.20 ❑ 1- and 2- family dwelling R(Commercialdndustrial 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. A.) i Page 2 JOB SITE INFORMATION AND LOCATION w Site utilities Job site address: 12_35 5t'J Sc h o 11 .w✓ R Catch basin or area drain 16.60 City /Slate/ZIP: -'- eay.fe O Q 6 ) - ` 423 Drywell, leach line, or trench drain 16.60 Suitebldg. /apt. no.: r Project name: Vic, Dz. nel'(.D , Footing drain (no. linear fl.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 _ OC Rain drain connector 16.60 • , / - / Sanitary sewer (no. linear ft.:1 Page 2 AIM. �o , Storm sewer (no. linear ft.: 1 Page 2 WI ' Subdivision: Lot no : Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: Fixture or item Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 I t'■S-47LiL - 41 v - P1ol.hr .5 t S Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ROPERTY OWNER TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: I 1 . 1 ? j (N(a y.(Qty iM e i (-; Expansion tank 16.60 Address: 151.6 t t4 mrG e Y) b it i -e-if � y Fixture/sewer cap 16.60 City/State/ZIP: - 5 , y � 0 t2 e lob 6 Floor drain/floor sink/hub 3 16.60 ii-lf Phone: ( ) Fax: ( ) Garbage disposal 16.60 ©APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: }�- 1}D2i C�fLSQ� �IL� 1 11/1 k714 Interceptor /grease trap 16.60 Contact name: d a w • i d rt !c k. m i ( Medical gas (value: S ) Page 2 Address: 2 I 2-- 14y» Gt, vi- Primer 16.60 City / State/ZIP: IN OOa c-t vid vg 14 01 pie,1(F Roof drain (commercial) 16.60 • Phone: ( 3 y,0) -2.2_s- 51331 Fax::( ) ZZS 1 Sink/basin/lavatory • 16.60 Tub/shower:shower pan 16.60 E -mail: tip e •Yl j. in arm Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: 11-19"1 Diti a)UbVl ftA(/ii;15 Water heater 16.60 Address: •j L ,yiv t g 1) Other-. City/Stale/ZIP: A)C0C,l( VV ik- ' g67 (It Subtotal Minimum permit fee: $72.50 rn Phone: ( 5,Q) 23 1 5 Fax: (300) 7-2.5 Qf� 17 Residential backflow minimum permit fee: $36•25 '72', ) CCB Lic.: ir' „ „ n 335 ` Plumbing Lic. no.: Pe .Z.I 3 Plan review (25 %ofpermit fee) Authorized signature State surcharge (12% of permit fee) 13, 10 TOTAL PERMIT FEE 8/• Print name: . Jt1ta t ‘01104, Date: 9" 3.Og This permit application expires if a permit is not obtained within 180 days after it bas been accepted as complete. •Fee methodology set by Tri County Building Industry Service Board. I ;\ Iding Wermiti ?PLIAF- PermitApp.doc L2/27/06 440 46161(10'02ICOStWEB) CITY OF TIGARD - _ . B 1 UILDING DIVISION PERMIT #: PLM2008-00362 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/8/2008 Phone: (503) 639 -4171 a �� � (Ii Inspection Requests (24 Hrs.): (503) 639 -4175 -' INSPECTION WORKSHEET FOR DATE: 9/19/2008 TIME: 7:00AM PAGE: 8 SITE ADDRESS: 12388 SW SCHOLLS FERRY RD CLASS OF WORK: SUBDIVISION: PP1993 - 057 LOT #: 001 TYPE OF USE: PROJECT NAME: MCDONALDS DESCRIPTION: Installing floor sinl: adding (1) 3" and replacing (2) 3 ". OWNER: MCDONALD'S CORPORATION, PHONE #: CONTRACTOR: HENDRICKSON PLUMBING LLC PHONE #: 3E0- 2255087 Inspection Request Scheduled For: Date: 9/19/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 075697 -01 360.798 -0268 N Corrections /Comments /Instructions: C 01/4- i.e._ c) PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: L 11-&—A1M,. -- Date: 42. I I- °k. \, 0 (' Phone #: (503) 718- _ 4 CITY OF TIGARD _ . BUILDING DIVISION PERMIT #: PLM2008 -00362 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 988/2008 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 4J1 INSPECTION WORKSHEET FOR DATE: 9/11 /2008 TIME: 7:00AM PAGE: 5 SITE ADDRESS: 12388 SW SCHOLLS FERRY RD CLASS OF WORK: SUBDIVISION: PP1993 LOT #: 001 TYPE OF USE: PROJECT NAME: MCDONALDS DESCRIPTION: Installing floor sinls: adding (1) 3" and replacing (2) 3 ". OWNER: MCDONALD'S CORPORATION, PHONE #: CONTRACTOR: HENDRICKSON PLUMBING LLC PHONE #: 360 - 225.5081 Inspection Request Scheduled For: Date: 9/11/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 305 Plumbing underslab 075375-01 360- 907 -7348 N Corrections /Comments /Instructions: r X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: (� 1 _ ..j 1 J ' — Date: °I (1 l 1 °c) Phone #: (503) 718- CITY OF TIGARD - . BUILDING DIVISION PERMIT #: PLM 00R 003(;2 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/8L008 Phone: (503) 639 -4171 11 Inspection Requests (24 Hrs.): (503) 639 -4175 !� IL. INSPECTION WORKSHEET FOR DATE: 9/11 /2008 TIME: 7:00AM PAGE: 4 SITE ADDRESS: 12388 SW SCHOLLS FERRY RD CLASS OF WORK: SUBDIVISION: PP1993 - 057 LOT #: 001 TYPE OF USE: PROJECT NAME: MCDONALDS DESCRIPTION: Installing floor sinks: adding (1) 3" and replacing (2) 3 ". OWNER: MCDONALD'S CORPORATION. PHONE #: CONTRACTOR: HENDRICKSON PLUMBING LLC PHONE #: 360 - 225 -5087 Inspection Request Scheduled For: Date: 9/11/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough-in 075377 -01 360 - 907 -734B Y Corrections /Comments/ Instructions: \ PASS 111 PARTIAL APPROVAL 111 CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 67 k►d- -' ( i 1 t PA Date:'' I / J O P) Phone #: (503) 718-