Permit 's CITY OF TIGARD PLUMBING PERMIT
Avti rin DEVELOPMENT SERVICES PERMIT #: PLM2000 -00217
,,� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/15/2000
SITE ADDRESS: 09416 SW WASHINGTON SQUARE RD PARCEL: 1S126C0 -01107
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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
Remarks: Tenant improvement: Moving existing fixtures to new locations within existing space. No new fixtures added.
FEES
Owner:
Type By Date Amount Receipt
PPR WASHINGTON SQUARE LLC PRMT GEO 06/15/200C $50.00 0003024
BY THE MACERICH CO 5PCT GEO 06/15/200C $4.00 0003024
ATTN JANET FISHER, ASSET
SANTA MONICA, CA 90407 Total $54.00
Phone 1:
Contractor:
ANCTIL PLUMBING INC
16900 SW MERLO RD
BEAVERTON, OR 97008 REQUIRED INSPECTIONS
Phone 1: 503 - 642 -7323 Rough -in Insp
Reg Underfloor /Underslab
eg #: LIC 00000241
PLM 26 -162PB Final Inspection
ORIGINAL
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
1 /
Issued By: Alf ` Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD Plumbing Permit Application Plan q�eck#
13125 SW FALL BLVD. Commercial and Residential Rec'd by rk. `e
TIGARD, OR 97223 5 I 64,tii- Date Recd lv' 00
(503) 639 -4171 SuP2£X �� - c7c7 SQ Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit #P(."ZfxO QdoZl
Related SWR ARM /3.5
Called
Name of Development/Project FIXTURES (individual) QTY PRICE t AMT
Job ANeg 4-{Ao cit 45 Sink 11.50
Address Street Address Suite Lavatory 1 11.50 (I .50
q ii Sc µ{gtI Tub or Tub /Shower Comb. 11.50
7 Bldg # Ci /Slate Zip Shower Only 11.50
Name Water Closet , 11.50 t (.50
Glare �1 s 2u4-it)uc ,mn.. Urinal . 11.50
Owner Mailing Address �A Suite Dishwasher 11.50
3 Sty} 12' • Garbage Disposal 11.50
City /State Zip Phone Laundry Tray 11.50
Peotbir q Pecs , GL 33021
Name Washing Machine /Laundry Tray 11.50
Ap{ Qy 44A1, i -s Floor Drain/Floor Sink 2" 1 11.50 i (, Co
Occupant Mailing Address Suite 3" 11.50
4" 11.50
City /State Zip Phone
Water Heater 0 conversion .like kind 11.50 (I ; o
Name Gas piping requires a separate mechanical permit.
AvlC'kl iYtU4UOl/'k1 J1tC.
MFG Home New Water Service 32.00
Contractor Mailing Address 1 J Suite MFG Home New San/Storm Sewer 32.00
t (o0o0 S(,t) A' 1&I9 (Q Hose Bibs 11.50
Prior to permit City /State Zip Phone Roof Drains 11.50
issuance, a copy (jefae,(4-0„ Cog. q q-t>u L ,M)3) ( t(, -732.3
Drinking Fountain 11.50
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date 15.00
required if 2.1.-1 1 g t.( f /0(7.Jot Other Fixtures (Specify)
expired in COT Plumbing Lic. # Ex . Dat
database 2 (o -1( Z P13 C.,( 3v (2006
. Name
Architect (,tji LA Sewer - 1st 100' 38.00
Or Mailing Address Suite Sewer - each additional 100' 32.00
lb3 Sus ue, /laic q Water Service - 1st 100' 38.00
Engineer City /State Zip Phone
ict.0 Clt(^ i.[tl[L( N,1 b 11411 Water Service - each additional 200' 32.00
Describe work to be done: / Storm & Rain Drain - 1st 100' 38.00
New 0 Repair 0 Replace with like kind: Yes 0- No 0 Storm & Rain Drain - each additional 100' 32.00
Residential O Commercially
Additional description of work: t NNZ ,34 t..h� Commercial Back Flow Prevention Device 32.00
f Residential Beddow Prevention Device` 19.00
i Q,U1.CL4 ill C. f tract[ 1 Catch Basin 11.50
Are you capping, moving or replacing any fixtures?) I. 4 Insp. of Existing Plumbing or Specially Requested 50.00
Yes 0 No 0 Inspections per/hr
If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information ✓
Isometric or riser diagram is required if Quantity Total is > 9
given is correct, that I am the owner or authorized agent of the owner, and `SUBTOTAL
that plans submitted are in compliance with Oregon State Laws. 5'0�‘
Signatu Own _ /Age
nt �� D at 8% SURCHARGE
,( u, -ivy O � %cflt, 6,1120`0' . 3 r X4.00
Contact erson Name hon
/ I (( Ara( ,. ( (03)(yZ ?3Z 3 *`PLAN REVIEW 25% OF SUBTOTAL
.m BATHHOUSE' 78:00 "�' -, . , ' , Required only if fixture qty. total is > 9 • 2 50 00 TOTAL Y 0
Cre. u r b ng f t' _ D(. 7C;t oil n! ; nd 0 •Minimum permit fee is $50 + 8% surcharge, except Residential BadASow Prevention
r j ttij f t ?_ ': " EE e , = nd. = rVICe }, Device, which is $25 + 8% surcharge
••AII New Commercial Buildings require plans with isometric or riser diagram and
plan review.
ltdstsVormslplumapp.doe 11/18/99
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
.: . New Moved I Replaced 'ReriiovedlCapped
Sink
Lavatory J
Tub or Tub /Shower Combination
Shower Only
Water Closet
Urinal
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2" 11
3"
4"
Water Heater
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
•
I:ldstsVormslplumapp.doc 11/18/99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST C
24 -Hour Inspection Line:: 639 -4175 Business Line: 639 -4171
• / BUP
Date Requested 1/./3e) AM PM _ (' BLD
Location q `tlfr Suite MEC
•
Contact Person Ph Co 2- 37SL PLM �05C) 00 a 1 7
Contractor Ph (o c()_ 732.3 SWR
BUILDING Tenant/Owner % rd �� ELC
Retaining Wall / ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing /
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
•
PLUMBING
Post & Beam -
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
ajetlip
GO PART FAIL
HANICAL •
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date / • Inspector 11 /n/6 Ext
Final
PASS PART FAIL 0 NOT REMOVE this inspection record from the job site.
•
CITY OF TIGARD BUILDING INSPECTION DIVISION • MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Z BUP
(` � /
Date Requested ( P 00 AM PM BLD
Location q"I1l. t/04)& . '' L ( 4 - Suite MEC
Contact Person Ph 44 - PLM 'D - 007J -
Contractor Ph Le 20 - g? � SWR
BUILDING . Tenant/Owner 1 _ 5k'3 ELC
Retaining Wall J ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear •
Int Sheath /Shear
Framing
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling •
Roof
Misc:
Final
PASS PART FAIL
LUMBINQ)
Post & Beam
Under Slab
"op O
Water Service
Sanitary Sewer
Rain Drains
Fir
�� PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk �p v�
Other Date a Inspector / 4(/ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.