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.