Permit 1
CITY TIGARD PLUMBING PERMIT
4 r l'' I , DEVELOPMENT SERVICES PERMIT #: PLM2005 -00408
.,� P DATE ISSUED: 9/22/2005
13 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 -00300
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: TI, other fixtures are: (1) expansion tank & (1) primer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: 2 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 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 9/20/2005 $182.60
TIGARD, OR 97223 [PLMPLN] Plan Review 9/20/2005 $45.65
Phone : 503-639-8865 [TAX] 8% State Surcharl 9/20/2005 $14.60
Total $242.85
Contractor:
CH KRUSE PLUMBING
5802 A NE 88TH ST REQUIRED ITEMS AND REPORTS
VANCOUVER, WA 98665 •
Phone : 360 -573 -4337
Reg #: LIC 111654
PLM 37 -296PB
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 yo • ollow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR.
952-1:11-0010 thro. •h OA ' 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
ca ng 503 - 246 -6699 , e • 1 -8I ► 32 -2344.
Is. ued By: A , 0 /Li <2 i Permittee Signature: k 7-
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.
# 8/25/2005 08:46 S Burnhamonline Denise Buehring ->Val Henzel 6/7
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Plumbing Permit Apptacatioh'`'
City of Tigard MM
Received ' J
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Dece O ,) PennitNo.: I Ltip s '' W 0S /
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13125 SW Hall Blvd., Tigard, OR 97223 ,1. r . Notified/Method: Revie r�, 07 Other Permit No. e�ws �pa
Phone: 503.639.4171 Fax: 503.598.1960 � * " )' ilu Datdsy: �� •/�1 7
ltfr�. ® Sec Page 2 for
Internet: Hour
www.ci.tigard.or.us Inspection Line: 503.639.4175 l -1 id t
i ,? e. Date ed /Meth d• / A` �`� t;
Intt: �,S � � °� � 7 Notified/Method: „, li Q ! G Supplemental Information
1 � � • TYPEa;t3 \1 ' . /, . / , A , r ' ;..: 3pgr ; SCHEDULK -' .
❑ Demolition For special information use checklist
❑ New construction Description I Qty. 1 Ea. I Total
r Addition /alteration/replaeement ❑ Other: New 1- 2- family dwellings (includes 100 ft. fur each utility connection)
' CATCGO1:tY Oil CONSTRUCTION , ; SFR (1) bath 249.20
I ' mmercial /industrial SFR (2) bath 350.00
1:1 1- and 2- family dwelling
SFR (3) bath 399.00
❑ Accessory building ❑ Multi- family
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: q31, j tOX_4..3 Catch basin or area drain 16.60
Drywell, leach line, or trench drain 16.60
Footing linear t„,.3 Q R� e2}- 3 - Page 2
t ooting drain (no. near ft.: ) g
Suite/bldg. /apt. no.: t t O Project name: Ct iJ� �hta f 7let�t o home utilities 110.00
Cross street/dlrections 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
Water service (no. linear ft.: ) Page 2
Subdivision: 13pOt Sh1✓fl 1A R , I Lot no.:
Fixture or item
Tax map /parcel no.: /6/ QQ - 00 300 Absorption valve 16.60 • DFSCIiPT101V Ol? 'W,ORK .; - Backflow prevcnter Page 2 •
Backwater valve 16.60
®'( ,c:17-12.,
` r� Q e�Nrtetr5 ' � 5 Clothes washer 16.60
r 1�F':� t._\ -F• Dishwasher 16.60
Drinking fountain 16.60
- 'ROPARTY' OWNER .., , '„� ,MENAN 16.60
Q.., 1, Ejectors/sump
Name: 17 V pr ( � 1 fi e.- J -f,- 0Apert Expansinn tank f 16.60 /6, (CC.)
Address: .uj.--i S � 0 3. 13j1) Fixture/sewer cap 16.60
Floor dra'11/floor sink/hub a 16.60 J , A6 City /State/ZIP: ���} PA , v°Llpo rt. 16.60
Q 1 Garbage disposal
Phone: (gyp ,O) 6-J • 5 2) Fax: ( LO) Q.)56 SBGq Garbage
16.60
A!'PLICANT
CONTACT PERSON Ice maker 16.60
Business name: Z.r, yL pv 'n')tCl , Interceptor/grease trap 4 1 16.60 / ,, //0
Contact name: --- c -- ) ..9. ,,,, ‘ P‘ A L �� �p Q.�if. Medical gas (value: $ ) Page 2
, sk - 4 Primer • I 16.60 /( , (i fJ _
Address: t rl la 7 .. 1).) J� ��rtJrX1 " Roof drain (commercial) 16.60
::t) Sinkry ) 4)0,,L.,' HI 9 16.60 3(7, 4,-, -'1 ° 1917 I Fux' ' (-312 z"- ` - 1 .f Tub /shower /shower pan 16.60
E -mail: el,bue a.�.v`� 1 t.V FF2 ,pvvcrn\k J&.L- ( -' Urinal 16.60
CONTRACTOR Water closet / 16.60 /6'. bc)
/ / ' Water heater / 16.60 /6, aC)
Business name: l K(/t
5 � o Y l Other:
Address: 'b °k(6(7 (' Subtotal
City/State/ZIP: tl) \ Of (i1AA C • ( Minimum permit fee: $72.50 dd 1,
Phone: 40) 5.-7-3 � r � Fax: (3(0) S
-S 3G -r Residential backflow minimum permit fee: $36.25 /D a. • 1'0
Gs ( /� Plan review (25% of permit fee)
CCB Lic.: `� 6 L J Plumbing Lic. no.: (� 7
State surcharge (8% afpermit fee) � - (
Authorized signature: lr)
4(64; _ TOTAL PERMIT FEE a•1Fa •85
� , � I Date: This permit application expires If a permit is not obtained within
Print name: N rio o 180 days after it has been accepted as complete.
*Fee methodology set by TN-County Building Industry Service Board.
i:\ auildingTermit .APLM- PermilAPp.doc 05/05 440.4616T(10/02/COAMYL'B)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00408
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/22/2005
k
Phone: (503) 639 -4171 - "il�
II
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 30
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GODIVA CHOCOLATIER
DESCRIPTION: TI, other fixtures are: (1) expansion tank & (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 - 8865
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360 -573 -4337
Inspection Request Scheduled For: Date: 11/4/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 020389 -01 360 - 5113 -1375 N
Corrections /Comments /Instructions:
V
•
•
❑ PARTIAL APPROVAL
❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /n Date: Phone #: (503) 718-
,CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005-00408
13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 9/22/2005
Phone: (503) 639 -4171 '41
Inspection Requests (24 Hrs.): (503) 639 -4175 s' __
INSPECTION WORKSHEET FOR DATE: 11/3/2005 TIME: 7:06AM PAGE: 66
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GODIVA CHOCOLATIER
DESCRIPTION: TI, other fixtures are: (1) expansion tank & (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8865
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360 - 573 -4337
Inspection Request Scheduled For: Date: 11/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final • 020189-01 360 -518 -1375 N
Corrections/Comments/Instructions:
•
/i
'
•
•
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
y FAIL \ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED •
Inspector: , • Date: 11 -3 pi Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION • r , • PERMIT #: PLM2005 -00408
13125 SW Hall Blvd., Tigard, OR 97223 ` - DATE ISSUED: 9/22/2005
Phone: (503) 639 -4171 Awl p „
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/7/2005 TIME: 7:05AM PAGE: 73
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GODIVA CHOCOLATIER
DESCRIPTION: TI, other fixtures are: (1) expansion tank & (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -8865
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360 - 573 -4337
Inspection Request Scheduled For: Date: 10/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 017692 -01 360 - 518 -1375 N
Corrections/Comments/Instructions:
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL El CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ��
Ins Date: �'V v Phone #: 503
P ( ) 718 -
r
H CITY OF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 .. 4 DA ISSUED: PLM2005.00408
'- Phone: (503) 639 -4171 �YI(I
9/2712005
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 9/23/2005 TIME: 7 :07AM PAGE: 66
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 09360 SW WASHINGTON SQUARE RD LOT #: TYPE OF USE:
PROJECT NAME: WASHINGTON SQUARE
DESCRIPTION: GODIVA CHOCOLATIER
TI, other fixtures are: (1) expansion tank & (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8865
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360- 573 -4337
Inspection Request Scheduled For: Date: 9/2312005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 , Plumbing underslab 016450 -01 360 - 518.1375 N
Corrections/Comments/Instructions:
/_
. i PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718 -