Permit CITY TIGARD PLUMBING PERMIT
i& DEVELOPMENT SERVICES PERMIT #: PLM2005 -00443
--- 13125 SW Hall Blvd., Tigard, OR 9 503 - 639 -4171 DATE ISSUED: 9/19/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09359 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: T.I. Other fixtures: (1) expansion tank, (1) ice maker, (1) primer, (2) roof drains.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 4 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 2 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQUARE RD [PLUMB] Permit Fee 9/19/2005 $249.00
TIGARD, OR 97223 [PLMPLN] Plan Review 9/19/2005 $62.25
Phone : 503 [TAX] 8% State Surcharl 9/19/2005 $19.92
Total $331.17
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Phone : 503 691 - 6166
Reg #: LIC 87906
PLM 34 -250PB
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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 q (1irct q -stions to OUNC by
calling 503 - 246 -6699 r 1- 800 - 332 -2344. / f
Issued By: .Y, Permittee Signature: 4r, /
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that u ness day.
This permit card shall be kept in a conspicuous place on the job site until completion of he project.
Approved plans are required on the job site at the time of each inspection.
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Plumbing Permit Application FOR OFFICE USE ONLY
City of Tigard L.:-
J DateBy 9 - 7 -Qs ,....... Permit No? \ \ � ,, 0ow
13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax 503 598.1960 ( >t :i: j !C,'41n#4 (� (7/9 Ot Permi No
Inspection Line: 503.639.4175 i Or,' � � U° i � Date/By / o �' SI a 3 . a)„ 293
24- Hour Ins
P � 3 U , L L) i\ G _C. i Date Ready /By rp° ® See Page 2 for • Internet. www ci.tigard.or.us Notified/Method TN T, Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty I Ea. 1 Total
® Addition/alteration/replacement ® Other: Commercial TI New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
❑ I- and 2- family dwelling ® Commercial /industrial SFR (2) bath 350 00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 9359 SW Washington Square Road Catch basin or area drain 16.60
City /State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16 60
Suite/bldg. /apt. no.: T -21 I Project name: Washington Square Starbuck Footing drain (no linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW Scholls Ferry Road Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.. ) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: 151260000300 Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Plumbing for tenant space buildout in new mall expansion Backwater valve 16 60
Clothes washer 16.60
Dishwasher .i 16.60 (( (
❑ PROPERTY OWNER Drinking fountain 16 60
® TENANT
Ejectors /sump 16.60
Name: Starbucks Coffee Company Expansion tank 1 16.60
v ...tao
Address: 2401 Utah Avenue South Fixture /sewer cap 16.60
City /State /ZIP: Seattle, WA 98134 Floor drain /floor sink/hub 16.60 ( ,40
Phone: (206)318 -1575 Fax: ( ) Garbage disposal 16 60
® APPLICANT ® CONTACT PERSON Hose bib 16.60
Ice maker ( 16.60 ((. • G, L 1
Business name: Olympic Associates Company
Interceptor /grease trap 16.60
Contact name: Jeffrey Strockbine Medical gas (value: $ ) Page 2
Address: 701 Dexter Avenue North, Suite #301 Primer 1 16 60
City /State /ZIP: Seattle, WA 98109 Roof drain (commercial) 2 16.60 3 3 .?.J
Phone: (206) 674 -6119 Fax: : (206) 285 -4371 Sink/basin/lavatory I6 60 6, G ,4
Tub /shower /shower pan 16 60
E -mail: jstrockbine @olympicassociates.com
Urinal 16.60
CONTRACTOR Water closet 16 60
Business name: TBD � a , (1 4 )e- ^-, 1\\R O Water heater ( 16.60 (( , ( 0
Address: Other:
City /State /ZIP: Subtotal
Minimum permit fee. $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee $36 25 „Z.. v'9 . '
CCB Lic.: Plu .ping Lic. no.:
Plan review (25% of permit fee) ( 5'
State surcharge (8% of permit fee) / f . f 2.
Authorized signature:
A tJ TOTAL PERMIT FEE , g , / 7 ■
Print name: .1lr t 5-r F.PC,y, gt Date:? 5E Za , 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 Building Industry Service Board.
I Uiwldmg\Permits \PLM- PermitApp doc 06/05 440 -4616T(I0 /02/CO'I/WEB)
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005- 00443
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/19/2005
Phone: (503) 639 -4171 r
Inspection Requests (24 Hrs.): (503) 639 - 4175 I I..
INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 35
SITE ADDRESS: 09359 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: STARBUCKS
DESCRIPTION: T.I. Other fixtures: (1) expansion tank, (1) ice maker, (1) primer, (2) roof drains.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -8865
CONTRACTOR: MODERN PLUMBING PHONE #: 503 -691 -6166
Inspection Request Scheduled For: Date: 10/21/200,5 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 019005 -01 503 - 572 -2179 Y
Corrections /Comments /Instructions:
R oil F a --4tv; oV J S4 8 (4 -GA44-1 F✓e--er S,-A-v
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i i___II ..
,. "IF
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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t' Inspector:11 t- r, -�,11V — Date: I D h.I 1 0 c Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION. PERMIT #7 51111°C.) " 5-'1) . '
13 '225 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Ai Ix
Inspection Requests (24 Hrs.): (503) 639 -4175 111
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 736--q W , -So , CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: 611A-(R
OWNER: PHONE #:
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CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: G (— I - 7 - C5 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3'1'1 36o --6 o ( 9 3c
Corrections /Comments /Instructions:
•
•
•
V . 's - PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
)
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
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Inspect° Date: . �D' Phone #: (503) 718-
-
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200S -00443
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171 gym, •:�,
Inspection Requests (24 Hrs.): (503) 639 - 4175!x-
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 70
SITE ADDRESS: 09359 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: STARBUCKS
DESCRIPTION: T.I. Other fixtures: (1) expansion tank, (1) ice maker, (1) primer, (2) roof drains.
} OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8865
CONTRACTOR: MODERN PLUMBING PHONE #: 503 -691 -6166
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 021112 -01 503-572.4411 N
Corrections /Comments /Instructions:
•
tgilLASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 4 Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION :� PERMIT #: PLM2005 -00443
13125 SW Hall Blvd., Tigard, OR 97223 � ` DATE ISSUED: 9/1912005
Phone: (503) 639 -4171 �e
Inspection Requests (24 Hrs.): (503) 639 -4175 ^'I I ..
INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AM PAGE: 44
SITE ADDRESS: 09359 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: STARBUCKS
DESCRIPTION: T.I. Other fixtures: (1) expansion tank, (1) ice maker, (1) primer, (2) roof drains.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8865
CONTRACTOR: • MODERN PLUMBING PHONE #: 503- 691 -6166
Inspection Request Scheduled For: Date: 11/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 020826-01 503572 -2179 N
Corrections /Comments/ Instructions:
" IF
tt PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /i, Date: I Phone #: (503) 718 -
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: PLM2005.00443
13125 SW Hall Blvd., Tigard, OR 97223 _ DATE ISSUED: 9/19/2005
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) F•I
■ 639 -4175 ,._ __..
INSPECTION WORKSHEET FOR DATE: 10/12/2005 TIME: 7:04AM PAGE: 37
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SITE ADDRESS: 09359 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: STARQUCKS
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DESCRIPTION: T.I. Other fixtures: (1) expansion tank, (1) ice maker, (1) primer, (2) roof drains.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503.639 -8665
CONTRACTOR: MODERN PLUMBING PHONE #: 503- 691 -6166
Inspection Request Scheduled For: Date: 10/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 018093-01 503-572-2179 N
Corrections /Comments /Instructions: •
4 _ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Ins i rri} Date )/ 7 Phone #: 503 718 -
P l ).
CITY OF TIGARD
, ;
BUILDING DIVISION PERMIT #: PLM2005 -00443
L�-
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 "44
_..
INSPECTION WORKSHEET FOR DATE: 9130!2005 TIME: 7:05AM PAGE: 17
SITE ADDRESS: 09359 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: STARBUCKS
DESCRIPTION: T.I. Other fixtures: (1) expansion tank, (1) ice maker, (1) primer, (2) roof drains.
OWNER: WASHINGTON SQUARE LLC, PHONE # : 503-639-8865
CONTRACTOR: PHONE #:
MODERN PLUMBING 503-691-6166
Inspection Request Scheduled For: Date: W3012005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 017126-01 503 -572 -2179 Y
Corrections /Comments /Instructions:
•
•
•
•
1
V A -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: Date: , ,P 1 Phone #: (503) 718-