Permit C ITY OF TIGARD PLUMBING PERMIT
4 DEVELOPMENT SERVICES PERMIT #: PLM2000 -00347
- i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/19/00
SITE ADDRESS: 09477 SW WASHINGTON SQUARE RD A -7 PARCEL: 1S126C0 -01107
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: 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 - replacing lavatory, water closet, floor drain & water heater
FEES
Owner:
Type By Date Amount Receipt
PPR WASHINGTON SQUARE LLC SPOT CTR 9/19/00 $5.31 27200000000
BY THE MACERICH COMPANY PRMT CTR 9/19/00 $66.40 27200000000
ATTN: JANET FISHER, ASSET MGNT
SANTA MONICA, CA, 90407 Total $71.71
•
Phone 1: .
Contractor: -
ANCTIL PLUMBING INC
16900 SW MERLO RD
BEAVERTON, OR 97008 REQUIRED INSPECTIONS
Phone 1: 503 - 642 -7323 Rough -in Insp
Reg #: LIC 00000241 Final Inspection
PLM 26 -162PB
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: I . p/ - m p/ Permittee Signature: 6 � .,
Call (50 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF,.TIGARD Plumbing Permit Application Plan Check#
13125 SW HALL BLVD. Commercial and Residential Recd By Alta
TIGARD, OR 97223 Date Rec'd� d ''' r +
(503) 639 -4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Pennn #fC /t "� C.:�- 1 -17
Incomplete
Related SWR #
�iJMi f
6d1 ! ' °Das, Called
Name of Development/Project FIXTURES (individual) . ` QTY 'PRICE ; . AMT
Job i.a.I is - 1.36.„ <I4,LATh.,. 5gL)Z.v4 Sink - -
Address Street Address Suite Lavatory / ...1460 , 6 0
MI 5u) (, )1S14,; 0nb. . Q,I . Tub or Tub /Shower Comb. 11.50
Bldg # City/State Zip Shower Only 11.50
Name Water Closet / 450 /t,,4
Urinal , 11.50
Owner Mailing Address Suite Dishwasher 11.50
Garbage Disposal 11.50
City/State Zip Phone Laundry Tray 11.50
Name Washing Machine /Laundry Tray 11.50
Floor Drain/Floor Sink 2" / _...14c5e- /6,6,0
Occupant Mailing Address Suite 3" 11.50 6
4" 11.50
City/State Zip Phone
Water Heater 0 conversion 0 like kind /
Name i I II Gas piping requires a separate mechanical permit. / COQ f0�
/V )r t t Q 1(J 01/4, ,�tAL- . MFG Home New Water Service 32.00
Contractor + Mailing Address ,./ Suite MEG Home New San/Storm Sewer 32.00
I c400 Sul Aorta 2a. Hose Bibs 11.50
Prior to permit City/State Zip Phone Roof Drains 11.50
Issuance, a copy Drinking Fountain 11.50
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date 15.00
required if 2q 1 Pt c� / Q t Other Fixtures (Specify)
expired in COT Plumbing Lic. # Ex . Date
database 2 (o - I (02 eg 6/3o( 01
Name
Architect Sewer - 1st 100' 38.00
or Mailing Address Suite Sewer - each additional 100' 32.00
Water Service - 1st 100' 38.00
Engineer City /State Zip Phone 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 No 0 Storm & Rain Drain - each additional 100' 32.00
Residential 0 Commercial
Commercial Back Flow Prevention Device 32.00
Additional description of work:
Residential Backflow Prevention Device* 19.00
Catch Basin 11.50
Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Yes g 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 user diagram is required if Quantity Total is > 9
given is correct, that I am the owner or authorized agent of the owner, and
*SUBTOTAL
Q
that plans submitted are in compliance with Oregon State Laws.
S natu %Owner/Agent A / Date , O 8% SURCHARGE ' 37
Contact Person N e P • na
O rL h. 8 0 0 t-,', 6 2-2,z **PLAN REVIEW 25% OF SUBTOTAL
Required only A fixture qty. total is > 9
1 BA HOUSE 7800 ' ° -= - i TOTAL ��
9 li"aCI • O 250. E ..F;,
kJh' a. * OUS \: 00
, ( i7 LC ud : . umb + j , u r trod Q : elli nd . 'Minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention
zn .. nllta /E r ::: tX,i V 7 i i ': ; j ri J it 1) Device, which is $25 + 8% surcharge
"AII New Commercial Buildings require plans with isometric or riser diagram and
plan review.
L dstsVormslplumapp doc 11/18/99
PLEASE COMPLETE:
Fixture Type,, by WorkPerform,�ed " ..
L New; ' Moved `I `4Repla ed R oved /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Urinal
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
•
1:ldstsVormMplumapp doc 11/18199
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639-4
BUP -
Date Requested /D v AM PM BLD
Location 699 y 7 7 5 w 416 S't - Suite 4 -7 MEC
Contact. Person Ph 50.3 ‘ 7$Z3 PLM j 4 • a o 3 7
Contractor Ph SWR
BUILDING . Tenant/Owner s, 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
Po
Water Service
Sanitary Sewer
Rain Drains
Fin
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date 6/ 4 7 4' Y Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 .
/ BUP �►rriG —0° �3l
Date Requested /6 - . 2 - AM PM v BLD
Location 0 9 (1 ? s IA' &G S i t • Ad' Suite MEC
Contact Person CZ-4 �- 7 Ph 527- l fO -.36,57 2 4.ri - t 13
Contractor Ph SWR
s UILDING Tenant/Owner - ELC
Re. -ining Wall ELR
Foo 'ng Access:
Foun ation FPS
Ftg Dr.'n SGN
Crawl D -in Inspection Notes:
Slab SIT
Post & Bea •
Ext Sheath/ - : r
Int Sheath /Shr :r
Framing
Insulation
Drywall N. ling
Firewall
Fire Sp' nkler
Fire A.: rm
Sus. d Cello
•
r._ - . - . FAIL
LUMBj�
�`''ppIost & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
INY
ASS 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
Other D Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.