Permit •
CITY TIGARD PLUMBING PERMIT
P ERMIT #: PLM2005 -00159
DEVELOPMENT So R 2CES 639 -4171 DATE ISSUED: 4/28/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H -4,5 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: New: (1) sink. Moved:(1) lay, (1) water closet, (1)water heater, (1) 2" fl. drain.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS: 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
• DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQUARE RD [PLUMB] Permit Fee 4/28/2005 $83.00
TIGARD, OR 97223 [TAX] 8% State Surcharl 4/28/2005 $6.64
Phone : 503 - 8865 Total $89.64
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Phone : 503- 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 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503 - 246 ;•99 or 1- 800 - 332 -234>,
Issued By: , , - Permittee Signat r l
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
04/25/2005 1:31 5036916771 . MODERN PLUMBING PAGE 02
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1url?"2006 15:34 FAX 503 6rCEIVa7 OF TIGARD j 003
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Plumbing Pennft Anolicatge 2 5 200 FOR OFFICE USE ONLY .
City of ingfird
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CITY OF 'u A,, • .
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13125 SW Hall Blvd., Tigsni, OR Plan Review
Phenix ina-A39A171 Paw 503 stclouLDING D ,. D../ftr. Odin, Pi:mitt:02: % .. ,, -,
24- Harr Inspection Line: 503.639A173 - _al ' 4 11 CleteRadyftly; !.....I'l Ei See Penn tbr
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Internet wom.cl.fgartntue eiraified/Medmd: --) I Supplementel Information
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I R:7 " :,t. A.P::: . .v ,...,..1!..,, .4 1 .. ,...I„..,..1. - i . •4 •
• hepxptat1; , ...,:,.. ... . .
ci New 001151ructi0n El DemolitiOn Far • maim: use Magical
Loptieri on
- sy. D. Toral
P■ Addldon/alteration/ropleoernent El Odle:: New 1. 2gtamily dwellings (includes 100 ft. for each utility C011neettem) , :
1',Oftrige sm(obth 24920 .
0 1- awl lately dwelling WoosineeeistAnduatrid
SKR (3) bath 399.00
El Accessory building 1:11:duki-fitonly
Etch additional bath/kitchen 45,00
El Matter builder , _ 0 Other:
Fbe sPrITIlder1-.-.5% it rage 2
7 . i • .' '' '' 7 ' . ' ( : ? )• :1 titi; Wr *0' ' ' ' ' 7. 17 1- ?."1 " = ,,,, 1115,; ;.:
. 4 ' ' ' ''' •• '... .:. ‘, i. Ith. •• •_. . - jajlif , ' ' ' ' • I '1 .. ” V.. r. . 1 ' • :. Site utnities
. -
Job situ address: • 5 , r , 4 '_,. - u) • . . I " . • R d Catch basin or area In 16.60 .,
City/State/Z0
• a sti 46. f?..... 9`72,13 Dryweil, leech line. or trench dr;lo fi.60 _
v Footing drain 01o. linear it.:_) rage 2
Suiteibldg./apt_ no.: 135 Pftiect0s= R art i'vel 4.t -C mammon= rum utitIlla 110.00
Own smoar/dIrectiona Oa jab tine .
'-' 1141mbigeS 16.60
. . . _
Rain drain tormentor 1640
Sanitary GCNIVer (no. linear ft.: _) rage 2,
.1■Mir ' ••■■■ 11■11•1•••■
Stara. Sewer (no. linosr ft.: _„) Pap 2
waver as:vim 00- [ lacer IL; ..,-,) Pap 2
SUbdivIdon: 1 Lot no.: -
- - - - FLvture or item
Tax map/paleol nO.: - . . '
Abototion valve t 6.60 -
VA:i . .i Y rAlliti:■.'..i::: : ;:':•:': . : l if ; ; ' '' Backflow prevetem Page 2
r e.. n C.1. rd 1 rrN e OZ)\./ g. re en+ Back-water valve 16.60
Matra waihar t6.60
DiEintamber 16410
Drieldeg 2111:10411 [6.
i ''' I ftidi;=77beteitEna j i . lijig ri ll i f I ''O'' .. .1 '' 0 117 mectanestimp 1660
NUM:
Expansion tank 16.60
Address: ' Fixturefeewer gulp 16.60
City/Stec/ZIP: Floor drain/floor . sinkAmb 1 16 I te,isiO
Phone: ( ) Fax: ( 1 Gatbage disposal td.al
16.60
III / 1 4 . p i l 1 rx:...;; " -. ;-..' :, 1;1 4 ..11 rtriirl.. • 111 1 EC 9, n , .s • '.'.' 31 f
!Delimiter 16.60
Bushmen man=
nterceptor/grew trip , VS 60
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Contact par= Medical gas (value: S ) Page 2
Address: Primer 16.60 _
I 6.00
Rad' drain (etinlitlerelal)
CitY/StateraP: .
Sinlolmain/levetery 2_ 16.60 33 2_0 ,
Phone! ( ) Fax: : ( )
Tub/shower/shower Pan I 6.60 -
E-mail:
16.60
a .4! r...• I
' :1(1 4 Pr': . :' tqll.4 I 441; P '2 ;7E : . : '' ' l ill ' .2. •'34 : *;.,..A,
Water he aterj2d-e2 j_cY
Blames I comet Nik . ak - . i Li. nt•■• ' 4:
Address: t kelp 40' U k tA) Other:
,
. Subtotal 153. 60
City/SrateraP; nil a . t6),,-. m (2 e " 's Ct( 7._ minimum permit tem S72.50
Phi (5' ) ,c0 , i uq, Fax (503 ) (.c4 / (A1 - 71 Residential baeldlow minimum permit fee: 536.25
KT review (pSeofs of permit ibc)
MB Lin • - i -- ,, - A' Plumbing La. no.: ' , . 0 '14,
State surcharge (13% of permit fee)
Authorized 5118r:store: V• ifirliS Tam. pERmrr FEE g9, Li
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n'
Prini be 6 cfra. h Ge Of' 5-C...... c's .4 ICI 5- mil per rso"d P A P y r r a ' a- arbeet a ai P ` ma ' k u n :o t attained withi atptete, k)
*Fee methodology sot by Tti.Counry .Bunding IneidgeY Service Board. :
Mulrotgoecrmlui.P1.14.PavitApp4ec 1203 40447074,0162/03MAVI1D) -
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CITY OF TIGAF,J • , •
BUILDING DIVISION PERMIT #: pLM2005 -00159
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/2005
Phone: (503) 639 -4171 Ale i 111 e
Inspection Requests (24 Hrs.): (503) 639 -4175 „. „.. °`__..
INSPECTION WORKSHEET FOR DATE: PAGE:
5/11/2005 TIME: 7:12AM 51
SITE ADDRESS: CLASS OF WORK:
09516 SW WASHINGTON SQUARE RD NM
SUBDIVISION: WASHINGTON SQUARE . L #: TYPE OF USE:
PROJECT NAME: BEN BRIDGE JEWELERS
DESCRIPTION:
New: (1) sink. Moved(1) lav, (1) water closet, (1)water heater, (1) 2° fI. drain.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503635.8865
CONTRACTOR: MODERN PLUMBING PHONE #: 503 -691 -6166
Inspection Request Scheduled For: Date: 511112005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 006596.01 503 -691 -6166 N
Corrections /Comments /Instructions:
•
�i PASS ❑PARTIAL APPROVAL ❑CANCEL
❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
riati •
Inspector: Date `/ ‘6-- Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00159
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/28/2005
Phone: (503) 639 -4171 � vu ,m� 7 „ m ��
• �
Inspection Requests (24 Hrs.): (503) 639 -4175 -44-
INSPECTION WORKSHEET FOR DATE: 5/19/2005 TIME: 7:12AM PAGE: 79
SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H -4,5 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: ' TYPE OF USE:
PROJECT NAME: BEN BRIDGE JEWELERS •
DESCRIPTION: New : '(1) sink. Moved:(1) lay, (1) water closet, (1)water heater, (1).2" fl. drain.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 603- 639.8865
CONTRACTOR: MODERN PLUMBING PHONE #: 503 -691 -6166
Inspection Request Scheduled For: . Date: 5/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 007291 -01 503 -691 -6166 N
Corrections /Comments /Instructions:
•
•
•
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: 1.164- ' "' 4 Date: AIM I OS'Z Phone #: (503) 718-
CITY OF TIGARL
BUILDING DIVISION PERMIT #: PLM2005.00159
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 4/28/2005
Phone: (503) 639 -4171 Az7A,,Ap
Inspection Requests (24 Hrs.): (503) 639 -4175 All, ° IL
INSPECTION WORKSHEET FOR DATE: 7/1/2006 TIME: 7:14AM PAGE: 13
SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H -4,5 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: •
PROJECT NAME: BEN BRIDGE JEWELERS
DESCRIPTION: New: (1) sink. Moved:(1) lay, (1) water closet, (1)water heater, (1) 2" fI. drain.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639.8865
CONTRACTOR: MODERN PLUMBING PHONE #: 503 -691 -6166
Inspection Request Scheduled For: Date: 7/1/2005 Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 010643 -01 503 -691 -6166 N
Corrections/Comments/Instructions:
r .
❑ PASS '
ASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / 42 Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005-00159
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/28/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/5/2005 TIME: 7:12AM PAGE: 36
SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H-4,5 • CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: BEN BRIDGE JEWELERS
DESCRIPTION: New: (1) sink. Moved:(1) lay, (1) water closet, (1)water heater, (1) 2" fI. drain.
OWNER: WASHINGTON SQUARE LLG, PHONE #: 503- 639.8865
CONTRACTOR: MODERN PLUMBING PHONE #: 503 - 691 - 6166
Inspection Request Scheduled For: Date: 7/5/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 010728 -01 503691 -6166 N
Corrections /Comments /Instructions:
•
•
•
•
•
•
PASS , ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO. ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:fld - 114 ^^' Date: "lr /Uir Phone #: '(503) 718-