Permit C ITY OF TIGARD PLUMBING PERMIT
° " COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00047
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/8/2008
PARCEL: 1S12600-00300
SITE ADDRESS: 09653 SW WASHINGTON SQUARE RD MO2 A ZONING: C -
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: WASHINGTON SQUARE
Project Description: (1) 100 ft. waste line to two new spaces and (1) 100 ft. water line to two new spaces. Spaces:
9653, 9659, 9619.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: 100 ft
WATER CLOSETS: 1 WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
WASHINGTON SQUARE LLC Description THE MACERICH COMPANY escription Date Amount
9585 SW WASHINGTON SQUARE RD [PLUMB] Permit Fee 2/8/2008 $159.80
TIGARD, OR 97223 [TAX] 12% State Surch 2/8/2008 $19.17
Phone : Total $178.97
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 rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B •
_
� Permit Signature:
0
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.
„ Feb. 7. 2008 11:29AM Modern Plumbing No. 7706 P. 5/512100
E\I Plumbing Permit App rc� -1! �1 1-01( ()1.1 i r. I:sE c1
City of Tigard /377- aco
13125 SW Hall Blvd., Tigard, OR 7-°/(6 Dare By 7 70 1' /3/l - �'- rr Aryl e'_ 7
- - . Phone: 303 639.4171 Pax 503.595.1960 ABD Dale B, Plan Re+tea ` q Permit N.
Inspection perAion hide: 303.639.4171 -1�G
Y 0� N Date Ready/By. ® See Page 2 for
I I .,.11, P. Intranet: awligard- or,gov GI 1Q
v�5 NonSe Supplemental os FEE., , -
O Now construction ❑ Demolition For special krormation we chech1i .
Deassipti,m 1 Qtr. f Ea 1 Total
x Addition/alteration/replacement ❑ Other. New 1- 2-family dwellings (includes 100 IL for each utility connection)
r. : .= `•`r' ''
; �;: C,,A'Ii( Rt O, C ONS1"JtvCT[QN SFR 1 bails � 249.20
,,. •, . �.: ..;: ,'�.'. �� '. - O _
❑ 1- and 2- family dwelling X Commorcial/industrial SFR (2) bath _ 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ J M �� isterbuilder ❑ Other
additional bath/kitchen 45.00
9ti '• :`,. �4 !d�'PE= i_.•s .1-47d11,'A1Vb o ,, Fyesprinkler�sct.f) I Paget
' f.A�C;i!17'I �'' `� Site ttlmtles
lob site address: 6 11 1 i I - Catch basin or area drain 16.60
City /Statc/ZIP: I) el , kr 0 R.. Drywell, leach line, or trs aclt drain 16.60
Suite/bldg./apt. no -: j IProject name e: Footing drain (no. linear 8.: -.) Page 2
Crows street/directions bons to job site: -"
Manufactured home utilities 110.00
Manholes 16.60
t A f S C) G � /4053 ,, 46 59 Mein drain connector 16.60
9 /t'
` 1 9 W L04 . Q C (. 'D - Sanitary sewer (no. airiest ft.A DO) Page 2 6 /
Stone sewer (no. line 1L: ) Page 2 g6 /
Subdivision: 1 Let no,: . Water service (no. linear ft: Page 2
Fixture or bt®
Tax map/parcel no.: - , ... 4' ,'T►�,�, �9N':CiF 1V.°, j► ' Absorption valve 16,60 `
,' r
.(: „ . ` ' - .....,• • .. % Badcflow pteventer Page 2
a na (0)C • I v 0 U.) a S 1 1 1 n e 1 Ca g y"� e. Bsckwnner' valvo 16.60
S! O- C e--.5 •
i....01 app ) t6 i o I u.�.) a1 . Clothes washer 16.60
t o °^. o c a s e, F4 Dishwasher 16.60
y R O '' ; ,,,d:, ,S� r�•} h .. -: ; ' :l, , „� Drinking fountain
- ?r�5�,.r,'r I-•+ f ees! „" � " '�'J,•!l`i+,11('� � r 16.60
Name: s
...AA
_ 16.60
Address: Expansiontank ■ 16.60
1~unore /sewer cap 16.60 L/9.260
City /State/ZIP. Floor drain/floor sin
- 6 16.60
Phone: ( ) Fax: ( ) Garbage disposal
, ;,• 'ti, ;APPLirax'f % [ ' Ol!1TA( P Bose bib 16.60 .. 16.60
`
' ' "' • ' - T; ARSON
Bttsiuoss name: lee maker 16.60
Interceptor/greasetraP • 16.60
Contact name: -
W - Medical gas (value: $ ) Page 2
Address: p�� -
16.60
City /State/ZIP: Roof drain (commercial) _ 16.60
Phone: ( ) I Fax: : ( ) S 1O 16.60
E-mail: ThWhhower/shower pan 16.60
Urinal 16.60
,!O#CTOA'. 'Water closet
16.60
Business name: Modern Plumbing Co. Water heater 16.60
Address: 11120 SW Industrial Way Other f OD' wa 'r 1,6e.
City/State/ZIP: Tualatin, OR 97062 g IOW \,Jaste 1.1.-e I r\51( Subtotal /59. cU
Minimum permit fee: $72.50
Phone: (503) 6916166 Fax: (503) 6916771 Residential baddlow minimum permit fee: $36.25 - -
CCB Lic.: 87906 "- mbing Lic. no.: 34 250PB Plan review (25% of permit fee) i
/���
State surcharge (l2% of permit fee) IC? . ) 1
�
Authorized signature: y � __ � TOTAL PERMIT FEE I ') .9 7
I 'tint name: D b b h 6.Cof 9 Dam: 2 7 /U Q �1 permit application expires if a permit is not obtained within i
180 days alter it has been accepted as complete.
"Fee methodology set by Tri -County Building Industry Service Mears.
L • Pem3Appdoo 06116/06 440.4616T(10/02/COM/WEa)
Accumulative Sewer Tally Parcel # 1S12600 - 00300
Tenant Name, WaSangton Square This SWR# NA CREDITS DUE
Site Address. 9653, 9659, 9619 Washingtc ton Sq. Rd. This PI,M# PLM2008 - 00047
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value capped off value added added total total
count off #s count # value #s values
Baptistry/Font 4 0 0 0 0 0
Bath - Tub/Shower 4 0 0 0 0 0
- Jacuzzi /Whirlpool 4 0 0 0 0 0
Car Wash - Each Stall 6 0 0 0 0 0
- Drive through 16 0 0 0 0 0
Cuspidor /Water Aspirator 1 0 0 0 0 0
Dishwasher - Commercial 4 0 0 0 0 0
- Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eve Wash 1 0 0 0 0 0
Floor Dram /Sink - 2 inch 2 0 0 0 0 0
- 3 inch 5 0 1 5 0 -1 -5
- 4 inch 6 0 0 0 0 0
- Car Wash Drn 6 0 0 0 0 0
Garbage Disposal
- Domestic (to 3/4 HP) 16 0 0 0 0 0
- Commercial (to 5 1 -IP) 32 0 0 0 0 0
- Industrial (over 5 HP) 42 0 0 0 0 0
Ice Machine /Refrigerator Drain 1 0 0 0 0 0
Oil Sep (Gas Station) 6 0 0 0 0 0
Rec Vehicle Dump station 16 0 0 0 0 0
Shower - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink - Bar /Lavatory 2 0 1 2 0 -1 -2
- Bradley 5 0 0 0 0 0
- Commercial 3 0 0 0 0 0
- Service 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer - Clothes 6 0 0 0 0 0
Water I:;xtractor 6 0 0 0 0 0
Water Closet - Toilet 6 0 1 6 0 -1 -6
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
l'OTAI.S 0 0 3 13 0 0 -3 -13
Current Fixture Value -13 divided by 16 = -0 8 Current EDU 1 EDU = $ 2,800
Previous Fixture Value 0 divided by 16 = 00 Previous EDU
Change -13 divided by 16 = -0.8 over (under) $ (2,240 00)
Enter EDU Change Here -0 8
Notes:
Authorized Name /Signature: Barbara Bkutler Date: 2/8/2008
Building Division
Note The property owner shall retain the ORIGINAL sewer tally record If credits exist, this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I. \Building \ Forms \ScwcrTallyShcet xis 02 /02/07
-------411PPF
CIT ,OF TIGARD •
BUI ING DIVISION PERMIT#: PI..M2008-00017
13125, W Hall Blvd., Tigard, OR 97223 DATE ISSUED: :MAIM
Phone: (503) 639-4171 ���a4P��yp��11�Il'�
Inspection Requests (24 Hrs.): (503) 639-4175 __..
INSPECTION WORKSHEET FOR DATE: 24,7/2008 TIME: 7:00AM PAGE: 30
5.3
SITE ADDRESS: 09649 SW WASHINGTON SQUARE RD t.04 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT#: TYPE OF USE:
PROJECT NAME: POTTERY BARN
DESCRIPTION: (1) 100 ft. waste line to two new spaces and(1) 100 ft.water line to two new spaces. Spaces: 90553,
9659, 9619.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503-691-6166
Inspection Request Scheduled For: Date: 7127/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-iia 0657301 603-691-6166 N
Corrections/Comments/Instructions:
PoAce4-c -, t y" Co,./1- S-,,o is) s- ,L t z"( v‘00,/ i,„-
I I PASS IX PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: d� i-1\1\-- Date:2 121? I oZ Phone #: (503) 718-
CITY OF TIGARD 0 - ,-,, , • • ...___7
BUILDING DIVISION PERMIT #: Pt..Ivi 003 000.11
1
13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED: /Ii/2008
Phone: (503) 639-4171 pul�ugl�t ii\
Inspection Requests (24 Hrs.): (503) 639-4175 ,'� ,,o/
INSPECTION WORKSHEET FOR DATE: 2.06/2008 TIME: 7:00AM PAGE: 19
'7ee53 1
SITE ADDRESS: f SW WASHING-ON SQUARE. RD L04 CLASS OF WORK:
SUBDIVISION: WASHING ION SQUARE LOT#: TYPE OF USE:
PROJECT NAME: POTTERY BARN
DESCRIPTION: ('1) 100 It,waste. line to two new spaces and(1) 100 ft. matel line to two new ::paces. Spaces: 9653,
96593, 96:19.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503- 1-6166 I
Inspection Request Scheduled For: Date: ?J2CJ2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in (165660.01 613.691-5166 N
Corrections/Comments/Instructions:
•
n PASS ❑ PARTIAL APPROVAL X CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: cr6 V-v,-,.-A V'7 mow— Date: '_ 2 C 4; Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT#: PLM2008-000117
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2101:.,I008
Phone: (503) 639-4171 �,,��"11�Nlnlpiglpl��l�l�
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2129200€3 TIME: 7:03AM PAGE: 4�3
96,53
SITE ADDRESS: 119SW WASHINGTON SQUARE RD 1.04 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT#: TYPE OF USE:
PROJECT NAME: POTTERY BARN
DESCRIPTION: (1) 100 ft. waste line to two new spaces and(1) 100 ft. water line to two new spaces. Spaces: 9653,
9659, 9619..
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: ?.;03691-6166
Inspection Request Scheduled For: Date: 1129120013 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Plumbing final 06584a01 603691-0166 N
Corrections/Comments/Instructions:
OLA
CL--c, Yom"
PASS I PARTIAL APPROVAL ❑ CANCEL NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6914'i a-J ► A k) Date: Z`Z<A,,,0cr) Phone #: (503) 718-