Permit CITY TIGARD PLUMBING PERMIT
k DEVELOPMENT SERVICES PERMIT #: PLM2005 -00439
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1 S 122600 -600 -
PARCEL: 1 S00300
SITE ADDRESS: 09396 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Building fixtures. Other fixtures 1 expansion tank and 1 circ. pump.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: UNK FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 9 URINALS: 1 GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES: 2
TUB /SHOWERS: 1 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 9/13/2005 $298.80
TIGARD, OR 97223 [PLMPLN] Plan Review 9/13/2005 $74.70
Phone : 503-639-8860 [TAX] 8% State Surcharl 9/13/2005 $23.90
Total $397.40
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 -000 0 th ugh •AR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calli n 03- 246 -669" '4r 1 -8b0 332 -2344.
Issu d By: _ i -u / ' Permittee Signature: )( ' r/vt)
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.
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Plumbing Permit Application `��n IV E0 % ,: Fo USE ONLY
City of Tigard Received _ _
Date /By 65"-D6-7., Permit No I cc03 i 5/39
13125 SW Hall Blvd., Tigard, OR 97223 �± Plan Review
Phone: ,503.639.4171 Fax: 503.598.1960 SEA 0 6 � Ili Date/By: q I r / O 5 O ther Permit NoSit a �a
24- Hour Inspection Line: 503.639.4175 -
p Date Ready /By. funs ® S P age 2 for
Internet: www.ci.tigard.or us nF T fit Notified/Method 316-' Supplemental Information
TYPE OF O i(01 G DiVi ' Onn
❑ New construction ❑ Demolition FEE* SCHEDULE V`
® Addition/alteration/replacement ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
CATEGORY OF CONSTRUCTION New 1- 2- family dwellings (includes 100 ft. for each utility connection)
❑ 1- and 2- family dwelling ® Commercial /industrial SFR (I) bath 249.20
❑ Accessory building El Multi SFR (2) bath 350 l►
❑ Master builder ❑ Other: SFR (3) bath 399.00
Each additional bath/kitchen 45.00
9 34 6 JOB SITE INFORMATION AND LOCATION Fire sprinkler ( sq. ft) Page 2
Job site addreisJA985 SW WASHINGTON SQUARE RD Site utilities
City/State /ZIP: PORTLAND, OR 97223 Catch basin or area drain 16.60
Suite/bldg. /apt. no.: STE RII Project name: GiGI SALON & SPA Drywell, leach line, or trench drain 16.60
Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: Manufactured home utilities 110.00
Manholes 16.60 _�
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
I ,
Subdivision Lot no : Storm sewer (no linear ft.: ) Page 2 1,
Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: Fixture or item
DESCRIPTION OF WORK Absorption valve 16 60
INSTALL FOLLOWING FIXTURES & ASSOCIATED PIPING TO INCLUDE Backflow preventer Page 2
WASTE, VENT, CW, HW. INSTALL (1) ELEC WTR HTR, (1)CIRC PUMP, Backwater valve 16.60
(1) EXP.TANK, (10) SINKS, (1) SHOWER, (1) WC, (1) WASH H /U, (1) FD Clothes washer / 16.60
® PROPERTY OWNER Dishwasher 16.60
❑ TEN ANT
Drinking fountain 16.60
Name: BREMIK CONSTRUCTION Ejectors /sump 16.60
Address: 321 SW COLUMBIA HWY Expansion tank I 16.60
City/State /ZIP: TROUTDALE, OR 97060 Fixture /sewer cap 16.60
Phone: (503)665 -2086 Fax: (503)665 -2836 Floor drain/floor sink/hub !- 16.60
® APPLICANT 1:1 CONTACT PERSON Garbage disposal 16.60
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
ii�� drain (comm cial) 16.60
Phone: (503) 230 -8991 Fax: : (503) 230 -9238 Mei avatoryZi Ira 16.60
E -mail: M.FRIEDOW @ALLIANT- SYSTEMS.COM Tub ower /s ower pan (.. 16.60
CONTRACTOR Urinal I. 16.60
Business name: ALLIANT SYSTEMS, LLC Water closet 1. 16.60
Address: 1600 NW 167 PL, SUITE 330 Water heater i' 16.60
City/State /ZIP: BEAVERTON, OR 97006 Other: ca.& I7�K fl
( v /g C Subtotal
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 . 73 . a!/
I Plan review (25% of permit fee) 4 , 0
Authorized signature: )1 /I , ��� State surcharge (8% of permit fee) e 3 90
Print name: MEG FRIEDOW Date: 08 - - TOTAL PERMIT FEE 7, !/e7
I \13u1ld.ng \Pemns \PLM- PermiApp doc 06/05 440- 46161'110 /02 /COM /W813)
CITY OF TIGARD
BUILDING DIVISION ' 'PERMIT #: PLM2005 -00439
13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 9/13/2005 _ . , ii
. Phone: (503) 639 -4171 1 �,,,, ^ �
Inspection Requests (24 Hrs.): (503) 639 -4175 Ii
INSPECTION WORKSHEET FOR DATE: 11//612005 TIME: 7:03AM PAGE: 77
SITE ADDRESS: 09396 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: t31G1 SF?A_D
DESCRIPTION: Building fixtures. Other fixtures 1 expansion tank and 1 circ. pump.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -8860
CONTRACTOR: ALLIANT SYSTEMS PHONE #: 503-230-8991
' Inspection Request Scheduled For: Date: 11/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 021398 -01 971 - 563 -3371
Corrections /Comments /Instructions:
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❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / of Phone #: (503) 718=
CITY OF TIGARD
BUILDING DIVISION . - "' , -.PERMIT #: PLM2005.00439
13125 SW Hall Blvd., Tigard, OR 97223 ..4164'' w DATE ISSUED: 9/13/2005
Phone: (503) 639 -4171 �w � 4
Inspection Requests (24 Hrs.): (503) 639 -4175 "''_�
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 128
SITE ADDRESS: 09396 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
1 PROJECT NAME: 0101 SPA
DESCRIPTION: Building fixtures. Other fixtures 1 expansion tank and 1 circ. pump.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 603-639-8860
CONTRACTOR: ALLIANT SYSTEMS PHONE #: 503-230-8991
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 021083 -01 971-236-3721 N
Corrections /Comments /Instructions:
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❑ FAIL L!/ /CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:' / �� Date: P. , / Phone #: (503) 718-
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CITY OF TIGARD
BUILDING DIVISION r 'PERMIT #: PLM2005-00439
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 IL
INSPECTION WORKSHEET FOR DATE: 11/9/2006 TIME: 7:09AM PAGE: 79
SITE ADDRESS: 09396 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GIGI SPA
DESCRIPTION: Building fixtures. Other fixtures 1 expansion tank and 1 circ. pump.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8860
CONTRACTOR: ALLIANT SYSTEMS PHONE #: 503 - 230 -8991
Inspection Request Scheduled For: Date: 11/9/2005 Pour Time: • •
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 020652 -01 971 - 235-3721 N
Corrections /Comments / Instructions:
•
1/73e/ •
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
F CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 �� • Date: . Phone #: (503) 718 -
IT
CITY OF TIGARD PLM200500439
. BUILDING DIVISION PERMIT #: 9/13/2005
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Art,
Inspection Requests (24 Hrs.): (503) 639 -4175 I � ..
10/24/2005 7:02AM 95
•
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
09396 SW WASHINGTON SQUARE RD
, SITE ADDRESS: WASHINGTON SQUARE CLASS OF WORK:
SUBDIVISION: GIGI SPA LOT #:. TYPE OF USE:
PROJECT NAME: Building fixtures. Other fixtures 1 expansion tank and 1 circ. pump.
DESCRIPTION:
WASHINGTON SQUARE LLG, 503-639 -8860
• OWNER: ALLIANT SYSTEMS PHONE #: 503230 -8991
CONTRACTOR: PHONE #:
10124/2005
Inspection Request Scheduled For: Date: Pour Time:
CA # I c n De onription RATA 86- 255 Me9lage
Corrections /Comments/ Instructions:
/
i' • SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PL" ZooSr.:ao 2/3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 44
SITE ADDRESS: 13 144 si/ it Jfrar #J $ .4- 6 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: 6) /G SPA
DESCRIPTION: ejUILDlaen
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time: •
Code # 3Z Inspection Description Confirm # Contact # Message
PLOIFSI 16, eou6-lff -T4 oIdsr1-0 (
Corrections /Comments /Instructions:
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0 - PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL - ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: L1 4j Date: 42)362_ Phone #: (503) 718 -
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PLM2005 -00439
9/13/2005
9/30/2005 7:41 AM 104
09396 SW WASHINGTON SQUARE RD
WASHINGTON SQUARE
GIGI SPA
Building fixtures. Other fixtures 1 expansion tank and 1 circ. pump.
WASHINGTON SQUARE LLC, 503- 639 -8860
ALLIANT SYSTEMS 503 -230 -8991
9/30/2005
320 Plumbing rough -in 017057 -01 971 - 235 -3721 Y
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00439
13125 SW Hall Blvd., Tigard, OR 97223' DATE ISSUED: 9/13/2005
Phone: (503) 639 -4171
• Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/14 /2005 TIME: 7:09AM PAGE: 77
SITE ADDRESS: 09396 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GIGI SPA
DESCRIPTION: Building fixtures. Other fixtures 1 expansion tank and 1 circ. pump.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 6398860
CONTRACTOR: ALLIANT SYSTEMS � .c1 3 — 1 PHONE #: 503-230 -8991
Inspection Request Scheduled For: Date: 9/14/2005. Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 015623-01 971-235-3721 Y
Corrections /Comments /Instructions: t •
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 06 Le' Date: 9 9 jO6 Phone #: (503) 718- Z-1410 .