Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PE
DEVELOPMENT PLM2004 -00064
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/13/04
SITE ADDRESS: 09653 SW WASHINGTON SQUARE RD PARCEL: 1S12600 -00300
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: M FLOOR DRAINS: 2 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Addition of fixtures for T.I.
FEES
Owner:
Description Date Amount
PPR WASHINGTON SQUARE LLC
BY THE MACERICH COMPANY [PLUMB] Permit Fee 2/12/04 $99.60
9585 SW WASHINGTON SQ. RD. [TAX] 8% State Surcharp 2/12/04 $7.97
PORTLAND, OR 97223 Total $107.57
Phone :
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : 503 Rough -in Insp
Final Inspection
Reg #: MET 00002486
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
Issued B Permittee Signature
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
.
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02/11/7004 10:18 FAX 5095981280 CITY OF TIGARD 11°03
P lumbing hermit Application,- City of Tigard .
Page 2 - Supplemental Information . •
•
•
Fee Sehedule: Residential Fire Sts i • ression - tems:
1 ` r Tr1�,lIm � n �� r 1 �Yi 7 i : , y G;. . tAsi 1 i r rt, C 0
r �— I I 1 '(I' '1�� •�Yi +j �: ^�,�� � it ':J...1 f• .ra� ✓ 1 It_i... .i = t,R i%,,I ' :[�....
i { ! I . i l 1� a r -J m i I' '} nu c �c 1 yrJU..
- _ 100' 55.00 , to h 00 115.00
poles � � 001 to 3,600 S] �' •�
E0odrg drain - each additional 100' 45.40 3 r 01 to 7300 $220.00 _I. Sewer - let 100' aditiMMIIII 7 .201 and e , , -, $309.00
Soler - - additional 100' 46.40 . —
w, Scaifir.4 - lift NY 55.00 IMO Medical Gas S • mss
Water - oe - each additional LP - to ' 1 ' ^ '' '� l - j !a ji ;r..:k. . ', . F n_ 4 „ = .�' ; mr •�� . : ., I' • W1al100' 46.40 r:::i`�. ;. ;T � b fi r' '. a ' . �„,7; i 1 , " if . 1'
S t o r m & Rain D r a m - 161100' 55.00 — 1.00 to . r 1 . e , Mirnrainn f e $'72.50 .
Storm& Rain Drain - rash 100 additional , tb1 00 or 0011 thereof o And
i MIME= 00 1.00 w O ,0oo.a0 372.5 for the ,000 00 tmd 5 51 l 52 for cacti
- rr , m
, '•=r - - + am, , t•I 7•' - . R `! _ I�a;•;,r ` ew additional 5100. frae f t
f, {• ; ' .!.:2_..'' t i _ i ir5 .. 1 } ` . i :FL ='I ^.L- - d ( . 'J" 1 c . _ L ^s. ,1t including $10,000.00. •
Conaoerc101 BM now l'lwsudon I.IIII Dcviee 46.40 MI 010.001 M to 525.000.00 e 30 for the $i rat ai n or fraction and thereof, to
Bxai • n'Grial • • - . Prevention Device ends
and includin ,000.00.
—rain i i — $25,001,00 to $50.600.00 w S379,512 for the first S25,000,00 and 51.43
Drain, �� fauu d w1 • 5 larch additional 5100,00 or filiation thereof. ID BLit 17ecdon of existing plumbing or _ • , and Including 550.000.00.
750
$50,001.00 end die firm u p $742.00 for firm $50,000,00 and 5120 for
carbintal: - s —
each rdditional $100.00 or fraction dicta dicta !' r + •
�✓ stare ' ork:
Are you capping, moving or replacing existing fxtttret9
" yearn, please liamleate work performed by fixture. Failure to
accurately r h , fixtures could result in increased sewer fees
r: i • s i , f F i 1 . : E r .. ' � t i , : i
� . s C r „ t, tints ragtar'dilag fixture work:
13a olainowor • —111111= I • py. r s t r C
Car Wash - Ear118ta1l INO110
Drive Tluu -IMMOMIIIIN111
, 'dor/Wata' • suer
I'.. : hot -vial
-Domestic limmENNIMMeill
Floor DT9tJrdalc -3" ' � _ .
' • 4" �� '
Car Waal] Drain
1 , , :Pe • ' 'fl $tie �� �.
Disposal el 0 — MOO * , te: If the fixture work under this permit results In an
-Industrial • :water - , Crest of sewer EDU$, a sewer permit will be issued and
Ica' : rater s- Statiatab r � � -- i e!9 assessed for the sewer increase must be paid before the
011 • -ot' ca�� lmlbitlgpertnft be issued.
Rae:ve icle Don • S ORB= —
Shower -Gana , MINIM
-drain
Sink -Dantavanny t I '1'ottil
-coal � �lii me or riser diagram is required if fixture quantity
�r�
-Service .lfa6�9. .
�� �
w ,„,,..., .,.
as . - f!Iathest =
Wets Retractor 7, Review
Wrater Closet r �r _� p review is regtt[z ed if fixture quantity total is may.
Urinal
Othcrrortize
Evx114arp nakit7 - e..aApp.40. was '
E0 39Vd ONISWIl1d Nel3TOW TLL9T69E05 917:17t 1700Z/tI /Z0
CITY ,OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested 3 AM 'PM BUP
Location q6 . 3 W/ S - Suite MEC
Contact Person ffrizA, Ph ( ) ' / -4' /4i 4o PLM L71-66062 C�
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC'
Access:
Ftg Drain ELR
Crawl Drain —
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors )�', i r
Ext Sheath/Shear L lam '
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
•
Fire Alarm
Susp'd Ceiling
Roof
Other: -
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Ot - r:
t r itOPART FAIL
CHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
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 L Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA /��
Approach/Sidewalk Da � a� 6 I nspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL