Permit /N . r
A CITY OF TIGARD PLUMBING PERMIT
�� DEVELOPMENT SERVICES PERMIT P ERMI 00500,
,g...11- � I I' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/30/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09384 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Building fixtures.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS: 1 TRAPS:
STORIES: WATER HEATERS: 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 9/28/2005 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchari 9/28/2005 $5.80
Phone : 503 639 - 6685 Total $78.30
Contractor:
COLUMBIA MECHANICAL INC
1702 DIKE RD REQUIRED ITEMS AND REPORTS
WOODLAND, WA 98674
Phone : 360 - 225 - 5761
Reg #: LIC 151 122
PLM 37 - 451PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503 -2 699 or 1- 800 - 332 -2344.
Issued By: j , c.e:7 (2 „ Permittee Signature: 01, q � 4 ,,&....6-.) - (1_,
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
I
• Building Fixtures i EC VED /$ 4pp - �3od
Plumbing Permit Application 1:012 01:FICF. USE ONLY,
City of Tigard std 2 8 2005A R y 0 � ' O Bh Permit No 2� c t ,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Rev! w Ir /�
Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TIGA - %i,.vfu Date/By Other Permit N6i ,l 905 vyr� 0 f
24- Hour Inspection Line: 503.639.4175 J„ ns
BUILDING DNI' = �1,,� - 11. 1 Date Ready/By. ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE : ' " . . . , '
. .
0 New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
(XAdditio teration/ lacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION . SFR (1) bath 249.20
❑ 1- and 2- family dwelling ommercial/' dustrial SFR (2) bath 350.00
El 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: 0 LJ" ( SL) &Ask2 l,16 3, / "0 Catch basin or area drain 16.60
City /State/ZIP: // Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: E 1077-24506 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
l •• DESCRIPTION OF .WORK Back flow preventer Page 2
•v� j7-0- /vet -) / 3 c /-/ Bt ''Odiy Backwater valve 16.60
7 P- /VeW it�lg� Clothes washer 16.60
// �� Dishwasher 16.60
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Expansion tank 16.60
Address: Ft er cap 16.60
City / State/ZIP: F oor sink/hub i 16.60
Phone: ( ) Fax: ( ) - Jarbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State/ZIP: Roof drain (col. •• - ial) 16.60
Phone: ( ) Fax :: ( ) Sink/basi 't avato / 16 60
Tub /shower/shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Vi trrr closei / 16.60
Business name: CO .,Vr i (j '1V4 ( 4 g C4-4 I (, qL • w ater heater 16.60
Address: i 70 Z LUXE 2 Other
City /State/ZIP:t, j000 ,A/J/ G /4 77679 Subtotal
Minimum permit fee: $72.50
Phone: CIO ) 025 MO Fax: (60 ) aa5' - $ 75-37'' Residential backflow minimum permit fee: $36.25 '7 cv
CCB Lic.: /57/ 72_ Plumbing Lic. no.87 _Z ff3 Plan review (25% of permit fee)
/ id/1/4 State surcharge (8% of permit fee) 6. rt
Authorized signature: - 2 - / - oG TOTAL PERMIT FEE -7 g 3 D
Print name: /` Z D &z!t,,`( Dale /gi 6 6 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 \Buildmg\Penmts\PLMF- PermitApp doc 06/05 4404616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard .
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) , Total Square Footage: Permit Fee:
Footing drain - 1 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55 00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty Fee (ea) Total additional $100.00 or fraction thereof to and
Commercial Back Flow Prevention Device 46.40
including
148. i0g for the first $10,000.00 $10,001.00 to $25,000.00 $148.50 for the first $ and $1.54 for
Residential Back flow Prevention Device each additional $100.00 or fraction thereof to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or
each additional $100.00 or fraction thereof to
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: Plan Review for Complex Structures
Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
Quantity by (Fixture) Work Performed ❑ Any new commercial building.
Fixture Type: Replace El Any new exterior plumbing site utilities.
Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food service area.
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain ❑ Any NFPA 13 -D multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink - 2" Submit 2 sets of plans with any of the above.
-3"
-4"
Car Wash Drain Isometric or Riser Diagram - , •
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial three (3) or more stories in height.
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory /
- Bradley
-Commercial
- Service
Swimming Pool Filter
Washer - Clothes . *Note: If the fixture work under this permit results in an
Water Extractor
Water Closet - Toilet / increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
-
Other Fixtures: plumbing permit can be issued.
i \ Building \Permits\PLM- PennnApp doc 07/06/05
CITY OF TIGARD
BUILDING DIVISION / PERMIT #: PLM2005 -00600
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005
Phone: (503) 639 -4171 z°
Inspection Requests (24 Hrs.): (503) 639 -4175 4.:
� "►°"
INSPECTION WORKSHEET FOR DATE: 11/16/2005 TIME: 7:03AM PAGE: 36
SITE ADDRESS: 09384 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: ('RESHU[TERBUG�
DESCRIPTION: I3 uAiding fixtures.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639-6685
CONTRACTOR: COLUMBIA MECHANICAL INC PHONE #: 360.225-5761
Inspection Request Scheduled For: Date: 11/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 021436 -01 503- 702 -2827
Corrections /Comments /Instructions:
•
(
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / �� Date: P Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION r PERMIT #: PLM2005.00600
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005
Phone: (503) 639 -4171 444
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 65
SITE ADDRESS: 09384 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: THE.SHU I I tNBUG
DESCRIPTION: Building fixtures.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -6685
CONTRACTOR: COLUMBIA MECHANICAL INC PHONE #: 360-225 -5761
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 021131 -01 503-702 -2827 N
Corrections /Comments /Instructions:
Ai
❑ ASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
/FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00500
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/10/2005 TIME: 7:04AM PAGE: 17
SITE ADDRESS: 09384 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: THE SHUTTERBUG
DESCRIPTION: Building fixtures.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -6685
CONTRACTOR: COLUMBIA MECHANICAL INC PHONE #: 360-225-5761
•
Inspection Request Scheduled For: Date: 10/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 017882 -01 360 -518 -4248 Y
Corrections /Comments /Instructions:
4 • •
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 12' (� Date: ID/ P Phone #: (503) 718-
CITY OF TIGARD ` " ,. - ,
BUILDING DIVISION PERMIT #: PLM2005- 00500
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005
Phone: (503) . 427,1., 1
Inspection Requests (24 Hrs.): (503) 639 -4175 ,. "_'_..
INSPECTION WORKSHEET FOR DATE: 10/3/2005 TIME: 7:07AM PAGE: 27
SITE ADDRESS: 09384 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: THE SHUTTERBUG
DESCRIPTION: Building fixtures.
•
OWNER: WASHINGTON SQUARE LLC. PHONE #: 503- 639 -6685
CONTRACTOR: COLUMBIA MECHANICAL INC PHONE #: 360 - 225^5761
Inspection Request Scheduled For: Date: 10/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 017239 -01 360. 518 -4248 N
Corrections /Comments /Instructions:
•
•
$4-.P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
ji -Y)/()
Inspector: Date: Phone #: (503) 718-