Permit . CITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2000 -00255
, o�� �; DEVELOPMENT SERVICES � DATE ISSUED: 7/6/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09612 SW WASHINGTON SQUARE RD G -2 PARCEL: 1S126C0 -01107
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR 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: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replacement of 3 plumbing fixtures with like kind. One lavatory, one water closet and one water heater. No
change in EDU's.
FEES
Owner:
Type By Date Amount Receipt
PPR WASHINGTON SQUARE LLC PRMT DEB 7/6/00 $50.00 0003454
BY THE MACERICH COMPANY
5PCT DEB 7/6/00 $4.00 0003454
ATTN: JANET FISHER, ASSET MGNT
SANTA MONICA, CA 90407 Total $54.00
Phone 1:
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone 1: 691 -6166 Top -out Insp
Reg #: LIC 87906 Final Inspection
PLM 34 -250PB \
P
N .
S CS CL
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.
ill
Issued , ,,..: ; I. � / �_� .0 "� _�� Permittee Signature: ij�J )0 ,L-/
Call (503 639 -4175 by 7:00 P.M. for an inspection needed the next bus'ness day
CITY OF�'IGARD pl_M 2a� ®_ � 2 P lumbin Permit Application - - ^� � .,
Plumbing PP Plan Check ,
13125 SW HALL BLVD. Commercial and Residential Recd By _ V :.� J
TIGARD, OR 97223 Date - . 1' '., 0
(503) 639 -4171 Date to ". _
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit #
Related SWR #
Called
Name of Development/Project FIXTURES' :(individual) ' , ',:_, : 2 QT•i, - PRICE 'AMT:
Job Sink 9.00
Address Street Address S uite Lavatory / 9.00 9. 00
96/2 SW W! Sh,kic ton S8 f� `Z Tub or Tub /Shower Comb. 9.00
Bldg # City /State u Zip Shower Only 9.00
Name
-7-/64e./) Water Closet I 9.00 9
Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
Washing Machine 9.00
City /State Zip Phone
Floor Drain /Floor Sink 2" 9.00
/ Name 3" 9.00
C�/ca QG'C,eJscje /es, 4" 9.00
Occupant Mailing Address Suite Water Heater 0 conversion • like kind 9.00
Gas piping requires a separate mechanical permit i 9 oo
City /State Zip Phone Laundry Room Tray 9.00
Urinal 9.00
Name
/2W)Lise_41) i e b /.--)
3/
Other Fixtures (Specify) 9.00
Contractor Mailing Address Suite 9.00
// /8 3W 2 raisin 1 9.00
%1 Prior to permit City /State Zip Phone Sewer - 1st 100' 30.00
issuance, a copy 71fil,4fiw) U� �I)d(o2 t2 -6016,(4, ""11 Sewer -each additional 100' 25.00
of all licenses are Orego onst. Cont. Board Lic.# Exp. Date
required if Y79 0 W / a -CO Water Service - 1st 100' 30.00
expired in COT Plumbing Lic. # w Exp. Date Water Service - each additional 200' 25.00
database d[J " c250 P8 / - CO Storm & Rain Drain - 1st 100' 30.00
Name Storm & Rain Drain - each additional 100' 25.00
Architect Mobile Home Space 25.00
or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00
Pollution Device
Engineer City /State Zip Phone Residential Backflow Prevention Device' 15.00
(Irrigation timing devices require a separate
Describe work to be done: restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00
Residential 0 Commercial 0 - Catch Basin 9.00
Additional description of work: 4 4 /01 3't, E., Insp of Existing Plumbing 40.00
P d. W 'e'j OO per /hr
Specially Requested Inspections 40.00
per/hr
Rain Drain, single family dwelling 30.00
Are you capping, moving or replacing any fixtures?
Yes • No O Grease Traps 9.00
If yes, see back of form to indicate work performed by QUANTITY TOTAL . '
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is required if Quantity Total is > 9 3 ,
WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL `
I hereby acknowledge that I have read this application, that the information _ 7,1.
given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE . •
that pla• • submitted are in corn I' with Oregon State Laws.
Sig of Owner /Agent /� / D , ate l - �,� ) **PLAN REVIEW 25% OF SUBTOTAL
Cwt, � / � ( OIL �v Required only if fixture qty total is > 9
o _ TOTAL
Con . ct Person Name Phone . 1T.7'
D /ai)e OE �/ _ i 9 / - / / � • Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
•f� v (Qy� Prevention Device, which is $15 + 5% surcharge
"All New Commercial Buildings require plans with isometric or riser diagram
and plan review
1: dststplumapp.doc 7t2/98
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed /Capped
Sink
Lavatory /
Tub or Tub /Shower Combination
Shower Only
Water Closet J
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater /
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
•
I.ldstslplumapp doc 7/7/98
CITY OF TIGARD BUILDING INSPECTION DIVISION -
MST
_ 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 2 — 7 AM PM BLD
Location 9 2 / Z— 1.414 $4 5/J Suite MEC
Contact Person /yl 4 k7 Ph Cf G( PLM ov 2 ]
Contractor • Ph • SWR
BUILDING Ten ant /Owner ELC
Retaining Wall ELR
Footing Access: /' �+�
Ftg Drain
Foundation
C /-�a1R t H � Cc5Crrr- FPS
g
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ,4(41e_ = ✓,�
Roof i
Misc:
Final �iC,rJ
PASS T FAIL
UMBING
os Beam
- wimp
op Ou / aL* i
" "a er Service _
Sanitary Sewer
Rain Drains
Eg ia 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
Other Date (( S Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION !!�
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
1�0 U BUP
/. F Date Requested AM PM �C' BLD
Location ?/,0. 5't) GO-so 12.-J) Suite MEC
Contact Person ,6/,i/ Ph b4/ &016 PLM Ae70 —hDaZ_
Contractor Ph SWR
BUILDING Tenant/Owner 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 I • % � —
Roof A ��,
Fina
Final
PASS PART FAIL
Post & Beam •
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
PASS PART
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
Other oach /Sidewalk Date Inspector /G7 1L Ext /
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION •
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7 -f( AM PM BLD
Location g I fi fZ 5 c✓ ci}u S `l 5 Suite MEC
Contact Person m4 k7 . Ph ‘7/- f /' 6 PLM P - " aj 5
Contractor • Ph SWR
BUILDING Tenant/Owner • 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
--2>7/1-7e-( /
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUM I
ost & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
• ice%
4 . 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 `
0
Approach /Sidewalk ) ' /M
Other Date ! u Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.