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Permit • CITY OF TI GA R D PLUMBING PERMIT IAA DEVELOPMENT SERVICES PERMIT #: PLM2000 -00270 �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/27/00 SITE ADDRESS: 09459 SW WASHINGTON SQUARE RD A -14 PARCEL: 1S126C0 -01107 SUBDIVISION: WASHINGTON SQUARE ZONING: C -G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCYYGRP: FLOOR DRAINS: 1 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 0 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 FEES Owner: Type By Date Amount Receipt PPR WASHINGTON SQUARE LLC PRMT BLD 7/27/00 $50.00 0004022 BY THE MACERICH COMPANY 5PCT BLD 7/27/00 $4.00 0004022 ATTN: JANET FISHER, ASSET MGNT SANTA MONICA, CA 90407 Total $54.00 Phone 1: Contractor: MODERN PLUMBING 11120 SW INDUSTRIAL WAY TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone 1: 691 -6166 Reg #: LIC 87906 PLM 34 -250PB 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. Issued By: ,/(0, J-�_ 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 Ch ep� 7" Z9 . 13125 SW HALL BLVD. Commercial and Residential Recd B §, e i' 4 TIGARb, O R 97223 • Date Recd f7--Ai/- (503) 639 -4171 r Lupap ,0/1 Date to P.E. 7 -2.q. Dn 6 Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit# r1 M 2000 - 0027d Related SWR # f . Called 1. z. • • -Co 0 Diet N A.. lode. -.1 P6, Name of Development/Project rF, {(iiiclivldual)d" f >�, g''i "'" ? � 97, MAIM I .. ....� .. .�,> tr. ;s�., � °���:�:��aa � .�, -�.,, �+?.��:;.� ,, Job & j L koc.,ker Sink 9.00 Address Street Address Suite Al _/ t/ Lavatory f 9.00 1 .00 9459 SW W .Shin9 fan . ,tep / Tub or Tub /Shower Comb. 9.00 Bldg # City /State Zip Shower Only 9.00 Name / /l t2I?� Water Closet / , 9.00 9.00 Dishwasher 9.00 Owner Mailing Address Suite Garbage Disposal 9.00 Washing Machine 9.00 City /State Zip Phone Floor Drain/Floor Sink 2" J 9.00 9 Qa Name 3" 9.00 Foot /.0c1 v 4" • 9.00 • Occupant Mailing Address . Suite Water Heater 0 conversion • like kind / 9.00 Gas piping requires a separate mechanical permit. City /State Zip Phone Laundry Room Tray 9.00 Urinal 9.00 Name /220.0e-en Pi Urn b /r) q/ Ot Fixtures (Specify) 9.00 Contractor Mailing Address Suite 9.00 / / /20 SW T.�IGi.S h - i,nd, Ga04.1 9.00 Prior to permit City /State Zip • Phoole Sewer - 1st 100' 30.00 issuance, a copy T a.m. 7 , ae 9'20(07 (p9/ -d2/61° Sewer - each additional 100' 25.00 of all licenses are Oregon Const. Cont. Board Lic.# . Exp. Date _ required if g'7L9 06 . /L _ Water Seiice - 1 st 30.00 • expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 25.00 database 34, . A.6 /2 -CO Storm & Rain Drain - 1st 100' 30.00 Name Storm & Rain Drain - each additional 100' 25.00 Architect Mobile Home Space 25.00 or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00 • Pollution Device Engineer City /State Zip Phone Residential Backflow Prevention Device' 15.00 (Irrigation timing devices require a separate Describe work to be done: • restricted energy permit.) New • Repair 0 Replace with like kind: Yes O No 0 Any Trap or Waste Not Connected to a Fixture ' 9.00 Residential 0 Commercial • Catch Basin 9.00 Additional descripliQn of work: E G Insp. of Existing Plumbing 40.00 pL�.e," /04-e??f per/hr 0 o Specially Requested Inspections 40.00 per/hr ' ) Rain Drain, single family dwelling 30.00 Are you capping, moving or replacing any fixtures? Yes 0 No • • Grease Traps 9.00 If yes, see back of form toAindic to work performed - QUANTITY TOTAL d by , ,,,„ ,„.� ` : ,,,,,, � <ri t � � : ' ��`�� fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or user diagram is required if Quantity Total is > 9 4 �5 ,j i s 2" ,m, WORK COULD RESULT IN<INCREASED SEWER FEES. *SUBTOTAL ;55.grii ;55.g'' ; s.mgo . I hereby acknowledge that I have read this application, that the information ii it ;" 4-) „i;'' ,� O ct ' 'given is correct, that I am the owner or authorized agent of the owner, and . 5% SURCHARGE ? . "'j �;,? F t ;! that pla • s submitted are in c• - . :. ce with Oregon State Laws. - 4440s9 ;R ;;'•?4 ; `•r �".Z . ; s Sign o of Owner /Ag Date - **PLAN REVIEW 25 /o'�`�'r t;•�'';, ` "' ° OF SUBTOTAL ;;: �`'P ` dr) to ,/a - o Required only if xture qty. total is > 9 x` .��oi i s .4.'',1.% " "..`'ti? TOTAL r,�a k� � ' ; ��f �� Co C Person Name Phone ° 4 '' ` l '3 • Sy ' CCU -�a 'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow - Q J Prevention Device, which is $15 + 5% surcharge "All New Commercial Buildings require plans with isometric or riser diagram and plan review I.\dstslplumapp.doc 7/2/98 ' PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed /Capped Sink Lavatory / Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain /Floor Sink 2" / 3" 4" Water Heater f Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: • I:ldsts\plumapp.doc 7/7/98 • Accumulative Sewer Tally 6 71000— GD / 9(7/ Tenant Name: f d' �L o/OC�GE'� This SWR# Address: I) 7VA) This PLM #: 01000 — ct,a70 Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New Value Capped off value added # added #s total Count off #s count value values • Baptistry/Font 4 Bath - Tub /Shower 4 • - JacuzziAA/hirlpool 4 Car Wash - Each Stall 6 - Drive Through 16 Cuspidor/Water Aspirator 1 Dishwasher - Commercial 4 - Domestic 2 Drinking Fountain 1 Eye Wash 1 Floor Drain/sink - 2 inch 2 / 2. - 3 inch 5 -flinch 6 - Car Wash Dm 6 Garbage Disposal 16 - Domestic (to 3/4 HP) - Commercial (to 5 HP) 32 - Industrial (over 5 HP) 48 - Ice Machine/Refrigerator Drains 1 Oil Sep (Gas Station) 6 Rec. Vehicle Dump Station 16 Shower - Gang (Per Head) 1 - Stall 2 Sink - Bar /Lavatory 2 / °l - Bradley 5 - Commercial 3 - Service 3 - Swimming Pool Filter 1 Washer - Clothes 6 Water Extractor 6 Water Closet - Toilet 6 / 4 Unnal 6 TOTALS 7 1O A 7 � Total fixture values: 6240 7l/ •• divided by 16 = 9 EDU = 1L1) LA-s N co � ��tt.. - 1 - G�.t- r� i `Lbw HISTORY V ��o- ,-� 1 fi - .a, .moo eitsA . - Fnu PLM # coo -Ooai7 EDU# /2.9 SWR# koo -00 3 3' PLM# /gs9- e0 /3 EDU# 430 SWR# PLM #,,00 - , 3 EDU# /$.' SWR #'000 -oo /32- PLM# ,s 99 -DO /7 EDU# SWR # /9 9 -a0 PLM# 4q9 -00;,35 /30 SWR# f999-oo /5 9 PLM# /69 -owe) 7 EDU# /,.3v SWR # /y�� PLM# 1999 - oo /j/ EDU# i3e SWR # / ?99 - 0030 PLM # /9A ODOS3 EDU# /30) SWR # / 79 ceod3, c\dsts%swrtaly.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 244-lour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested f-- ( AM PM / e BLD Location 5' (/ 5 .3 41 ea 5 4 Suite - / (f MEC Contact Person G Ph e® f/ 6 PLM v—B 2 Contractor Ph SWR BUILDING Tenant/Owner 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 RtHfrf Water Service Sanitary Sewer Rain Drains F' AS 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 Date • /� Inspector Other e•• Ext Final PASS PART FAIL DO 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 BUP �� VS Date Requested -13 -o o AM PM BLD Location f Y 9 S W G 1, 5 /� Suite -- / e / MEC Contact Person //V(/ Ph '4/ 6/ PLM Pam' 29da Contractor Ph SWR BUILDING Tenant/Owner 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 =lOaiIing � / l a • Firewall / rP Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL , Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains PART FAIL ANICAL 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 1(61 L�j� Other Date Inspector �I 1 ' 7 Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.