HomeMy WebLinkAboutPermit (8) CITY OF TIGARD PLUMBING PERMIT
III COMMUNITY DEVELOPMENT Permit#: PLM2023-00383
Date Issued: 8/31/2023
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9499 SW WASHINGTON SQUARE RD A01
Project: Shiekh Shoes Subdivision: None Lot: None
Project Description: TI for new tenant: Relocate/replace(1)drain,(1)primer,(1)sink,(1)water closet,(1)water heater.
Contractor: MODERN PLUMBING Owner: PPR WASHINGTON SQUARE LLC
11120 SW INDUSTRIAL WAY BY MACERICH RET
TUALATIN, OR 97062 PO BOX 4085
SANTA MONICA, CA 90411
PHONE: 503-691-6166 PHONE:
FAX: 503-691-6771
FEES
Quantity Description Date Amount
ea Floor Drain/Floor Sink/Hub 08/31/2023 $25.02
Specifics: 1 ea Primer 08/31/2023 $12.51
ea Sink 08/31/2023 $25.02
Type of Use: COM 1 ea Water Closet 08/31/2023 $25.02
Class of Work: ALT 1 ea Water Heater 08/31/2023 $37.52
Type of Const: 1 12%State Surcharge- 08/31/2023 $15.01
Occupancy Grp: Plumbing
Stories:
Total $140.10
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 952-001-0090. You may obtain a copy of the rules
Issued By: Permittee Signature: s?t%e C 6 e 6'
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
t •
Piumbine Permit ApplicailiECEIVED
Building Fixtures AUG 3 1 2023
Received 3t ?3 : 0 Pe^ , 0-0. - t,x 3g4
_ City of Tigard Darn/Res
■ Bone S50}.71 Blvd.,Tigard,OR 97 Ty OF TIGARD Plan Review Other Permit No.:
Phone: on Lin 8.2439 Fax: 503.59jp71 fi Date/BY: funs: @Sea Page x for
Inspection Line: 503.639.4175 OV ING DIVISION Dole Reedy/By: '}, 'Q Sup ee Page 2l foInrormation
T I G A R D Internet: www.tigard-or-gov Notified/Method: I I�gar�., t//�✓y1�7
__... _. dUI .C( n(Ifq SCHEDULE
TYPE OF WORK
❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
■Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70437.78
SFR(2)bath
❑1-and 2-family dwelling IIICommercial/industrial SFR(3)bath 500.32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler(_sq.ft-) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
' ycL Catch basin or area drain 18.76
Job site address:gf.ILlq Sy) �`t Qd 1 S le AO I Drywall,leach line,or trench drain 18.76
City/State/ZIP; ` A DR. 9 �-D� 1 Footing drain(no.linear R: 1 Page 2
Suite/bldg./apt.no.: ate! I Project name: C1... %N S{'f '�j Manufactured home utilities 50.03
Manholes 18.76
Cross street/directions to job site: 18 76
Rain drain connector
Sanitary sewer(no.linear ft.: Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: Backwater valve 12.51
• DESCRIPTION OF WORK
s Clothes washer 25.02
d,e,-„�'110 1 �� �'1X�Q.Hi �(V Rsj'���� Dishwasher 25.02
- PI ANS SP?ESE$ A D P� Drinking fountain 25.02
Ejectors/sump 25.02
1 Expansion tank 12.51
0 PROPERTY OWNER 0 TENANT
Fixture/sewer cap 25.02
Name: Floor drain/floor sink/hub f 25.02 .2 c.152.
Address: Garbage disposal 25.02
City/State/ZIP:
Hose bib 25.02
I}
Ire maker 12.51
Phone:( ) I Fax:( )
Interceptor/greasetrap 25.02
❑ APPLICANT 0 CONTACT PERSON
Medical gas(value:$ ) Page 2
Business name: Printer / 12.51 125i
Contact name: Roof drain(commercial) 12.51
Address: Sink/basin/lavatory ' 25.02 .25 rt1G..
City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) I Fax::( 12.51
) Tub/shower/shower pan Urinal 25.02
E-mail: Water closet 1 25.02 2.cti7
CONTRACTOR Water heater i 37.52 _37.Q-
s� !
Business name: 1/et ThAinp4Water piping/DWV 56.29
Other: 25.02
Address: I
Subtotal fax�y
City/State/ZIP:.�u�yLAn p� 9-7 D 1�
Minimum permit fee: 572.50�7�pff
Phone:(�7j) I - L�(O Fax:(g3)iq(-to-1� ( Plan review (25%of permit fee)
O f
CCB Lie.: !j' Plumbing Lic.no.:3 j-, FJb PF State surcharge(12%of permit fee) /5i /
Authorized signature: � �)„[„_ TOTAL PERMIT FEE ?(�
Lek
_ This permit application expires if a permit is not obtained within ISO days
Print name: j�(�f NJ f` �}'ri61�� I Date: ^ `d']� I after it has been accepted as complete.
/'�-l *Pee methodology set by Tri-County Building Industry Service Board_
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