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Permit 1 ,7/o / CITY OF IGARD PLUMBING PERMIT v COMMUNITY DEVELOPMENT Permit #: PLM2009 -00270 T t G AkRD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/30/2009 Parcel: 2S102CB02600 Jurisdiction: Tigard Site address: 13066 SW PACIFIC HWY Subdivision: Lot: 0 Project: RODNEY'S STEAK & BBC) Project Description: Cap (4) 2" floor drains, and (1) lay. Install (2) 2" floor drains, and grease trap. Replace existing dishwasher, ice machine, (2) lays, a commercial sink, and a service sink. Owner: FEES WALTER, ANGELA D Quantity Description Date Amount 2863 RIVERWALK LP EUGENE, OR 97401 1 ea Dishwasher 09/30/2009 $16.60 PHONE: 5 ea Fixture /Sewer Cap 09/30/2009 $83.00 2 ea Floor Drain/Floor Sink/Hub 09/30/2009 $33.20 1 ea Ice Maker 09/30/2009 $16.60 Contractor: 1 ea Interceptor /Grease Trap 09/30/2009 $16.60 WESTERN PLUMBING 2 ea Primer 09/30/2009 $33.20 9460 SW TIGARD, AVE STE 101 4 ea Sink 09/30/2009 $66.40 TIGARD, OR 97223 1 12% State Surcharge - 09/30/2009 $31.87 PHONE: 503 - 639 -5296 Pla 1 Plan n R Re g eview 03/16/2010 $66.40 FAX: 503- 684 -9015 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $363.87 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Uti• • ' otification Center. • • - les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100 • - •• • y obtain a copy of the rules direct questions to OU b al n. 503.246.6699 or 1.800.332.2344. • Issued By: / �4 /i �/ /, Permittee Signature: ' 7 • Call 503.639.4175 by 7:00 a.m. for an inspection that busi s day. This permit card shall be kept in a conspicuous place on the job si - • til completion of the project. Approved plans are required on the job site at the time of each inspection. t CITY OF TIGARD PLUMBING PERMIT �'7 s • " COMMUNITY DEVELOPMENT Permit #: PLM2009 -00270 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/30/2009 Parcel: 2S102CB02600 Jurisdiction: Tigard Site address: 13066 SW PACIFIC HWY Subdivision: Lot: 0 Project: RODNEY'S STEAK & BBQ Project Description: Cap (4) 2" floor drains, and (1) lay. Install (2) 2" floor drains, and grease trap. Replace existing dishwasher, ice machine, (2) lays, a commercial sink, and a service sink. Owner: FEES WALTER, ANGELA D Quantity Description Date Amount 2863 RIVERWALK LP EUGENE, OR 97401 1 ea Dishwasher 09/30/2009 $16.60 PHONE: 5 ea Fixture /Sewer Cap 09/30/2009 $83.00 2 ea Floor Drain/Floor Sink/Hub 09/30/2009 $33.20 1 ea Ice Maker 09/30/2009 $16.60 Contractor: 1 ea Interceptor /Grease Trap 09/30/2009 $16.60 WESTERN PLUMBING 2 ea Primer 09/30/2009 $33.20 9460 SW TIGARD, AVE STE 101 4 ea Sink 09/30/2009 $66.40 TIGARD, OR 97223 1 12% State Surcharge - 09/30/2009 $31.87 Plumbing PHONE: 503 - 639 -5296 FAX: 503- 684 -9015 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $297.47 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: l - r� -_ ll L Permittee Signature: ^ r vC �• Q "" Call 503.639.4175 by 7:00 a.m. for an inspection that business day. J J I(�J 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. ' 09/ 29/ 2009 16:51 5036849015 WESTERN PLUMBING INC PAGE 01/02 Plumbing Permit ApplicatioRECEIVED FOR Oil CE USE ONLY . City of Tigard Received A PatnaitNo.: 1 P1 2nC) . 00.2710 11 fir 13125 SW Hall Blvd., Tigard, OR 972235 EP 2 8 2009 Date/By: c,-- y- Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Other Permit No.: A nn Inspection line: 503.639.4175 OF TIG' D ate/ 8y: T ► C; Al' n Internet: www.tigard- or.gov . CIT a ■ 0 VISION Notifed/met od: fe: Pate 2 for 7h y r f ! . :.�� • a r ^ ti \. P :: ; e- ADD eOtf1 mi! Oto7 ••, v ;, , F J r'{'• 'i va ,. p t .,• . , ., .-C , 1;'`"C ; -l i r . l ( i41 1 tr , $ , H I r ^Ir El New construction • ❑ Demolition For spedal igjormation use checklist 1; Addition/alteration/replacement 0 Other Description Qty. Ea Total New 1 - 2- family dwellings (Includes 100 R for each utility M r SFR (1) bath 24920 ❑ 1 -and 2- family dwelling D: Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi-family SFR (3) bath 399.00 ❑ Master builder ❑Other: Each additional bath/kitchen 45.00 , r , , -, y , < w Fire sprinkler ( sq. it.) Page 2 1 ..... rr. t, .....,M..,...., . .:..».. � :.u , !"„ 1 , - ,'' -. u ,. 4� °i. } , got : .:. �. .. ,. ,1, .: S gt d . .. l... Catch basin or area drain 16.60 City /St ,S a, • • �j�1r Drywell, leach line, or trench drain 16.60 • Suite/bldg. /apt. no.: 4. .�. I Footing drain (no. linear ft.: ____) . Page 2 Cross street/directions to job sic: Manufactured home utilities 1 10.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: _J Page 2 Storm sewer (no. linear ft.: _) Page 2 Subdivision: ` Lot no.: Water Vice (no. linear ft.: ) Page 2 Tax map /parcel no Fixture or item � . r r ' r Absorpdon 16.60 ' y I, s Y r , • ,u r.. t ^: l t 1 i Zt il` iii - ,,., „ ,,•f , , ,: .:.:.... , :.. , b ........ Baek9owpreventer Page 2 Backwater valve _ 16.60 ere ., %I wi .:II1.J.111. Clothes washer 16.60 u1,: r , c , J) "a r r xx ti . �. , 7. , -r f - 1 r f C .. . f , r Drinking fountain e 16.60 f ( c) 2 6 60 f + 1 .; c .. !,- ",, :.: ,.a. . . ..: .. , - 7': - . ri ' ... - :, : .. . L v .. _.;;._. f , , Ejectora/sump 16.60 Name: ill ci f : if 1.. 1. • Expansion tank 16.60 -.l`. . . _ :' . i. :. ` 0,1a N Fixture/sewer cap 5 16.60 1,33 o CC'S City /State-/ZIP: _ t.' A o IV • a.la Floor drain/floor sink/hub 2- 16.60 a x,C • 1 i Fax: ( ) Garbage disposal 16.60 `' - , Fr ` , r� f , '`' � ,'S. 7 Ti ' z a 7; `{ , 7 . , 5 Hose bib 16.60 •, '''''',./•-i _ . 1 16.60 I & 4 GO _a�:u � .. .., :e, <r.. � _ ,.. .._ Ice maker Business name: _ Interceptor /grease trap I 16.60 ! iw h Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 . 23 °24" City/StatetZlP: Roof drain (commercial) 16.60 _ Sink/basin/lavatory 16.60 - Phone: ( ) I Fax : : ( ) y - 6j1�A Tub/shower /shower pan 16.60 E-mail: Urinal 16.60 7u F , , y , l ' ' Wafer c 16,60 .ac�?,.1.'. w,.�2.:,;:. , „. {� .. ,. _.rti �✓ .a: � ;. r - ., .d:m S,. , > - . ,..a, ._ �. , .:.L r;:;� Business name:. Western Plumbing, Inc. Water heater 16.60 Address: 9460 SW Tigard Avenue, Smite 101 City /State/ZIP: Tigard, Oregon 97223 Subtotal Minimum permit fee: 572.50 Phone: (503) 639 -5296 Fax: (503) 684-9015 Residential backflow minimum permit fee: $36.25 CCB Liu.: 2439 Plumbing Lie, no.: 3429F13 Plan review (25% ofpermit fe State surcharge (12% of permit fee) . Authorized signature 1 1 TOTAL PERMIT FEE atm, I Peat name: Dana Jensen Date: -,..cR - 1 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-Coturty Building Industry Service Board. r : Sw1°tnAPamiaPLM,Pewl6App•doo oa'26106 440- 46161•(taie2JCOA1/wnB) % k).1( 0oder3 . _ -09/29/2009 16:51 5036849015 WESTERN PLUMBING INC PAGE 02/02 Plu Permit Application - City. of Tigard Page 2 - Supplemental Information Fee Schedule: • Residential Fire Su . 1 ression S stems: ;� F 5 l,.lS ii I 7 � ` 11 �Irr ... r +i I :;j itt 7 r r - - 2.., Y r ' \., y r g -r+ Footing drain - l 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional •100' 46.40 001 to 3 600 $160.00 3 601 to 7 200 $220.00 Sower - 1st 100' 55.00 • Sewer - each additional 100' 46.40 7 01 and , $309.00 Water Service - 1st 100' 55.00 Medical Gas S stems: Water Service - each additional 100' 46.40 r S „h , • >� 9 i . .... . u.a �. 4 J �. r ].C Fd. �..; 9 - ... .w . _ .S,. Y -rc ' '' _.: 5. -.m}, ..!..:.(... 4 Storm & Rain a Drin • 1st IUU' 55.00 -- $100 to $5 000.00 Minimum fee $72.50 Storm & Rein Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 fbr each t J "� :j s'. r �1 F; t J I , additional $100.00 or fraction thereof: to and r - r"s. .. .., ,. ,,, . . ... includin: $10 000.00. Commercial Back Flow Prevention Device 1111.11 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 minimum it fee $36,25 and includin_ $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 thaw to s' fall re • =red ins' actions • ' er hour 72.50 and includin _ $50,000.00. Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and for each additional $100.00 or fraction thereof. • Fixture Work: x : } ' , -' ' , x 7/ Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following please indicate work performed by fixture. Failure to Please check all that apply. accurate) re' ort Mures could result in increased sewer fees *. © Any new commercial building with water service 2" and cr n r I + �r cater except systems designed and stamped by licensed } � , 1 `_{,,,e, S / : y , i P 1' ' Si r -^.' r 1 + : .f _ ' , d5 ? greater, Y O "" }1 ti'J P r 4 Ai J I + . ',- f n ` I .r. - 1 , r ,t v J I ',■, , engineer. � r _ ` , 'J C . )' `;" 1.. ❑ Any new exterior plumbing site utilities. B. ' /Font -� - ❑ Medical gas and vacuum systems for health care facilities. Bath -Tub /Shower - - -MINN. -Jacuzzi/Whirl ...I - -_ . � ' Any multipurpose fire sprinkler System. Car Wash -Each stall - - ❑ Any complex structure as defined in OAR91 ti -75O -0040. -Drive Thru - -- x ;a +i?�: r�i;�i.)1[ •J - - -_ Submit 2 sets of plans with any of the above. Dishwasher - Commercial - -` =MIN • r r. �Y l ` i 17- M'M Dnn1aI1: Fountain -Domestic � L I .. . .. r r;s,J ,, ' � 1e19 ! p . - 7 , i , r 4 f o } J, ,. J ,, - i _ i + - - -_ ❑ Isometric or riser diagram is required for new buildings Floor Drain/sink - 2 • `iitilMliFil that meet the ualifcations above. - 3° - - -- - 4 " MIEN Comments regarding fixture work: • Car Wash Garbage -- DomesticDrain = =�� /4 - ,'� i � �i.ed� //✓/s✓Sl �`' FzaoR DR.4o Disposal - Commercial MIIIIIIMIN -_ 1,1 H4tv0 W464 R ice 04/ eA7.97 jDt/4 - Industrial MIIIIIIIIIIIIIIIIIIIIIIIIII Rou6Ai /N- j D amR ZAIt M#c.$ ]E lee Mach./Refri :.Drains IM 2 H4e0 '//<5 ) 2 MOP .5 ft PRE Rtiveg" Oil S. arator Gas Station 6 mi l< a 130E1_2- ° I FE.I' agti'l/ /K5 t j 6t26,11e Rec. Vehicle Dum' Station riZAP Shower 'rang IIIIIIIIIIIIIIIIII IIIIIIIIIIII *Note: If fire fi won under this permit results in an -sta. ���� t P Sink - Bar/Lavatory �IMIM �� � increase of sewer EDUs, a sewer permit will be issued and - Bradley fees assessed for the sewer increase must be paid before the - Commercial � � I plumbing permit can be issued. - Service �� �M Swimmin: Pool Filter -� Washer - Clothes - -_- Water Extractor 11111111111111111=111 Water Closet - Toilet • Urinal ' - 111111111•11111111111111111111111 Other Fixtures: 6: j,., . .: r.=illIllIll..lnIIMI - ,. ., vs .'ildinewcrmitetew- Nrmit,pp,doc 0922/06 This form is recognized by most Building Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. BUILDING DIVISION TIGARD TRANSMITTAL LETTER a TO: a r 0_ DATE RECEIVED: DEPT: BUILD DIMS N N Oti `II\t d1.I c o 011A FROM: r / ti / I;nra COMPANY: e _, Jr W, / (I PHONE: -g)5 BypJ RE: l to w tO t - wY ki(aOO- 004970 (Site Address) (Permit/Case Number) 'rode. name or su..'vision name an. of num.er ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and /or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): REMARKS: E_C t t EE 5 [. -.A-t& C (? 1 E L3 - FOR OFFICE USE ONLY Routed to Permit Technician: Date: Initials: Fees Due: ❑ Yes ❑ No F e escription: Amount Due: PLAa„/. ) Lai 4 $ (ale •y $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: l: \Building\ Forms \TransmittalLetter - Revisions.doc 4/4/07