Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00071
41116c 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/1/2005
SITE ADDRESS: -39499 SW WASHINGTON SQUARE RD F -2 PARCEL: 1S12600 -00300
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: '76 (Q 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; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing TI, add (1) breakroom sink, replace (1) lay & (1) toilet.
Owner:
FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQUARE RD [PLUMB] Permit Fee 3/1/2005 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 3/1/2005 $5.80
Phone : Total $78.30
Contractor:
PMSI LLC
21195 NW EVERGREEN PKWY STE 20 REQUIRED ITEMS AND REPORTS
HILLSBORO, OR 97124
Phone : 503 466 - 2222
Reg #: LIC 158286
PLM 34 - 434PB
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 -000 -I • : rough OAR 952 - 0001 -0100. You may obtain copies of these rules or direct - questions to OUNC by
callin% (503) 246-:• :1.
Issue By: i /� // Permittee Signa ,
Call (503) 639 -4175 by 7:00 P.M. for an inspection the next 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.
W iR - 01 -2005 14 12 MSI 5034662211 P.01
/ z EC IV ®'
Plumbing Permit Application c F012 01+1C ': USE ONLY
fir � ! t ax es
Received
City of Tigard : • 0 i 1 // • ermit No.: Q � Q 7/
Date/B A
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 ;,is,„
CITY OF Plan Review
Date/By. Rev
Rther Perron No.: 04,�Os-t�" tJfJ
Q ,1
4,,� 1 " , P
24- Hour Inspection Line: 503.639.4175
BUILDIN ¶ 1 ! ,y- ' 1 Date ReadylBy: �°' 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method:/ (� Supplemental Information
a 'IiYPE ' O ' F WORK . ) ?Ej" SCHEDU -, , ..
' ; ... 9 , : , :`; ;46 : ::: ; :10!;i - ;: . ;;i l - For special Informalion use checklist
El New construction ❑ Demolition Description I Qty. I Ea. I Total
q ,Addit ion / alteration /rep� j� ❑ Other. New 1- 2- family dwellings (includes 100 ft. for each utility connection)
.; ;I 1 - '+ and _�.l� tfriA�` 2- family - dwelling I� ".1..'�~li' i:!0.0. /RI!'.1)Ir "_ CO_.NSI'RVC ._ SFR (I) bath 249.20
❑ 1 -a..` ': SFR (2) bath 350.00
2-family - '
SFR (3) bath 399.00
❑ Accessory building ❑ Multi- family 45.00
Each additional bath/kitchen
❑ Master builder ❑ Other. Fire sprinkler ( sq. ft.) Page 2
( •:x-i A - . 'rim •••,_ •,- :,= ..,.,..n,...�..:u�.•.•... ,_, ;.
;,'w-s•.�?i( 7 t- kt j 0 . *l` NF_ :.LOCATION , - Site utilities
Job site address: g7j so/ W4 takn tJgd(/, /, 44 Catch basin or area drain 16.60
City/State /ZIP:` t t -7723 'i!l4�L 53 / Drywell, leach line, or trench drain 16.60
� . � � Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: `/G y VVIX . / C � UP w, Manufactured home utilities 1 10.00
Cross street/directions to job site: Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: , ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.:
-CO Fixture or item
Tax map /parcel no.: / j/ 2•0 W 300 Absorption valve 16.60
^,..3'• zleF.:3i iii9:�a:''= y!wr::e_cs" °dwir r':< , � { ;� ( � rr , l �{• ,
ri:ijrt_ '�;� :r'i " "'ti� >i;"� >3!7iy "I � r'�FiB �QN; '.. � � Backflow preventer g
n . 4 : (� Backwater valve 16.60
K ( J � y- Clothes washer 16.60
R p(a-ee 'yh.ri4- t1'1 I - lit 1/ l- IL'tle 16.60
Dishwasher
Drinking fountain 16.60
nL r -:a �• •;�.: a c•• 0 ,.,,,:::::�:� �I•sp.:-: D. `TENANT - 16.60
Ejectors/sump
Name: Expansion tank 16.60
Address: Fixture/sewer cap 16.60 _
City/State/ZIP: Floor drain /floor sink/hub 16.60
Garbage disposal 16.60
Phone: ( ) Fax: ( ) 16 60
:,: °re
Hose bib
pis . �'= ';r•.... :� .. ❑ CQNTACT PERSON 16.60
l: }i • f:ter, <3 is i i !Fh,.S : + ; :; i i i °a „{? :-:. ". ;!• Ice maker
Business name: pmS/ L, IL, ( . Interceptor /grease trap 16.60
Contact name: ib 106 f i-s `� Medical gas (value: S ) Page 2
Address: 1 g ! J a i V e, oeft 014 .Yft 214 Primer 16.60
Roof drain (commercial) 16.60
City/ State/ZIP: Lt�,1)GYv j k L/ 4 :CD
J Sink /basin/lavatory gy L 16.60 '
Phone: (q03) �(,� � `L��,
) � Fax: : ( cky(`'�,�,/ Tub /shower /shower pan 16
E -mail: Urinal 16.60
q ua ' za 1• � a:l 0:ii i i1 . „ t•'Y'- I t , * .� - . .. - • .. • r 16.60 10 . id ,
a'vL li •.. pa,„E:1 .i '•,'.„ ' 1t4 ;,4 TbA , Wat closet
-
Business name: )m(yi Water heater 16.60
Address: ht Nye �vev rears 046 L li� t Other:
/� i 7 Subtotal (�
9 ,
City/ State/ZIP: LJ Op_ ei /� Minimum permit fee: $72.50
Phone: 1 ��� , Fax: ( oi ioi , _ Residential Backflow minimum permit fee: $36.25
CCB Lic.: ' � ,�� Plumbing n g Lic. no.: q 2' L T/'/V 24 _ Plan review (25% of permit fee) ififfe State surcharge (8% of permit fee) 5 eO ,
Authorized signature: -` I TOTAL PERMIT FEE '' 30 yr, ei Date: / • L7- This permit application expires if a permit is not obtained within
�� L ,1 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
k\ Build :ng\Pem+us\PLM- PemitApp.doe 12/03 4404616T(10/02ICOM/WEB)
CITY OF TIGARQ Mik . __,
1
BUILDING DIVISION PERMIT #: PLM2005 -00071
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1/2006
Phone: (503) 639 -4171 .Alt
Inspection Requests (24 Hrs.): (503) 639 -4175 "'IL.
INSPECTION WORKSHEET FOR DATE: 4/12/2005 TIME: 7:09AM PAGE: 30
SITE ADDRESS: 09706 SW WASHINGTON SQUARE RD F -9A CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CRABTREE & EVELYN
DESCRIPTION: Plumbing TI, add (1) breakroom sink, replace (1) lay & (1) toilet.
OWNER: WASHINGTON SQUARE LLC, - PHONE #:
CONTRACTOR: PMSI LLC PHONE #: 503-466-2222
Inspection Request Scheduled For: Date: 4/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 004309 -01 503 - 849.5520 N
Corrections/Comments/Instructions:
7(.-/ .
•
r; -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 2 . 774d --- - Date: / Phone #: (503) 718 -
L—