Permit CITY T I G A R D PLUMBING PERMIT
I' DEVELOPMENT SERVICES PERMIT #: PLM2000 -00213
..,� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 63 -4171 DATE ISSUED: 8/10/00
SITE ADDRESS: 09619 SW WASHINGTON SQUARE RD L -4 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: 2 TRAPS:
STORIES: WATER HEATERS: 2 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 4
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Tenant improvement: Install two (2) mop sinks, two (2) water closets, two (2) 2" floor drains, two (2) water
heaters, and two (2) drinking fountains. Capped 3 mop sinks, 3 water closet, 5 floor drains, and 2 water heaters.
Sewer permit SWR2000 -00132
FEES
Owner:
Type By Date Amount Receipt
PPR WASHINGTON SQUARE LLC INSP RCP 8/10/00 $50.00 HAND
BY THE MACERICH CO PRMT RCP 8/10/00 $115.00 HAND
ATTN: JANET FISHER, ASSET 5PCT RCP 8/10/00 $13.20 HAND
SANTA MONICA, CA 990407 PLCK RCP 8/10/00 $41.25 HAND
Phone 1:
Total $219.45
Contractor:
VISILE P. VARGA
EURO PLUMBING
2012 SE BLAIRMONT DR REQUIRED INSPECTIONS
VANCOUVER, WA 98683
Phone 1: 360 - 882 -8199 Plumbing Undersl
Top -out Insp
Reg #: LIC 141361
PLM 6489JP Misc. Inspection
Final Inspection
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 thr ugh OAR 952 - 0001 -0080.
You may obtain copies of these rules or direct questions to OUNC by . I Ing (503) 246 -1987.
Issued By: / Permittee Signature:. N
Call ( 3) 639 -4175 by 7:00 P.M. for an inspection neede. l day
CITY OF TIGARD Plumbing Permit Application Plan Check# (o -s ue
13125 SW HALL BLVD. Commercial and Residential Rec'd By
TIGARD, OR 97223 Date Rec'd 61--- /- od
(503) 639 -4171 Date to P.E.
Print or Type Date to DST 6
Incomplete or illegible applications will not be acceAted Permit #P r omp o - ao 13
b v f iv Related SWR #vZ�? -0O/ 3.?
Ou Pa2 ��
Called 4r 7 -00 - 8;05
t E A r ,W w /sa /P
Name of Developmen r FIXTURES (individual) QTY PRICE AMT
Job (�6 77 ' / [/ Sink Plop 5/92x a 11.50
Address Street Address i � (,t,41 Suite Lavatory 11.50 23
r
" ` f V v Tub or Tub /Shower Comb. 11 50
Bldg # City /State Zip Shower Only 11.50
??7,?,/1-74 t.-, /f � `i Water Closet 11.50
Urinal 11.50
Owner Mailing Address Suite Dishwasher 11.50
Garbage Disposal 11.50
City /State Zip Phone Laundry Tray 11.50
Na al i e � /J�� Washing Machine /Laundry Tray 11.50 ���222
U /f / -7 Floor Drain/Floor Sink 2° 11.50 `�/;
Occupant Mailing Address Suite 3" r 11.50 Pte'
4" 11.50
City /State Zip Phone
Water Heater 0 conversion 0 like kind 11.50
Gas piping requires a separate mechanical permit. 'W F/
Name �� ee e eit"r_ MEG Home New Water Service 32.00 n
Contractor Mailin Address 2 0 / y Suite MEG Home New San/Storm Sewer 32.00
a t /7 o [4 e Hose Bibs 11.50
Prior to permit CI y /State Zip Phone 3'O Roof Drains 11.50
issuance, a copy � il. - 8(5 d
0me ye 97 Drinking Fountain 2 11.50
of all licenses are Oregon Const. Cot. Board Lic.# E. Da
required if r ‘ �j .-d 2 OtheriFixtures (Specify) 45.00
expired in COT Plumbing Lic. # ( , (4i � t. j Z ,, ` 0
database U _ 4 -V ` •
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 to be done: Storm & Rain Drain - 1st 100' 38.00
New Repair 0 Repla ' like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00
Residential O Commercial
Additional description of work: Commercial Back Flow Prevention Device 32.00
Residential Backflow Prevention Device* 19.00
Catch Basin 11.50
Are ou capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00 C
Yes 0 No R. Inspections per/hr J
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.
I hereby ac rlowlz.ge that I have read this application, that the information QUANTITY TOTAL
Isometric or riser diagram is required if Quantity Total is > 9
given is co/ ectrl at I am the owner o6 thorized agent of the owner, and *SUBTOTAL,
•I subm• e• are in complia ; m ,th Oregon State Laws. SUBTOTAL it --
sh ,if i7 ?J1� Date 8 % SURCHARGE (�
_ �I�.!� %moo: ` /3.20
OJT. ct a o r'ame ' , • hone
l R Va r .' 3 '(o1 52g2 11 3q "PLAN REVIEW 25% OF SUBTOTAL 9/ a
1 BATH HOUSE $178.00 l Required only if fixture qty total is > 9 •
2 BATH HOUSE $250.00 - - TOTAL
�' ��
3 BATH HOUSE $285.00 • • '
(This fee Includes all plumbing fixtures In the „d and the first ' , Minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention
100 feet of sanitary sewer storm sewer and water service) Device, which is $25 + 8% surcharge
"All New Commercial Buildings require plans with isometnc or riser diagram and
plan review. n L ' u ^
1
I \fists \forms\plumapp doc 11/18199 �•..`� l7 I y � � i (�+
�� \\ ,
1 F� S T 1
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed /Capped
Sink
Lavatory 3
Tub or Tub /Shower Combination
Shower Only
Water Closet c Z, 3
Urinal
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
lasts for mslplumapp doc 11/18/99
•
Accumulative Sewer Tally
Tenant Name: ro Y✓/ 4 s' I This SWR# 1 ° v — m 0 / 3
Address: 96 wA v,) leo 5- . / This PLM #: "2-0 00 — °zr3
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
Value Capped off value added # added #s total
Count off #s count value values
Baptistry/Font 4
Bath - Tub /Shower 4
- Jacuzzi/Whirlpool 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4
- Domestic 2
Drinking Fountain 1 2
Eye Wash 1
Floor Drain/sink - 2 inch 2 5 / o
- 3 inch 5
- 6
- Car Wash Drn 6
Garbage-Disposal 16
- Domestic (to 3/4 HP)
- Commercial (to 5 HP) 32 -
- Industrial (over 5 HP) 48
Ice Machine /Refrigerator Drains 1
Oil Sep (Gas Station) 6
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2
Sift -Bar /Lavatory 2 `— J
- Bradley 5
- Commercial 3
- Service 3 3 9 ( 2 r
Swimming Pool Filter 1
Washer - Clothes 6
Water Extractor 6
Water Closet - Toilet 6 _ 3 / / -
Unnal 6
TOTALS 0 (l 0 -� a_3
x 0 �
Total fixture values: 0l0 la divided by 16 = EDU � � - ' 9 / E ' "
HISTORY rY eb_w-c_ae_420
PLM# 2000 -oo 2_1 13 p SWR# 2xoo -4 PLM# col /7 EDU# /3 SWR#/W-0008/
PLM# tf4 ,pp2 3 5--EDU# SWR# ,' q. o is - PLM# - oot v tEDU# o SWR# 1 -0 co7r
PLM# /q qq. o, iq / EDU# / 3 SWR# (q . doh 36 PLM# ..Ss SWR# /K6'_ co de/
PLM# /q do I EDU# ( d SWR# q -00 092 PLM # _coo7c EDU# / ' f SWR# /f9 .pDo3
i:ldsts .swrtaly.doc
PLEASE COMPLETE:
Type - . Quantity by Work Performed :. . •
New F Moved - 1 ':Replaced " > Removed /Capped
Sink
Lavatory 3
Tub or Tub /Shower Combination
- Shower Only
Water Closet Z, 3
Urinal
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2" 62 f 3
3"
4"
Water Heater - 9--
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I:ldstslfmmslplumapp doc 11/18/99
•
Customer Receipt
CITY OF TIGARD Printed: 08/11/2000 10:29
User: front
Station: 02
Operator: JMT
Rcpt No: 0004425 Date: 08/11/2000
Customer No: 000000 Amount Due: 219.45
Name: EURO PLUMBING . as • 219.45
Address: 2012 SE BLAIRMONT DRIVE Check: 0.00
VANCOUVER, WA 98683 N/A 0.00
Change: 0.00
Category: PLUMB Plumbing Permits
Type Description Amount
PLUMB Plumbing Permit 50.00
PLMPLN Plumbing Plan Check 41.25
TAX St. Build Permit Tax 8% 13.20
PLUMB Plumbing Permit 115.00
Cet- 0'4 g
%, „
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP •
Date Requested AM PM BLD
Location %(9. 5t °kg 5 d' go f Y�-e i g�,z-,^ Suite • MEC
Contact Person Ph 5 3 Cr Z a - 3ko 1' PLM tau - 6021 3
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 IOW
Firewall '
Fire Sprinkler �� �� :Ar
Fire Alarm
Susp'd Ceiling •
Roof
Misc: - -- -
Final
PASS PART FAIL
(PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Cy ins
SS 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 ' 1 Inspector Ext
Final
PASS PART FAIL DO OT 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 fP /V/ / CO AM PM BLD
Location "((e l q 0Q,5k gZ� Suite MEC
Contact Person Ph -(.00- 882 - 81V PLM
Contractor 0, , ELC Ph SWR
- jl
BUILDING Tenant/Owner S
Retaining Wall ELR 1
Footing Access:
Foundation FPS •
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath/Shear �� p n tn '� n M �/� /
Ina Sheath /Shear L `C_ l !s�F' s_S �/ ' W' ` c� `---r-
Framing
Drywall _co( j .n S e / D , ^ S
Drywall Nailing 1' L� C�J /' `
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof W
Misc:
Final
PASS PART FAIL /
PLUMB(G c &
Pos & Beam
Unser :b /1,5
ater Service
Sanitary Sewer
Drains
F'
PA 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 1 //
Approach /Sidewalk Date 9 ( v Inspector h'7 / �' Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.