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Permit CITY TIGARD PLUMBING PERMIT 4 4 DEVELOPMENT SERVICES PERMIT #: PLM2004 -00474 ' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/13/2004 SITE ADDRESS: 09467 SW WASHINGTON SQUARE RD A -11 PARCEL: 1S12600 -00300 SUBDIVISION: WASHINGTON SQUARE ZONING: C -G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; 2 TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 2 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Remarks: Plumbing TI, add (1) new 3" floor drain, move (1) dishwasher, (1) sink and cap (1) 2" floor drain and (1) sink. FEES Owner: Description Date Amount WASHINGTON SQUARE LLC [PLUMB] Permit Fee 10/13/2004 $83.00 BY THE MACERICH COMPANY 9585 SW WASHINGTON SQUARE RD [TAX] 8% State Surchar! 10/13/2004 $6.64 TIGARD, OR 97223 Total $89.64 Phone : 503 639 - 8860 Contractor: MODERN PLUMBING 11120 SW INDUSTRIAL WAY TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone : 503 - 691 - 6166 Rough -in Insp Top -out Insp Reg #: LIC 87906 Insp existing /capped fixtures PLM 34 - 250PB Final Inspection 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) 246-=;•9. Is ed By: / r,�� ,, /' Permittee `Call (503 • -4175 by 7:00 P.M. for an inspection needed the next business day 10/13/2004 12:27 5036916771 MODERN PLUMBING PAGE 02 _ 10/12/ 7,204 L5:34 FAX 5036961900 CITY OF TIGARD 1j 003 b ( , Phimbin P @1C>a11t Ayplilc an FOR OrFfr . 1.1s12 ONI.- City of Tigard D ear G / , o a 10 Pench Ned 1 J► I ■DeN 13125 SW Mall Blvd.. Tigard, OR 97223 Plan Review Phone: 503.639'4171 Fax: 503. 998.1960 "..'.z' F'i1'b` t /ly Odur Pemr' ' �F1 19 11) + 24. iF101T Inspection Ltne: 503,679.4175 _t_L1 ,.. I- Date Retdy/Bin a' gee Pogo z for Internet www.ei.tigard.ocus Nedleed/Melbed: a Supoevisi ni hiformadon Il:d` 1" �•1 i. '•' .•,';�'1„I'' I i''F '' _'i_111.:1'1%I+4; ^ ., i1r , , `r: I i, ' ..1 ' ' {,I • 'r1 4,. � . 1 ' 14 r • l ' rrl; •, •.I' ... .467 ' A ;. :, . •.d'. 1'O n : r -4'4, , •-...• .fr q. ..i-' 614 .L1 h ; 1 .:.:41, I'!, ' .e .e .N- . : '. ❑ New construed= ❑ Demolition Par speciel iefannoica ase checklist _ Description 1 Qty. [ Ea. I Total IgAdditionialteradon /replaccrilent U Other. New 1.24stmily dwellings (includes 100 ft, for each utility connection) ile.II;i TD:4lf!: ?:1 :1. Ii{,Sia .. ,a'' 5 r: t •-. � Ir: .r u r l,i' : f; lv`',•[S,S;, -: 1'• • SFR(1)bdlo _ 249.20 U 1- and 2- family dwelling grCoromadatl1ndust ial SPP. (2) bath 350.00 ❑ Accessory btd1601 El Muld- thtmly 5FR (3) bath 399.00 Each additional bath/ kitchen 45.00 ID Neater Milder in Othtx: Fire sprinkler (__ sq lt.) Page 2 MI!I'f:is�, ®ul.'I �: 11 q'�lB i.�� ll�Il�d, f Nli Jf�riSia! Site utilities m t sin '` ` , Camh bacin or area di in 16.60 City/State/W:74k a r 1 OIL • 3 - Drywall, leach lino, or hatch drain 16.60 Shite/b,dg /apt on - " J beer name; e: . T a ,,,,. 'FE Dee Footing drain (no. linear ft.: •) Page 2 Mantifactutsd Main utilities 110.00 Cross streardieecgous tv job site - . _ Matt1:0106 16.60 l a sink ts. oArl es. it u Q 02_. - Rain thorn carmeetor 16.60 / ' Sanitary sewer (no. linear ft: _--- _.) Page 2 ' Storm sewer (no. linear ft.; - ) Page2 -- Subdivision: I Lot no.: W8te1' Bervlce 01o. brunt 11.: „....,) Page 2 - - Fixture or item toap/pareel nn.: ; ha +p,,r r�r / �/�,, * � � , ^ pQ . ,. a �L' 1..2:•1;.: Abcerohan valve 16.60 i l' I N;al , .l. }i n19) y;' ;I.J WIQ I © "l „ r . , l; i 'III P1: F..E;'. DackflOW ter Paget - !, t' \ Tr. • at► - pre 1t1't Backwater valve 16.60 : Clothes washer 16.60 Dishwasher _ 16.60 1040 0 ;l •;,, .- i; . •_ . . • - • :1 F.f.rd�l'At;;.n, . a.ra t - Dritlidagfbuntain 16.60 '" rd , • I �; u 1'.I: • • ; 1 4 i' I d p 4 .'a :1 , vJn,"' . • -•'r �� . �ii�l�ni' � �hlU Fklt;otors(srirrrp 16.60 Name: 5'16 - 04 bit _, 4,5 Expansion tank w 16.60 Address: • Haiti owes tap 16.60 City /StatrfZU Meer dram/flo0r sinkfiub f 16.60 ( a(i , GO_ 16.60 Piwne 0545)7m 3 ' 7(5 Fax: (548) 2 3 5 % 1 Garbage dispos e 6 p cci ..-- pp , :, : ,., '. • Rote bib 16.60 I! 13 4 .' � ..1';. i!IP�'.11' 1 �i �!''" , Ir' ,,. +'u.' - O1l,I �,::i teemalear 16.60 Euaiaeee name-- 0 ode r r �� `'. A IM- 44 , /\ Iamrcepwr/grcaao trap 1 6.60 Camel llama .h H �� - - - - AA Medical gas (value: ) Page 2 • Address: 1 ‘ \ 2 O S „i 1 r1 et 5 lr ( WL. Primer 16.60 Roof dra in (utnrrlercial) 16.60 City/State/ZIP: -y �,.a1 d `f ��) { �')Qfa SinWb�asinnavetary 3 16,60 LF9, • :(543)(0 11 -a 1111.0 Fart : :(sJS) Let/ I -a' 7'71 r Tubrakowsr /shown* poo 1660 E 4 1 5 4 1 2 r s d a 1 4,. b o) a ei e r . eC*' Urinal 16.60 i c t �; l.':: "1: { h in 4' I ;`dII.;SI: it :}' •, "., • tl" I 11'}i': S(; "I :I I Ifj ,�l i. l jilI,,. . II n : ,I t'.1 . , l i � '. Ili1 :- I` r, i � ";iu "•''..� .. Water docet ---, .I , • , .-' , � '�.'JM'l N�'��' I;p�iii'h,_ 4,;,�� ',`�, 9 , f i i r' Ruthless none_, O a e,r 'P � u Y" k) 1 IN 5 I water beater 16.60 Address: X 1 \ 10 `� y ■ • t) ' - 1 o al J A..4 cj, Wawa' $3. 60 Cit T' a, (Q. 't v1 * • 9 C71c Z Minimum pcmdt fey 572.50 Phone: (1 13) ) , 91- . (V (. Fax: (CATS 9 ( - ep 77 Residential bacidlow minimum permit fee: £36.25 CCB Lie_: - Q moron 1 .to , n o. ; , . a O ) Pion review (.2545 of permit the) .. Butte eurehnrge (g% of penult tee) (o. (gl Z Authorized signature: ` _l�)_ .I ���i___ 1 TOTAL PERMIT FEE gift to Print name: ' a f 0 4" lc - e . Dow: 1 Q •� _ This per tit application eapiras it a permit b not obtained within 180 days after it has been aeeeptad At complete. *Fee niet1to601ogy sat by Th"County Building lndusuy Service Beard. ire...7S. a- evrv@App.d.. ryes 44e-MI TtiainteMNW1,f1 Accumulative Sewer Tally Parcel # 1S12600 -00300 Tenant Name: Starbucks -• This SWR# N/A Site Address: 9467 SW Washington Sq Rd This PLM# 2004 -00474 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off #s count # value #s values Baptisery/Font 4 0 0 0 . 0 0 Bath - Tub /Shower 4 0 0 0 0 0 - Jacuzzi/Whirlpool 4 0 0 0 0 0 Car Wash - Each Stall 6 0 0 0 0 0 - Drive through 16 0 0 0 0 0 Cuspidor/Water Aspirator 1 0 0 0 0 0 Dishwasher - Commercial 4 0 0 0 0 0 - Domestic 2 0 0 0 0 0 Drinking Fountain 1 0 0 0 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain /Sink - 2 inch 2 0 1 2 0 -1 -2 - 3 inch 5 0 0 1 5 1 5 - 4 inch 6 0 0 0 0 0 - Car Wash Drn 6 0 0 0 0 0 Garbage Disposal - Domestic (to 3/4 HP) 16 0 0 0 0 0 - Commercial (to 5 HP) 32 0 0 0 0 0 - Industrial (over 5 HP) 42 0 0 0 0 0 Ice Machine /Refrigerator Drain 1 0 0 0 0 0 Oil Sep (Gas Station) 6 0 0 0 0 0 Rec. Vehicle Dump station 16 0 0 0 0 0 Shower - Gang (per head) 1 0 0 0 0 0 - Stall 2 0 0 0 0 0 Sink - Bar /Lavatory 2 0 0 0 0 0 - Bradley 5 0 0 0 0 0 - Commercial 3 0 1 3 0 -1 -3 - Service 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 0 0 Washer - Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet - Toilet 6 0 0 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 2 5 1 5 -1 0 Current Fixture Value 0 divided by 16 = 0.0 Current EDU 1 EDU = $ 2,500 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU a • - 0 divided by 16 = 0.0 over (under) $ - nter EDU Change Here 0 Notes: No change in EDU's Signat re: _ _ _ /_�,, . _ _� Date: /,� ��� Building Division (Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher hich must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. is \Building \Sewer Tally \SewerTallySheet.xls 7/1/04 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested l6 J Z Z AM PM BUP Location q1/6-7 1.6),Q„ ` S' G2- Suite MEC Contact Person Ph ( ) & 6. / lP (, PLM 06 4 7 T Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain s ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam l,l).-C�� �.� Sr Anchors Ext -�r7 Ext Sheath/Shear _ Int Sheath/Shear Framing Insulation Drywall Nailing Firewall - Fire Sprinkler ' Fire Alarm Susp'd Ceiling Other: / j ...7 , �� Final / j PASS PART FAIL PLUMBING Post & Beam Under Slab - Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: A S ART FAIL M ANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL •• Service Rough -In UG/Slab Low Voltage . Fire Alarm Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA /� Approach/Sidewalk Dat v �� /��j Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL