Permit - CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2011 -00053
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/16/2011
Parcel: 1512 6CC00100
Jurisdiction: TIGARD
Site address: 9700 SW WASHINGTON SQUARE RD
Project: Nordstrom Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: Install new grease trap. No change to EDU's.
Contractor: TAPANI PLUMBING Owner: PPR WASHINGTON SQUARE LLC
PO BOX 2350 C/O NORDSTROM
BATTLE GROUND, WA 98604 ATTN: TAX DEPT
PO BOX 2229
SEATTLE, WA 98111
PHONE: 360- 687 -3983 PHONE:
FAX: 360- 687 -4494
FEES
Quantity Description Date Amount
1 ea Interceptor /Grease Trap 02/16/2011 $25.02
Specifics: _ 1 12% State Surcharge - 02/16/2011 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment - 02/16/2011 $47.48
Class of Work: ALT
Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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 N i ion ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir questions to OUN • •y calli . 03.232.1987 or 1.800.332.2344.
Issu By: 4 / , Permittee Signal
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.
02/15/2011 15:22 3606666697 TPT PM FAX PAGE 02/02
Plumbing Permit Application
Building Fixtures � FOR OFFICE USE ONL;i'
City of Tigard Received
Dat P
ay: / /5 f/ , Permit �
57223 = D 1L 2
13125 SW Hall Blvd., Tigard, OR 201 ����� �tC5
111 .
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.:
inspection Line: 503 CITY OF TIG :RD Pogo x for
'1'.l 6 /t iL P) }, • Date Ready/By: Jails: ®See Pa
Internet: vwtw.tigard or.gov r'i 11 min., ra„,„ Notified/Method: Supplemental Information
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w;.k r '''' + J y.+t'!cs`a.` " O,V i u ,i"P; r' �.� A i •�.,.1�«_1, iA�'�.; ln:�F.i•h i:, k(+.t� f., ;., ∎.'k •f` atkR.:• ' 4T Jrd k7 °w. "" 'eSzVizztzfa "L�' agiL a ^Pi W lI 1,9?M : 5 {•I,,.1`.h.' ,,,:;, C:d:.. ...,..r u.�'_ _,� « ..... .:,; :o..waat b,:z.- ..
❑ New construction ❑ Demolition For special information use checklist
Description _ Qty. i Ea. I Total
K Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
ti . i0 .W Ji.E7 .f' tail ;P`'r� ?a, r c P �',:. �r �'§""'s z� '' J SFR (1) bath 312.70
❑ I- and 2- family dwelling IFI, Conunercial/industrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi- family SFR (3) bath 50032
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: ""
�?�. ��,� re +g� �&.P� F G Fire sprinkler (_ sq. ft.) Page 2
s" .' iV r'; , h` y r 3 \; F :• r Site utilitles:
5 L N C 1E01 • 2-1- Catch bash or area drain 1.8.76
Job site address: 9 0. () t�/ASMZNtq f yr 1 �I9.I 1=�
City / State/ZIP: _ Drywell, leach line, or trench drain 18.76
I R 2 D 412 7 zz 3 Footing drain (no. linear ft.: )_ Page 2 •
Suite/bldg. /apt. no.: C, Project name: N 0 ty Ds-7 IA". Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.70
fi 5h" l ( nJ 5 ,c-i: +4 u Rain drain connector 18.76
-
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:
Tax map /part el no.: Backflow preventer 31.27
�s� _ i. a � t ° : t `e7 , .n . a Xz � . , c r t : ± x a. , , , . ,•.• Sackwatcrvalve 12.51
ll � � ! r � Cloches washer 25 -02
Ai. ,..) 0/ g_ tkiz - i ,e_4P Dishwasher 25.02
Drinking fountain 25:02
Ejectors /sump 25.02
_ m AS "r > ° i ` 1 , :a 7 't ',t.' . �` r-4', ss: ` rte Fxpanston tank 12.51
Name: NOrZ-7 , 5 T �,n..-N
fixture/sewer cap 25.02
Floor drain/Poor sink/hub ■ 25.02
Address; 9700 /t,,) 1,4.4%11 _r 50,.t RD. 'W Z
7 Garbage disposal 25.02
City /State /ZIP: tc, t4 r< 7 o 9 7 - Z -3 Hose bib 25.02
Phone: ( S D I ) (. 2 0 ..- 0555 Fax: ( ) Ice maker 12.51
i S' x "'nt, 4,AtI :� r +, ;'i . �' �t tm� 1, t ' .h Interceptor /grease trap =I 25.02 S • Z
Medical gas (value: $ ) Pag 2
Business Warne
` �PJ4, , c,r 1i r'% 3. "rte _
Primer 12.51
Contact name: C /}�'..L �nr".►'7 /.A _,
Q Roof drain (commercial) 12.51
Address:
To. U SX 13 0 Sink/basin/lavatory 25.02
City / State/ZIP: I30'TT)_f lataQ Tom' 1,, j r 4 9g ( t./ Solar units (potable water) 62.54
Phone: (340 ) (oS 7 - 3 9 $ 7 1 Fax: : (301) ) 4 g 7_ y N g y Tub /shower /shower pan 1111 12.51
E -mail: _' 1 -1< 14 • - 1 -- - e • N �
.� ? tti•1., .c 0,I 6, .. Co •--, Urinal 25.02
: I i + .v �, � . �, Water clos
,_;' , � y � Py t �- P , _ 25,02
•��'.6'. � �_te ww� M/ �t :'"� - . ..�' o,�'i.',d�i'�.�:u � � � 1 ,.. �i� ""' � , ,,. ,P;. Water heater
Business name c/t X7.52
Wl it v4 - SO t)'. Water pip 56.29
Address: Other: 25.02
City /State /ZIP; Subtotal Zc, L
Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 7A ..57)
/� Plan review (25% of permit fee) -
CCB Lie.; to 0 17 Plumbing Lic. no.: 3 7 _ t~cdrti
State surcharge (12% of permit fee) g • 7c'
Authorized signature:
7:.. / TOTAL PERMIT PEE
Print name; re rwl, p. ,30-1 -0 Date: z_ is-...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- County Builditlg Industry $s rvice Boa
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