Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2009 -00339
T f d A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/25/2009
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9595 SW WASHINGTON SQUARE DR B12
Subdivision: Lot: 0
Project: True Religion Blue Jeans
Project Description: Replace existing fixtures.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 1 ea Floor Drain /Floor Sink/Hub 11/25/2009 $25.02
1 ea Lavatories 11/25/2009 $25.02
PHONE: 1 ea Water Closet 11/25/2009 $25.02
1 ea Water Heater 11/25/2009 $37.52
Contractor: 1 12% State Surcharge - 11/25/2009 $13.51
POWER PLUMBING CO Plumbing
PO BOX 19418
PORTLAND, OR 97280
PHONE: 503 - 244 -1900
FAX: 503- 244 -8825
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $126.09
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 Notific er. 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 estions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: / / Permittee Signatur -•
L
L i�iL� -ALL is - �
1/
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.
NOV /24 /2009 /TUE 12:27 PM POWER PLUMBING FAX No, 503 244 8825 P. 001
. 1.. ,
' Plumbing Permit /` lo Applicati • o l` 1 co
' DECEIVED 1
u' ding Fixtures ag ' e p m t ' _'` C1rrI .L C ' l�Ni Y o s a�
ist._- City of Tigard N0V 2 4 2009 D / �bI 02 Permit No.: . gee 9..0035
6 4 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.6 39.4171 Fax: 503598 OF TI GARD DaWSY. o'h° Permit No -
Inspection Line: 503.639.4175 Date Ready/13y: ld See Page 2 for
ig'il=iii Internet: www.tigard- or.gov : • ING DIVISION Notifid/Metbod: FM Su, pleruents] information
:r��c -a� �, ,�•^a ���} tq � yF -:,.- a�0: t z i_�. u �.`' r ." "'lr.� ..
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❑ New construction 111 Demolition
For S • ecla! in 'motion use checklist
IF Descri.tion 0 - -. Total
i' Addition/alteration/rtplacement ❑ Other; . m.,.2 , .• M New 1- 2- family dwellings (includes 100 ft. for each utility connection)
'1,51 , r w- �t y lr ni . ; .G eter fr i n lIc �r A ,q . .4- SFR 1 bath
.° z4 �.. M �,,, _ • .,r ; () 24920
1 ❑ 1- and 2 - fsxraiy dwelling Co mmercia)/industrial SFR (2) bath 1111 350.00
ID Accessory building ❑ Multi - family SFR (3) bath 399.00
Bach additional bath /kitchen 45.00
❑ Master builder ❑ Other:
' �A at ro r7� 1 n� "•; i n :E r, u,, c o " Fire sprinkler � sq. R) Paget
? r: Site utilities
Job site address: kit basin or area drain 16.60
Cit /State/ZIP: (�Q Drywall, leach line, or trench drain 1660
. Suite/bldg. /apt. no.: v z Project name: ■ • a l r y f Footing drain (no. linear ft: ) _ Page 2
Cross street/directions to job site: T'r a .A tit Z _ .� . Manholes home utilities 116.60
r / /'l�L , Menholea 16 -60
I. l ,(_ / V L / ,/ tat- Gi-i� , Rain drain connector 16.60
Sanitary sewer (no. linear ft: ) Page 2
Storm sewer (no. liriPar ft.: ) MI Page 2
Subdivision: Lot no.: Water service (no. linear ft: �) Page 2
Fixture or item
Tax map /parcel no
gyp^ .w,u L'Y b�. - L"VLl m , w• e: ,
.u xa ra;:ucax,t i Absorption valve 16.60
lf, L r�Frof ',�- ;,u��.: �� „ :,�,,,•:.w �aitit:: �. . Paolelowprwenter e2
Pa
Watu- oS4 g
[A.. ■ u r 1 / �� Bac kwa ter valve 16 -60
I / 2 L m U V Clothes washer 16.60
here f, / ! e /Jr5
Dishwasher 16.60
„ M ; my a ` is 1 a ae mr r r a -. ¢ T „. gis "r Drinking fountain ME 16.60
i�1 (u.. LS ' , ` .:S 0.13 " ,..194W..! Ejectors /sump
Name 16.60
Expansion tank 16
-
Address: Fixture/. ewer cap 16.60
City /Statc/Z1P: [Floor drain l t oor sink/hub ill. 36 60
Phone: ( ) Fax: ( ) e Garbage disposal 16.60
iFi hT"�' �- * �rl ..�1 I�i� LI(G'.<, �N mt' .". 1 "r �.rtQ . �(j* , I i,� , >. rU 4; ;1, -:: I Hose bib 16.60
r'.F.a-'rr' 5112t k? ye i 1,1 %RSd Y t� a • .^' ' •....a -''' a Ice maker _
1 Business name: i',0 1 t u,,,,-7,5,4 O 16.60
lntetoeptAr /grace t rap 16.60
Contact name: (." ra fir 2h-,ef Medical gag (value: $ ) Page 2
Address: p/ 411., y / q 41 r Pruner 16.60
City /State/ZIP: lb oulAd 44 --L P ov£ draixx (a e, ercial) 16.60 y� 02 -
iavato � 16 -60 I .s . tr .
Phone: (yp . ) a / / (, Fos.:: cc r.3) o Zy ��� Tub /shower /shower pan 16.60
E-mail r-'- Urinal 16.60
�, .. ,w ., u „ „, w,. ruff.
c,' } 08511„ '. '` ° 5 * ' Ai ::ie; . d l ,11 Water closet 16.60 , ,, �1.J ( 9 5 S
Business name: Q .e,. ' s //. r (.!J - Water heater 1-
16.60 �..It/1 3 ,
Address: / / ,5 Id j]� ` Other
City /State /ZIP: `� `1L . • ' 1 / Z Subtotal (
Minimum permit fee: $72,50 -, 1 11..
Phone: (9j) a. yl., -1geo Fax: (5b3) .17 ED"--S- Residentialbackflow minimum permit fee: $36.25 I- • �•
v
CCB Lic.: ` j 2 e. Plumbing Lic. no,: I gV 1. � Plan review (25% of permit fee) r^ '1
State surcharge (12% of permit fcc) Z.. 15.
Authorized signature: S TOTAL PERMIT FEE ry
D ate: This permit application expires if a permit 55 not obtained within 0 Print name: L {� Q S Id el P PP P P n
/ 180 days after it has been accepted as complete. / P i1
*Fee methodology set by Tri- County Building industry Service Board
IA BuilOinTerwitaLW PeCaltAyy doc 12/27/06 440 -06163-(10102/coM/wEB)