Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00485
"
J ° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/26/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09355 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Plumbing TI
CLASS OF WORK: ADD GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
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 9/26/2005 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 9/26/2005 $5.80
Phone : 503 639 - 8865 Total $78.30
Contractor:
ALLIANT SYSTEMS
1600 NW 167TH PLACE SUITE #330 REQUIRED ITEMS AND REPORTS
BEAVERTON, OR 97006
Phone : 503- 230 -8991 •
Reg #: LIC 153420
PLM 3 -487PB
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 -008 -i i ! through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503 -246 • .99 • 1- 0- 332 -2344. �I �,�
Issue • :y• .� / l J ,/ Permittee Signature: ' ^ y `'�' e Lf
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.
Plumbing Per'mit'Application FOR'OFFICE USE ONLY
City of Tigard Received Permit No.: 11 �../
13125 S W Hall Blvd., Tigard, OR 97223 Date/By: L/ /aA2S D Ks
Phone: 503.639.4171 Fax • 503.598.1960 A Plan Review Other Permit No.� p , Date/By. --06/ '.o
24- Hour Inspection Line: 503.639.4175 • i.�. c!� I Date Ready /By Jam ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK
❑ New construction ❑ Demolition FEE* SCHEDULE
® Addition/alteration/replacement ❑ Other: For special information use checklist
Description Qty. I Ea. I Total
CATEGORY OF CONSTRUCTION New I- 2- family dwellings (includes 100 ft. for each utility connection)
❑ 1- and 2- family dwelling Z Commercial /industrial SFR (1) bath 249.20
❑ Accessory building ❑ Multi- family SFR (2) bath 350.00
❑ Master builder SFR (3) bath 399.00
❑ Other: Each additional bath/kitchen 45.00
61' 5 JOB SITE INFORMATION AND LOCATION Fire sprinkler ( sq. ft.) Page 2
Job site address: 9S`W WASHINGTON SQUARE RD Site utilities
City/State /ZIP: PORTLAND, OR 97223 Catch basin or area drain 16.60
Suite/bldg. /apt. no.: STE R19 Project name: PAINTED WITH OIL Drywell, leach line, or trench drain 16.60
Cross street/directions to job site: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.: Storm sewer (no. linear ft : ) Page 2
Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: Fixture or item
DESCRIPTION OF WORK Absorption valve 16.60
INSTALL FOLLOWING FOR SINGLE TENANT RESTROOM: Backflow preventer Page 2
INSTALL (1) INSTANTANEOUS ELEC WTR HTR, (I) WATER CLOSET, Backwater valve 16.60
(1) LAV, (1) FD- & ASSOCIATED PIPING. Clothes washer 16.60
® PROPERTY OWNER ❑ TENANT Dishwasher 16.60
Drinking fountain 16.60
Name: TJU CONSTRUCTION INC. Ejectors/sump 16.60
Address: 11864 MORNINGSIDE WAY Expansion tank 16.60
City/State /ZIP: GRASS VALLEY, CA 95949 Fixture /sewer cap 16.60
Phone: ( ) Fax: ( ) Floor drain/floor sink/hub ' 16.60 l� �'e 0
® APPLICANT ❑ CONTACT PERSON Garbage disposal 16.60 �s
Hose bib 16.60
Business name: ALLIANT SYSTEMS, LLC Ice maker 16.60 •
Contact name: MEG FRIEDOW Interceptor /grease trap 16.60
Address: 1600 NW 167" PL, SUITE 330 Medical gas (value: $ ) Page 2
City/State /ZIP: BEAVERTON, OR 97006 Primer 16.60
Phone: (503) 230 -8991 Fax: : (503) 230 -9238 Roof drain (commercial) 16.60
E -mail: M.FRIEDOW @ALLIANT- SYSTEMS.COM
Sinlc/basin/lavatory ' 16.60 0 40
Tub /shower /shower pan 16.60
CONTRACTOR Urinal 1 6.60
Business name: ALLIANT SYSTEMS, LLC Water closet 16.60 [4.1i 0
Address: 1600 NW 167" PL, SUITE 330 Water heater ' 16.60 1000
City/State /ZIP: BEAVERTON, OR 97006 Other:
Subtotal t0o.4o
Phone: (503) 230 -8991 Fax: (503) 230 -9238 Minimum permit fee: $72.50
CCB Lic.. 153420 Plumbing Lic. no.: 3 -487PB Residential backflow minimum permit fee $36.25
Plan review (25% of permit fee)
Authorized signature: / V • s State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Print name: M FRIEDOW Date: 09 -26 -05
, \ Building \Pemuts \PLM- PermitApp doe 06/05 440 -46161(10 /02 /COM /WO_n)
CITY OF TIGARD
BUILDING DIVISION r PERMIT #: PLM2005 -00485
13125 SW Hall Blvd., Tigard, OR 9722 DATE ISSUED: 9/26/2006
Phone: (503) 639 -4171 !°1� +
Inspection Requests (24 Hrs.): (503) 639 -4175 I �..
INSPECTION WORKSHEET FOR DATE: 11/18/2005 TIME: 7:17AM PAGE: 77
SITE ADDRESS: 09356 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: PAINTED WITH OIL
DESCRIPTION: Plumbing TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8866
CONTRACTOR: ALLI ANT SYSTEMS PHONE #: 503-230 -8991
Inspection Request Scheduled For: Date: 11/18/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 021842 -01 408-828-6622 N
Corrections /Comments /Instructions:
Aar
i
•
FA SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
II FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 12 i Date: 1. / Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: PLM2005 -00485
13125 SW Hall Blvd., Tigard, OR 97223 `~ DATE ISSUED: 9/2EJ2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8,27,2005 TIME: 7:05AM PAGE: 72
SITE ADDRESS: OF WORK:
09355 SW WASHINGTON SQUARE RD
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: PAINTED WITH OIL
DESCRIPTION: Plumbing TI
OWNER: WASHINGTON SQUARE LLC, PHONE # : 503
CONTRACTOR: PHONE #:
ALLIANT SYSTEMS 503-230 -6991
Inspection Request Scheduled For: Date: 9!2712005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 016697 -01 971-235-3721 N
Corrections /Comments /Instructions:
•
•
•
3, -, SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: 1Th Date: - i Phone #: (503) 718 -