Permit CITY TIGARD PLUMBING PERMIT
i6 DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00055
` 1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/24/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09610 SW WASHINGTON SQUARE RD G -1 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: TI - Other fixtures are water cooler /fountain and trap primer
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: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 2 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
BY THE MACERICH COMPANY Description , Date Amount
9585 SW WASHINGTON SQUARE RD [PLUMB] Permit Fee 4/19/2006 $116.20
TIGARD, OR 97223 [TAX] 8% State Surcha 4/19/2006 $9.30
Phone : Total $125.50
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -691 -6166
FAX 503 -691 -6771
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 rul r-dir ct questions to OUNC by calling 503 - 246 -6699 or 1 -800- 332 -2344.
Iss ed By: &AAA Li Permittee Sign ure i if / � j , -h '
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.
pF , 18 06 04:43p MODERN PLUMBING 503 691 6771 p.2
Plumbing Permit Application APR 1 9 2006 FOR OFFICE USE ONLY
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City of Tigard aleat .8� T db' 13125 S W Hall Blvd-, Tigard, OR 97223 CITY OF T GA D D �. y /1/b Permit No. Z p p op
Phone 503.639.4171 Fax 503.598.1960 BUILDIN . I I ‘., � N PJaa Revleu' O��PetmitNo.sW � 'r i
�•' i 7,1` . i I Dare 3y: �
24- Hour Inspection line: 503.639.4175 Vii- '� ! I Dau Ready/By:
t
H see gage 2 for
Internet www.citigard.or.us J Norded/Method: T d 51.52 for each additional
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For spedal information use checklist
gt Description I Qty. I Ea. 1 Total
Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 It for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 1 24920
i , •::A 2 a; uwumg i X wmmercieuinriusuiai I w "A 1 4 / Lai I I iay.vv I
I ❑ Accessory building ❑ Multi - family SFR (3) bath
I 399.00
❑ Master builder ❑ Other Each additional bath/kitchen 45.00 .
n/_ Fire Site so>,Tiprink6es le+ ( sq. ft.) I Page 2
c (,,0 JOB SITE INFORMATION AND LOCATION - -- -
Job site address:-- 5 V� LkJ QSh•r\ -L �� c Catch basin or arcs drain I 16.60
City /State/ZIP: - 1 % 9 a cc( 6 oft- / Drywell, leach line, or trench drain I /6.60
Suite /bldg. /apt- no.:G -1 Project name: l.1 a n i e Ca n iI ( -4` Footing drain (no. linear ft : ) Page 2
Cross street/directions to job site: , Manufactured home utilities 110 00
R4anhes 16.60
1 Rain drain connector ! I 16.60
r Sanitary sewer (no. linear ft.. 1 Page 2 I
Storm sewer (no. linear fl: ) Page 2
Subdivision: Lot no.: Wate service (no. linear ft.: ) Page 2
Tax map /parcel no.:
Fixture or item
Absorption valve 16.60
--j DESCRIPTION OF WORK
Backflow preventer Page 2
f e t'1 C2 f\ l Irh le 4 e Y. Pik Backwater valve I 16.60
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER I 0 TENANT Drinking fountain x I [6.60 , .- G, p
Name:
Ejectors/sump 16.60
Expansion tank 16.60
Address:
Fixture/sewer cap 16.60
City/State/ZIP: Floor drain /floor sink/hub K ( 16.60 I, L., J 0
Phone: ( ) F ax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Business name:
Ice maker 16.60
Interceptor /grease trap
16.60
Contact name: Medical gas (value: $ ) page 2
Address: Primer / 16.60
Urinal City/State /ZIP: Roof drain (commercial) k
16.60
Phone: ( ) I F : ( ) Sink/basin/lavatory: Old z 16.60 3 3. 2i0 E-mail:
Tub/shower /shower pin 16.60
16.60
CONTRACTOR Water closet , r 16.60 1 cold 0
Business name: t? 6 e r i - P \ 1..LY-.4'\\c; r N9 Co, . Water heater V I 16.60 Lin 60
Address: 4 \ \ 2 Q S stir Other: /�
City/State/Subtotal Subtotal
t cz \ cx Cf- C C1(o Z. -
Phone- (5-03 (1.4:1 , Minimum permit fee: S72.50
7L3) j (. (,. Fax: (50'x) (c� 1 & '71 ) Residential backflow minimum permit fee: 536.25 I l 40.2-C
� CCB Lic.:C5' --/ `1 L1 L . ing Lic. no.: Pla review (2 5% of permit fee)
3- z Sc�#�t3 n
Authorized signature: , �� (} State surcharge (8% of permit fee) 3
TOTAL PERMIT FEE 1 12.5. 0
Print name: Oeb D( le.:_ e a Date: 4..../r. 0k, This permit application expires if a permit is not obtained w+ta m
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board
i •aulItn0_'tPeini+uPLM PernutAPP.doc 4645 4404616Tt :o o2JcoMJwsB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005•000 .•5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/24/2006
Phone: (503) 639 -4171 ttill
Inspection Requests (24 Hrs.): (503) 639 -4175 - --
INSPECTION WORKSHEET FOR DATE: 5/16/2006 TIME: 7:02AM PAGE: 24
SITE ADDRESS: 09610 SW WASHINGTON SQUARE RD G - 1 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: YANKEE CANDLE
DESCRIPTION: TI - Other fixtures are water cooler /fountain and trap primer
OWNER: WASHINGTON ON SQUARE LLC, PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503 691 - 6166
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Inspection Request Scheduled For: Date: 5116/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
399 Plumbing final 02995G 01 603.691.6166 N
Corrections /Comments /Instructions:
1 /7/n i (
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•
•
I/■ 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL , ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION • • ❑ ADDITIONAL FEES ASSESSED
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• Inspector: L./ Date Phone #: (503) 718- �✓
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2O06 -00O I6
13125 SW Hall Blvd., Tigard,'OR 97223 DATE ISSUED: 4/24/2003
Phone: (503) 639 -4171 �
. Inspection Requests (24 Hrs.): (503) 639 -4175 .�' � jL
INSPECTION WORKSHEET FOR DATE: 5110 /2006 TIME: 7:02AM PAGE: 37
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SITE ADDRESS: 09610 SW WASHINGTON SQUARE RD G-1 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: YANKEE CANDLE
DESCRIPTION: Ti - Other fixtures are water cooler /founLLiin and trap prime(
OWNER: WASHINGTON SQUARE LL.C, PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503 - 691 - 6'166
Inspection Request Scheduled For: Date: 5/ 10/200€; Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough•in 029627 -01 603-691-6'166 N
Corrections /Comments / Instructions:
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4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL ,FEES ASSESSED
Inspector: • Date: s 75 Phone #: (503) 718- g• G/ 3/
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM )0 00055
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/24/2006
Phone: (503) 639 -4171 ,,, +
Inspection Requests (24 Hrs.): (503) 639 -4175 s ' °_ _
INSPECTION WORKSHEET FOR DATE: 4/05/2006 TIME: 7:00AM PAGE: !;l
SITE ADDRESS: 09610 SW WASHINGTON SQUARE RD G - CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: YANKEE CANDLE
DESCRIPTION: TI Other fixtures are wafer cooler /fountain and trap primer
OWNER: WASHINGTON SQUARE LLG, PHONE#:
CONTRACTOR: MODERN PLUMBING PHONE #: 503 691 - 6166
Inspection Request Scheduled For: Date: 4/2512006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
0 Plumbing underslab 026640.01 503.691 -6166 Y
Corrections /Comments /Instructions:
d lier i lkit ri(IPAriiiiij
•
•
•
*ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NOACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
O , Inspector: J / Date: `6 ),/ Di Phone #: (503) 718 - �