Permit CIT OF TIGARD PLUMBING PERMIT
'w� DEVELOPMENT SERVICES PERMIT #: PLM2002 -00453
. � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/21/02
SITE ADDRESS: 09635 SW WASHINGTON SQUARE RD FC -5 PARCEL: 1S126C0 -01107
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION:
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: M FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 4 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing tenant improvement, replacing (4) sinks and relocating (1) RP device.
FEES
Owner:
Description Date Amount
PPR WASHINGTON SQUARE LLC
BY THE MACERICH COMPANY [PLUMB] Permit Fee 11/21/02 $112.80
9585 SW WASHINGTON SQ. RD. [PLUMB] Permit Fee 11/21/02 $0.00
PORTLAND, OR 97223 [TAX] 8% State Tax 11/21/02 $9.02
[TAX] 8% State Tax 11/21/02 $0.00
Phone 1:
Total $121.82
Contractor:
HIGHLAND PLUMBING
PO BOX 1866
OREGON CITY, OR 97045
REQUIRED INSPECTIONS
Phone 1: 503 - 723 - 4445 Top -out Insp
RP /Backflow Preventer
Reg #: LIC 145756 Final Inspection
PLM 3 -479PB
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 m y- obtaiin copies of these rules or direct questions to OUNC by calling (503) 246 -6699.
•
1 .. By: _' ' , .. S ; Permittee Signature:, // , ��j ►/ . ...{A__
all (503) 6) 9_41 75 by 7:00 P.M. for an inspection needed the next business day
Nov 19 02 1 5:43p p.2
-- - 3 - rtu oudaaaltresu CITY OF TIGARD
001
Plumbing Permit Application-
Cl Of T" :z:: AM PermitDo O— _ � Bui lding p ermit no.:
Ciryof7 Address: 13125 SW Hall RBA I 97223
Phone: (503) 639 -4171 Project/app1.no.: r
Fax: (503) 596 -1960 Nov 1 9 2002 Date issued: , Receipt no.:
Land use approval: __ err( o f TIGARD cam file no.: Payment type: r
o 1 & 2 family dwelling or accessory Commervi�ndustrial 0 Muld- family O Tenant improvement
0 New construction 0 dition/alteration/replacement 0 Food setriae 0 Other
.1013 SI EINFORMMAlION rEEsciicn' iF (for aiecialinfornationticchecklist)
Job address rr Description Qty. Fee(ea. Total
(.r .� ' 4. I .- C X1 t roc I--? •-. >
Bldg. no.: State no.: �' New 1 -tend 2-family dwellings only: .
�'i • t v- • (Wades 100B. for each sdilityeanoeetloe)
Tax map /tax lot/account no.: SFR (l) bath
Loc [Block: (Subdivision: SFR (2) bads
Project name: 4----- - ', ---- ., t 72 l't — SFP. (3) bath _ 1 J
City/county: 1 7(p: ,.- Each additional bath/kitchen
Description and location of work on premises: Sheotibties:
Catch basin/area drain
' Esc date of completionfinspection: Drywells/leach lineArtnch drain
.Poona drain (no. lia. ft-)
Manufactured me utilities
Business name: j 1-11e" I .P I' IrvA Uh r 1 c. Manholes
Addresser i . _ t-....: - - ' 4 " Rain drain connector •
City:(".%, c ,+"1 , L , State:( '3 ZIP: / ( Sanitary scwer(no. lin. ft.)
Phone. ; --t I lt- r Fax: •- , ►. fir, E-mail: " Storm sewer (no. lin. ft.)
6£B -0e.c '7 .= — y ' Plumb-bus. reg. no: Water service (no. hn. )
Cie yianamik...rw.: 'i 1 L`. -") C7( _o 'Fixture or Rene -
Coruractor's representative signature: 1,_a. Absorption valve
Print name: `_ • V Rack flow pceventer g p - ,'1, : , I . at Backwater valve
:Basinsaavattrcy '
Name: Clothes washer
Address: - Dishwasher
City: } state: l ZIP: Drinking fountain(s) •
Ejectors/sump
Phone: Fax: E-mail: - Expansion tank • .
O \ ' N• lt Fix . .
Name (print): . Floor dcains/fleor siNca/httb
Mailing address: — Garbage disposal
Hose bibb
City:. 1State: 'ZIP: • _ , lee maker •
_ Phone:. [Pax: 1E-mail: Intergcease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property Town as per ORS Chapter-447. - Sink(s). basin(s). lays(s) �i
Owner's signature: Date: Sump -7
1111111111.111111111111111 11111111111Milr. Tubs/shower/shower pan '
Name:
Urinal r -- r" —
Address:
Water closet -
Water beater
City: ] State: 1 ZIP Other: 7
Phone: 'Fax: 1 E-mail: Total
" Ara
all iiama:thou soaspt mat cads some eaa islis kdoo lax room rroneadan`- Minimum fee ....�.. $
O Moos 0 MairuCwd N otice ...This h19 perm ap
expires if a paint is oat obtained Plan review (at %) Si Li. Quin cad .muse. .. within. t HO days after it has been State surcharge (8 %) .... $
Name a[ mambolder an mews co m a:t card accepted as complete. TOTAL $
S .
caeshower titmouse Amoom • , 440.+616 (6i0 YCOtt)
_ s / A
CITY OF TIGARD 24 -Hour __
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ BUP
Received Date Requested / //W AM PM BUP
Location q6o 3 S Lt)/t"- . &• z_D' Suite MEC
Contact Person Ph ( ) PLM oZ — 4 7 1 5 - 3
Contractor h ( ) 3 �k'SWR
BUILDING Tenant/Owner ELC
Footing -
Foundation ELC
Access:
Ftg Drain j) CL /7-7- ELR
Crawl Drain
Slab Inspecti n Notes: SIT
Post & Beam
Shear Anchors g'7 ( - S 4 s
Ext Sheath/Shear 4
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall ' c
Fire Sprinkler
Fire Alarm �
Susp'd Ceiling 441512,211 i� /.i / _ / /
Roof
Other:
Final A I F Ark: /,L /
PASS PART FAIL
PLUMBING / ■ _.., / _
Post & Beam / ��
Under Slab ��//�t -� �� -
Rough -In /
Water Service j
Sanitary Sewer i�� ' 0---) ` C � �
Rain Drains / ✓ - - -ice - —
Catch Basin / Ma ole
Storm Drain
Shower Pan �i�� j ` ' ', //� it Othe 1 . , / /-
AS PART FAIL
E • ANICAL
Post & Beam
Rough -In
. Gas Line _
o idg ., _. 7-' . ,
Smoke Dampers
Final
PASS PART FAIL
i
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date 7 � . Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL