Permit 'w
CITY OF TIGARD PLUMBING PERMIT
" JIB" DEVELOPMENT SERVICES PLUMBING
P 251200 -0070
6 • 13125 SW Hall Blvd., Tigard, O R 97223 503 - 639 -4171 DATE ISSUED: 8/25/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Building fixtures. Other fixtures: (1) expansion tank & (1) primer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS; 1 TRAPS:
STORIES: 1 WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 2 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft .
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQUARE RD [PLUMB] Permit Fee 8/25/2005 $149.40
TIGARD, OR 97223 [PLMPLN] Plan Review 8/25/2005 $37.35
Phone : [TAX] 8% State Surchaq 8/25/2005 $11.95
[PLMPLN] Plan Review 8/25/2005 $125.00
Contractor: Total $323.70
PMSI LLC
21195 NW EVERGREEN PKWY #204 REQUIRED ITEMS AND REPORTS
HILLSBORO, OR 97124
Phone : 503- 466 -2222
Reg #: LIC 158286
PLM 34 -434PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -0001 -0010
through OAR 952 -0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -23- ip 1 �'.
Issued - �.2._ Permittee Signat ll. i,Y � a--t. 1 •
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
is 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.
• AL -8 -2005 09:09 MSI 5034662211 P.01
Plumbing Penult 'Application FOR OFFICE USE ONLY
City Of Tigard Received �/// �� 7
5� � + I Date By: i *23. , 6 ' eew t Other Permit No��' t �/ / 7
24- Hour Inspection Line: 503.639.4175 .� •� , A p ate -R d i /try / ram; 0 See Page 2 for
Internet: www.ct.tigard.or.us $ t -2 . \ Notified/Method: 1 1 510 Supplemental Information
...: ' Y,- ,:: : ., .: i s "` TYPE OF WORK . prat_ tt ` ((( , . , FEE! S CHEDULE: °. , !
❑ New construction ❑ Demolition
` F or special information use checklist.
Description I Qty. I Ea. I Total
4 . Addition/alteration/replacement ❑ Other: C1T Y 0 1 - 1-IG rI'- New 1- 2- family dwellings (includes 100 ft. for each utility connection)
°"°`.; �> `•:c CATECORY'OF CO?.SIRIICIION DIVISION SFR(I)bath 249.20
❑ 1- and 2- family dwelling lCommerciaUindustrial SFR (2) bath 350.00
❑ Accessory building ID Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45 00
❑ Master builder ❑ Other:
:Y::: ,: ..,..:, Fire sprinkler ( sq. ft.) Page 2
'"its:.: = •-_ : : = .JOB , SITE ;INIFORMATION AND LOCATION
'"' =. __'.. - -• - Site utilities
• : . : w �W A Pth 6/a,. t�•: c' • \ i • r/+• - .
? (slit ttaeSS: •' Catch basin or area drain 16.60
City/State/7_IP:1 �d t BR__ Ci 1 Drywall, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: • T ' q.. Project name: 9 E p t
oF Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: -
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: -
Absorption valve 16.60
'r;'s. . •, . .. ` '. -•. t ~.•.... DESCRIPTION, OF. WORK Backtlow prevcnter Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
-:; :,: Q PRQ R ,O%WIER`:Y: s" ' I ❑ TENANT :
I
Ejectors/sump 16 60
Name: Expansion tank 16.60 /L ion
Address: F wercap 16.60
City /State/ZIP: Floor drai floor sink /hub 7•tl 16.60 i
Phone: ( ) Fax: ( ) ar age disposal 16.60
: `::;';
:.: ; • - •i''' ]'APPLICAT'TT S r ' , -:: • ...; ' , Hose bib 1 .60
'! "? : <;i ir `i - : ❑ CONTACT PERSON Ice maker 16.60
Business name: ry1 Interceptor /grease trap 16.60
Contact name: 3 1 e . Medical gas (value: $ ) Page 2
Address:2 t� i . t 2j4 Primer PI 16.60 /tfJ,(
City /State /ZIP: 1 u� � c 1 - 1 t?-4- Roof drain (commercial) 16.60
,` � Sink/basin/lavatory 1 A, 9041f � 16.60 L� • cz0
Y7
Phone: ` L e - a � Fax: ' �J )4 oL • -1
Tub /shower /shower pan 16.60
E-mail: Urinal 16.60
: "{' CONTRACTOR '
i,','` ,,! Water closet ' 16.60 1ki)•4; 0
Business name: Water heater 1 16.60 tto • WO
Address: Other:
Subtotal
City /State /ZIP: -
Minimum permit fee: $72.50 /4q 4 sio
Phone: ( ) Fax: ( ) Residential backtlow minimum permit fee: $36.25 /
CCB Lie.: \5$a2� Plumbing Lic. no.: -U 34P Plan review (25% of permit fee) 37. .3b
State surcharge (8% of permit fee) f t w 9 ' sr . Authorized signature: k -I 9 8 7v
..,.„
Print name: ,i,„,_, O L Date: �. r �� This permit application exp �� I r pp
180 days after it h° p L Rtl „
*Fee methodology set by Tn- 9 ;, 7 U
i. \Building\Permts\PLM- PctmnApp doe 06/05 440-4616T( 10/02/COM/WEB )
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200& -00270
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2005
Phone: (503) 639-4171 angdo ( I
Inspection Requests (24 Hrs.): (503) 639 -4175 I I..
INSPECTION WORKSHEET FOR DATE: 1113/2005 TIME: 7:06AM PAGE: 22
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA . U
DESCRIPTION: Building fixtures. Other fixtures: (1) expansion tank & (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: PMSI LLC PHONE #: 503-466 -2222
Inspection Request Scheduled For: Date: 11/3/2005 Pour Time: •
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 020247 -01 503-209 -2618
•
' Corrections /Comments /Instructions:
•
-JPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V Date: / 1 /....32_,4 Phone #: 503 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00270
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/2512005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/2/2005 TIME: 7:04AM PAGE: '33
7
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Building fixtures. Other fixtures: (1) expansion tank & (1) primer.
• OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: PMSI LLC PHONE #: 503 - 466-2222
Inspection Request Scheduled For: Date: 11/212005 Pour Time:
Code #, Inspection Description Confirm # Contact # Message
399 - _ Plumbing final 020132 -01 503 - 519 -0606 Y
Corrections /Comments /Instructions:
❑ PASS • : RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 471 Date: I) /2 1 / 1 Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 00270
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2005
Phone: (503) 639 -4171 i_I
Inspection Requests (24 Hrs.): (503) 639 -4175 °_ t
INSPECTION WORKSHEET FOR DATE: 9/21/0005 TIME: 7:03AM PAGE: 93
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 09329 SW WASHINGTON SQUARE RD LOT #: TYPE OF USE:
PROJECT NAME: WASHINGTON SQUARE
DESCRIPTION: SEPHORA
Building fixtures. Other fixtures: (1) expansion tank & (1) primer.
OWNER: WASHINGTON SQUARE LLC.
PHONE #:
CONTRACTOR: PMSI LLC PHONE #: 503. 466.2222
g '' Inspection Request Scheduled For: Date: Pour Time:
W21/2005
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 016177 -01 503-466-2222 N
Corrections /Comments /Instructions:
•
:
4 .2.6„SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: y Date: 11 2I !15 Phone #: (503) 718-
1
CITY OF TIGARD
BUILDING DIVISION , `" PERMIT #: PLM2006 -00270
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2005
Phone: (503) 639 - 4171' r cl
Inspection Requests (24 Hrs.): (503) 639-4175 _W31; .
INSPECTION WORKSHEET FOR DATE: 9/12/2005 TIME: 7:04AM PAGE: 85
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Building fixtures. Other fixtures: (1) expansion tank & (1) primer.
1
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: PMSI LLC PHONE #: 503-466-2222
Inspection Request Scheduled For: Date: 9/1712005 Pour Time:
Code '# Inspection Description Confirm # Contact # Message
320 - Plumbing rough -in 015389 -01 503 -519 -0606 N
Corrections /Comments /Instructions:
ri
1A
w Jr �1 •
�/ ��
•
•
•
PASS • ❑ PARTIAL APPROVAL a CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED (77 Inspector / 7172.. Date: . O #: (503) 718 -
.
CITY OF TIGAR®
BUILDING DIVISION PERMIT #: PLM2005 -00270
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 / ..
INSPECTION WORKSHEET FOR DATE: 8/26/2005 TIME: 7:06AM PAGE: ?1
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Building fixtures. Other fixtures: (1) expansion tank & (1) primer.
OWNER: WASHINGTON SQUARE LLC. PHONE #:
CONTRACTOR: PMSI LLC PHONE #: 503 -466 -2222
Inspection Request Scheduled For: Date: 8/26/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing 014365 -01 503 - 209 -1939 N
Corrections/Comments/Instructions:
P I �,,.,� , �, U y� ce..c I A. L (,
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:. Date: F/7. t I Dr Phone #: (503) 718-
CITY OF TIGARD _,- , r
BUILDING DIVISION PERMIT #: PLM2005 -00270
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2005
Phone: (503) 639 -4171 �a 416111'
Inspection (24 Hrs.): (503) 639 -4175 ..'..
INSPECTION WORKSHEET FOR DATE: 8/25/2005 TIME: 7:12AM PAGE: 1
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Building fixtures. Other fixtures: (1) expansion tank & (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: PMSI LLC PHONE #: 503 - 466-2222
Inspection Request Scheduled For: Date: 8/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in . - 014299 -01 503-466 -2222 N -
Corrections /Comments /Instructions:
32 -ZC 17
/VoTRI--veil. •
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector Crb" Vv-w i X1/4) ,a— Date: 7) 2e) O S, Phone #: (503) 718-
. � ,,