Permit I, h " CITY OF TIGARD PLUMBING PERMIT
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` : COMMUNITY DEVELOPMENT Permit #: PLM2010 -00007
T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 01 /07/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9677 SW WASHINGTON SQUARE DR CO5
Subdivision: Lot: 0
Project: Aeropostale
Project Description: Replace existing lav, w /c, and w /h.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 1 ea Lavatories 01/07/2010 $25.02
1 ea Water Closet 01/07/2010 $25.02
PHONE: 1 ea Water Heater 01/07/2010 $37.52
1 12% State Surcharge - 01/07/2010 $10.51
Contractor: Plumbing
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062
PHONE: 503 - 691 -6166
FAX:
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $98.07
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: Permittee Signature: _ / .ez._/ /
/4 .—eall...r If -M.: 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.
Jan. 5. 2010 12:45PM Modern Plumbbing No. 7812 P. 2)/
•'Plumbing Pern E CEivED Applicati
Building Fixtures '),N p a; r' . C I (t�-4111 It 1:,,1 ti[ (•)\1 1 *. 4
.11 y )l " r`•:
JAN Received
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a AN 0 5 2010 City of Tigard R O� Permit No.: f • -7
"' H Date/By: J •
� 1 ` f v 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
n . ^- _ _^ ^'^
A, E1 Phone: 503.639.4171 Fax: 503 OF TIGARD 1 I)ate�y: Other Permit No.: Y( �'{ (� �(
Inspection Line: 503.639.4175 B UILDING DIVISION D ate Read /B Ju • � ® Se Page 2 for
f 1
. li , n R!I)1 Ready /By: II
Internet; www.tigard- or.gov Notified/Method: i�-? Supplemental information
TYPE OF WORK FEE" SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty, 1 Ea. 1 Total
(► - ddition/alteration/replacement ❑ Other: New I.2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) batty 312.70
❑ 1- and 2- family dwelling SP/ ommcrcial /industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( , sq. ft.) Page 2
JOB SITE 'INFORMATION AND) - TC LOCATION Site utilities:
Job site address: q Ip r) r- ) ,1,04 I
j �, I'itg ri, 55 Rd, Catch basin or area drain 18.76
CitylState/ZIP: G� /' ^7 Drywell, leach line, or trench drain 18.76
J � /_ Footing drain (no. linear ft: ) Page 2
Suite/b1dgiap1. no.: Project name: e„,,..- v i� 0 tiS 7at-K� Manufactured homc utilities 50.03
Cross street/directions to job Site: Manholes 18.76
)11b4 -19-S (. / 1 iI d-e t 4^`/ "e Clain drain connector 18.76
Sanitary sower (no. linear ft.: ) Pagc 2
( el' ' Storm sewer (no. linear ft: ) Pagc 2
Water service (no. linear It,: ) Pagc 2
Subdivision; [Lot no.: Fixture or item:
Tax map /parcel no.: Backdow preventer 31,27
DESCRIP'T'ION- OF WORT{ • Backwater valve 12,51
Clothes washer 25.02
!°.,_a " f rm,r6 /e Dishwasher 25.02
EdI rPe 7c ithr C Drinking fountain 25.02
U t r gyp.., - Ejectors/sump 25.02
❑ PROPERTY OWNER • ' ' • ' ' ❑ TENANT Expansion tank I2.51
Nye Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City /State /ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Tcc maker 12.51
. ❑ , APPLICANT • ` 0 CONTACT.. PERSON Interceptor /grease trap 25.02
Business name:
Medical gas (value: $ ) Pagc 2
Primer 12.51
Contact name: Roof drain (commercial) 12.51
Address: Sink/basin/lavatory / 25,0250 d
City /State /ZIP: Solar units (potable water) f 62,54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E-mail: Urinal _ 25.02
. Water closet / 25.02 2 S , 0 a
. CONTRACTOR' '' •
• / Water heater l _ 37.52 3 7.5D.
Business nam �alP, rLYt /0Y7/1.6) g/D
P�P Watcr t in WV 56.29
/
Address: (l / r}d 5/4) . • ` ` r- Other; 25.02 r
City /State/ZCP: 77,_,.6„,"-_,„, r 0 I q 7 d L" Subtotal I g •7
( 3 6o q ` 6 " f6 3 t 9 , - 6 Minimum permit fee $72.50
Phone: / Fax:
Plan review (25% of permit fcc)
CCB Lie.: i Y) - Plumbing Lie. no.: / if , - State surcharge (12% of permit &c)
Authorized signature TOTAL PERMIT FEE 4 03
Print name: ,MAASI , . Date: This permit Application expires it a permit is not obtained within 180 days
- ar +
► after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
t! nuilding1PermitslPLMU- PermitApp.doc 10/01/0 440.4616T(10 /O2.1CObr/WE9)
CITY OF TIGARD " I sue'"` r-15 1
PL /C -e)0,07
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 /em ill i�I �
Inspection Requests (24 Hrs.): (503) 639 -4175 f__I
INSPECTION WORKSHEET FOR DATE: - 7/Z // U TIME: PAGE:
SITE ADDRESS: / A CLASS OF WORK:
SUBDIVISION: L #: TYPE OF USE:
PROJECT NAME: CO c
DESCRIPTION: .
OWNER: PHONE #57c `33 7
CONTRACTOR: PHONE #: /_ 9 t _ / , G /
Inspection Request Scheduled For: Date: d e/ - o / Pour Time: .
DI • /
Code # Inspection Description Confirm : Contact # Message
74 p/A.A.,..._(,,, .4„...,/,
Corrections /Comments /I structions:
1 , F 1 .. ,
I - 2-6 - do E v v ,p,_, 3 ,
iT" ' -- ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL n , FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date:3/ /v Phone #: (503) 718- 2-4-2—cr