Permit ` ?a
C ITY OF TIGARD PLUMBING PERMIT
� DEVELOPMENT SERVICES PERMIT #: PLM2002 -00370
F`�'` -1011 - 13125 SW Hall Blvd., T igard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/8/02
SITE ADDRESS: 10100 SW WASHINGTON SQUARE RD A -1 PARCEL: 1S135BA -00102
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION:
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 9
OCCUPANCY GRP: A3 FLOOR DRAINS: 31 TRAPS:
STORIES: 1 WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 11 URINALS: 1 GREASE TRAPS: 1
LAVATORIES: 7 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: 300 ft
WATER CLOSETS: 6 WATER LINE: 100 ft
DISHWASHERS: 2 RAIN DRAIN: ft
Remarks: Plumbing new kitchen and restrooms.
FEES
Owner:
Description Date Amount
PPR SQUARE TOO LLC
BY MACERICH COMPANY [PLUMB] Permit Fee 11/8/02 $0.00
ATTN: JANET FISHER, ASSET MGMT [PLUMB] Permit Fee 11/8/02 $1,765.80
SANTA MONICA, CA 90407 [PLMPLN] Plan Review 11/8/02 $0.00
[PLMPLN] Plan Review 11/8/02 $441.27
Phone 1: [TAX] 8% State Tax 11/8/02 $0.00
Contractor: [TAX] 8% State Tax 11/8/02 $141.27
ROCK CONSTRUCTION + PLUMBING Total $2,348.34
P O BOX 8507
BEND, OR 97708 REQUIRED INSPECTIONS
1171 Sewer Inspection RP /Backflow Preventer
Phone 1: 541 - 309 -
319 - 117 Sewer Inspection RP /Backflow Preventer
Reg #: ��� 0112770 Water Line Insp RP /Backflow Preventer
PLM 9 - 184PB Rough -in Insp RP /Backflow Preventer
Rough -in Insp Final Inspection
Rough -in Insp
Rain Drain Insp
Rain Drain Insp
Gas Line
Gas Line
Gas Line
RP /Backflow Preventer •
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
00 / Permittee nature:
Issued By. Perm ttee Mk
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
09/12/2002 09:28 FAX 5035981960 CITY OF TIGARD I J 002
Building Fixtures _ , Bo a —r_s
Plumbing Pe -.t ".. •_ '• •'0tion orFICI: USE ONLY
Date received: 9 /7 O� Permit no.: e'i -O0�d
" "'tit Itl1 City of Tigard 1 V7222/40 7 Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Ti OI G
Cit of 7Ygard Phone: (503) 639-4171 ' Pro
ca g y d p.G�f
ecr/appl. no.: • e date:
Fax: (503) 598 -1960 EU Y nG e rr L ON Date issued By Receipt no.: . -
Land use approval: // (,1�1 Case file no.: Payment type:
• TYPE OT PERMIT
❑ 1 & 2 family dwelling or accessory Commercial/industrial ❑ Multi family Tenant improvement
❑ New construction Additio t • alteratio. eplacenient 0 Food service Other:
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address: (A)aShi Obn S0 �n� CQyt ) Q/OV Description Qty. Fee(ea.) Total
6' / ew 1 -and Z- family dwellings only:
wASt►!ct+Ohuite no.: A - 1 (includes 100 ft. for each utility connection)
Tax map /tax lot/account 3d.: SFR (1) bath
Lot !Block: 1 Subdivision: SFR (2) bath
Project name: , A SFR (3) bath '
City /county: 1 ar•' /(,ikalii :p •• , ZIP: 17 a Each additional bath/kitchen
Description andlbcation of work . prep4ises: oF Site utilities:
eXiMin• rPP1 IAt caJ*'S • , • t (&U-) R Catch basin/area drain
Est. date of completionsp_ect p.�. a0 3 ^ '�' Drywells/leach line/trench drain
Tin
Footing drain (no. lin. ft.)
TRACTOR Manufactured home utilities
r ti,
IIIIIMIM
Business name: 7.„_ _'=' \ _ ?4� Manholes
----- J, . ss: • 0 , ' D $ S0 - • 1 Rain drain connector
Z� ZIP: 0 '1 Q Sanitary sewer (no. lin. ft.) .
c - - S'// -3/ 7 •�/ 4 — - Storm sewer (no. lin. ft.)
Phone: Fax: _ — -E -mail: (
CAB no.: 1 / a- - z Q ' , I Plumb. bus. reg. no: ` 9 - 1 _q� Water service (no. lin. R.) •
Ci /metro lic. no.: -r-ii '01 30 Fixture or item:
Absorption valve
Contractor's representative signat 7 ure:
_ Back flow preventer
Print name: Date: / Backwater valve 11,11.11
CONTACT PERSON Basins/lavatory ■ 111111.11.1111111
Name: Perri c.k : • - or ar L i� Clothes washer 7.1.01 Dishwasher WMIIM 1111
�. -. •- •:'-
.. _ ' Drinking fountain(s) v_ll�t\
�., r. �7 Ejectors /sump �—
Phone &,� y,_ • I • I' , p -mail ba en--1-
e ! --1 i0j Ex.ansion tank AIIMPAIIIIIIIIM
—
OWNER
• Name (print): o e ' , fed Floor drains/floor sinks/hub M_
- v u a 1 Garba:e dis.osal V
Mailing address.' L I • ; i�►�o� j '� a l. . - � Hose bibb
City: t • a AMINIMMIETEWO. ZIP: ' _ Ice maker
Phone:4754Q7 • : • Fax: • E -mail: Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Primers)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: Date: Sump .
ENGINEER Tubs/shower /shower pan
Name: Ja50►'1 S rn o1kr- - ', leScklr>cthe1 Co. Um. al
� n Water closet
Address: '' U35 5.70 ra_ S- Q A , S . 1t, 0 Water heater
Basra " let. State: NIE ZIP:. ( :) _ Other: • ..._.
Phone: 39 I - W o ; • - axr 40a- S91- 74$$ Total
expires if a permit is not obtained fee $ � ���� %"
'Not all Juriadiaions accept credit cords, please call jurisdiction for more Informwoo. Notice: This permit application o
0 visa a Masurd rc, PlMinimum an review (at _ /o) S LT
u T
Credit card number: _ / / State surcharge 03%) .... s
Expires within 180 days after it has been TOTAL $ • =1� 7i
Name of cardholder as shown on credit cam accepted as complete. 4) /D�
S W.14/A/6"
Cardholder signature Amount �� � � <<14) 1 /� �� D0A-/ // 616 (6/001COK
L
PL1JNIBING PERMIT FEES:
• PRICE TOTAL New 1 and 2- family dwellings only:
FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures In PRICE TOTAL
Sink // 16.60 le04 the dwelling and the first100 ft. QTY (ea) AMOUNT
for each utility connection)
Lavato ry /7 16.60 //G ,26 One (1) bath $249.20
Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00
Shower Only 16,60 Three (3) bath $399.00
Water Closet b 16.60 90GD SUBTOTAL
Urinal / 16.60 l4 8% STATE SURCHARGE
Dishwasher 5 16.60 /44. PLAN REVIEW 25% OF SUBTOTAL
Garbage Disposal 16.60 /4"46 TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 9 16.60 /4/9
3" / 9 16.60 3fs yo
PLEASE COMPLETE:
4" 3 16.60 4/9490
Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. / /4,606$ Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer -. 46.40 Lavatory
Hose Tub or Tub /Shower
ose Bibs - 16.60
Combination
Roof Drains q 16.60 if�/ 3 !D Shower Only
Drinking Fountain 16.60 7 Water Closet
Other Fixtures (Specify) 16.60 Urinal
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Sewer - 1st 100' Floor Drain /Sink: 2"
55.00
SS, t�0 3"
Sewer - each additional 100' 11. 46.40 97.96 4^
Water Service 1st 100' 74 55.00 6 - 6 7 e a Water Heater
Water Service - each additional 200' ...... 46.40 Other Fixtures
(Specify)
Storm & Rain Drain - 1st 100' - 55.00
Storm & Rain Drain - each additional 100' _ 46.40
Commercial Back Flow Prevention Device 46.40 4/7 W -
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60
•
Inspection of Existing Plumbing or Specially 62.50
Requested Inspections per/hr COMMENTS REGARDING ABOVE:
Rain Drain, single family dwelling 65.25
Grease Traps
if 16.60 /440
QUANTITY TOTAL
Isometric or riser diagram Is required if
Quantity Total is > 9
'SUBTOTAL ./ 1,r-C,:'
I I
8% STATE SURCHARGE re
1/,1b �7 I
"PLAN REVIEW 25% OF SUBTOTAL ,
• Required only If fixture qty. total Is > 9 - • ,. ' L.,r, r
TOTAL I - , I
, s.
* Minimum permit fee is $72.50 • 8% state surcharge, except Residential Badcfl
Prevention Device, which is $38.25.8% state surcharge.
"All New Commercial Buildings require 2 sets of plans with Isometric or riser
diagram for plan review.
iMsts\forms\plm- fees.doc 12/26/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / Z 6- 0' z AM PM BUP
Location / 0/o O Su/ w4) <- s y ref Suite A - MEC
Contact Person faci R,6 Ph ( ) r f Z /7 7 --) PLM o L. — o ) 3 70
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm •
R Ceiling
Roof
Other:
Final
P PART FAIL
os Beam
Under Slab
p ater Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
e � ! S PART 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 ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
ita BUP
Received Date Requested / I AM ✓ PM BUP
Location / I 60 /OA' 30. R P Suite MEC
Contact Person ( --t Ph ( ) 7,01 O — I1 c25' PLM 07 70
Contractor Ph ( SWR
BUILDING Tenant/Owner �C�d ELC
f?j2e
Footing
Foundation ELC
Access:
Ftg Drain
•
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
:Ar
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
� Poostt , &
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Fi
(KW? 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 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 ( /2/4 ` Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
I BUP
Received Date Requested ` — / D AM BUP
Location 1 U 100 U)Jf - SO— P Suite MEC
Contact Person Ph ( ) d-c) - l 7c.13 PLM 3 70
Contractor Ph ( ) SWR
BUILDING Tenant/Owner F(. 6'14r-6-Z/‘ ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain Q ' .
Slab Inspection Notes: I SIT
Post & Beam
Shear Anchors • M
Ext Sheath/Shear / / / f
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
ry ewer
am
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
S PART FAIL
WE
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 [] Please call for reinspection RE: [] Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date & 1 Inspector iv4 Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested — 1 1 1 AM PM BUP
Location l � � 1./)/4" - D• Suite MEC
Contact Person Ph ( ) 79- - / 72-5 PLM - X1`7) 3 70
Contractor Ph ( ,) SWR
BUILDING Tenant/Owner �'— " '- ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation -
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: ,
Final �/� -�/� / 1J1� l '�l ALL
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab / V �- A � , wU • -� A ; �
Rough -In • e t ' -
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
�J l er:
4.:. -
PASS PART FAIL
ANICAL
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 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 3 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL