Permit t
C ITY OF TIGARD PLUMBING PERMIT
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° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00256
TIGARD DATE ISSUED: 6/9/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL; 1S12600
SITE ADDRESS: 09567 SW WASHINGTON SQUARE RD B03 B ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: FRED MEYER JEWELERS
Project Description: Interior plumbing. Other fixture: ejector pump.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES: 1
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 6/9/2008 $83.00
TIGARD, OR 97223 [TAX] 12% State Surcha 6/9/2008 $9.96
Phone : Total $92.96
Contractor:
JACK CORMAN PLUMBING INC
7483 SE JOHNSON CREEK BLVD
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 788 -6947
FAX 503- 788 -6949
Reg #: LIC 88311
PLM 3 -198PB
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 503.246.6699 or 1 800.332.2344
Issued y: C606Z/VPIAX, Permittee
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.
" ' i10M :JACK CORMAN PLUMB ING,INC. FAX NO. :5037886949 �-�1 Jun. 04 2008 09:29RM P2
Plumbing Permit Application I ;;,tit rti i,II t I
City of Tigard i _ RDatdEeSt'°d y / r / / 0we 49 , 5 - 6 ,
13125 SW Hell Rlvd ,Tigard, u • 1^ // 0 (/ Pamtlt No.:
Plan Ry:
•
, 1 Phone: 303.639,4171 Fax 503 59a.1960 y Other Permit No .614 1� �0) 8- - /
DntdD .
i Inspection Line: 503.6.9.4175 JUN 0 4 2 t•� Date Seedy/BY. has: to See Page 2 for
Internet: www.tigaid-or.gov Notified/Method: T _ Supplente ttal Information
Npl TYPE OF I Y II, II , °6 . . _ . FEE' SCHEDULE '
['Now construction . III kC + , .,_
For special lnfFlrrrrtulon use checklist.
Description l Qty. I Ea. I Total
v1 Addition/alteration/replacement ■ Other: New 1- 2- family dwellings (includes 100 R. for each utility connection)
, ., —, P- I4t CATEGORY OF CONSTRUCTION SFR (I) bath L 249.20
❑ 1- and 2-J dwelling 1.4 Commercial /industrial SFR (2) bath 350.00
0 Accessory building 0 Multi - family 5FR (3) bath 399.00
Each additional bath/kitchen 45,00
0 Master builder 0 Other:
Fire sprinkler ( sq. 0.) Page 2
.DOB SITE INFORMATION AND LOCATION Site utilities
Job site address: ) C
IScO� �� , ( 1 bit ►ti (1. 1 Catch basin or area drain 16 60
City/Stale/ZIP: • Drywcll, leach line, or trench drain 16 60
Footing drain (no, linear I: , Pale 2
Mc/bldg./apt, nt; 001 __ 11Q1II k ' i rtly(f art tt/S
Manufactured home utilities 110,00
Cross streetidirections to job site: v
---- Manholes 16.60
Rom drum connector 16.60
tali Sanitary sower (no. linear ft.: _ ) Page 2
tal put/m:14 -. t a_kA LDD0 . l L -p Storm sewer (no. Dinar ft.: Page 2
$abdivisio 1 b b�-� 0 � Lot n0•: Water service (no linear fl.. Page 2
Tax map/parcel no.:
Fixture or Item
Absorption valve 16.60
0 ;: DESCRIPTION OF WORK
1 Daeknow prcvcraer Page 2
n C� av
t ' F X l/`,t),l kl P.4 - Backwater valve 16 60
Clothes washer ^'- 16,60
Dishwasher 1660
- 0 PROPERTY OWNER CI TENANT
Drinking fountain 16,60
Name:
"- Ejectors /sump 1 1660 �,L »a
Expansion tank 16,60
Address:
— __ Fixlurtherwer cap _ _ 16.60
City/ Slate /ZIP: Floor drain /foorsittk/hub 16.60 -
Phone: ( ) - Fax. ( ) Carhngc disposal ~ _ 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
l
Ice maker 16.60
Business name: . -.
Interceptor /grease trap 16,60
Contact name:
Medical gas (value. S _ ) Page 2
Address: Primer _ 16.60
City/State/ZIP: Roof drain (commercial) 16.60 Phemo: ( ) Fax.: ( ) Sink/basin/lavatory .-- 16 60 ;)_O
E
Tub /shower /shower pan 16 60
j'; Urinal 16.60
CONTRACTOR _ Water closet
Business name:t ! I ) 16.60 t� 'jpl�
. - ` LA 10' „Ll • fr IA Water heater I 1 16.60 t j o o4/0
AddleBa: r t i1 4 / other kr City/State/ZIP: Subtotal
Phone: ( ) ,9(' , j/ L I
Fa -1 .'
a ( ) ^ , Minimum permit foe: $72.50
r � e i 1 Residential hacktlow minimum permit fee; $36 25
CCB Lie.: 1 P lumbing Ljc. no.: 3. (,C1 s u* • Plan review (25% of permit fee)
Authorized signature: /,1•41414°'—'' State surcharge (12% of permit fee) CIAO
Print name: _ _ TOTAL, PERMIT FEE X1'2_: Ion
A I �16Lv1 � . Date y, y • A f ' Thte permit oppllcatlan capIr a It permit Is not obtained within
/ IRO day* after It has been accepted as complete.
'fee methodology *et by 'I n - County Building Industry Service Board
t.uundlse ennitetrlra- romatAt+t+.dno ant7rro, 440- 4.tterttauvmMnvral
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008.00256
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 61
Phone: (503) 639 -4171 v Afe , °:, F�I�I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/10/2008 ' TIME: 7:00AM PAGE: 24
SITE ADDRESS: 09567 SW WASHINGTON SQUARE RD B03 B' ,CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: FRED MEYER JEWELERS •
DESCRIPTION: Interior plumbing. Other fixture: ejector pump.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: JACK COWMAN PLUMBING INC PHONE #: 503 -788 -6947
Inspection Request Scheduled For: Date: 7//012008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final • 072434 -01 503- 788 -6947 N
Corrections /Comments /Instructions:
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C Gl ✓'<. )1,-)
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2 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V v �n�J f 1 �w-�_ Date: 7 / 101 Off( Phone #: (503) 718-
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008-00256
13125 SW Hall Blvd., Tigard, OR . 97223 DATE ISSUED: 6/9/2008
Phone: (503) 639 -4171 V i
Inspection Requests (24 Hrs:): (503) 639 =4175
• INSPECTION WORKSHEET FOR DATE: 6/10/2008 TIME: 7:01AM PAGE: 31
SITE ADDRESS: 09567 SW WASHINGTON SQUARE RD B03 B CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: FRED MEYER JEWELERS
DESCRIPTION: Interior plumbing. Other fixture: ejector pump.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: JACK CORMAN PLUMBING INC PHONE #: 503 788 - 69217
Inspection Request Scheduled For: Date: 6/1012008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in. 071150 -01 503 - 788-6947 N
Corrections /Comments / Instructions:
rte � p�. - Re% 6'�l W a ✓ C 10 v-2,
.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ' ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
' h
Inspector: QTh Date: -
I (o I t7C) Phone #: (503) 718-
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