Permit e.o 1,00-1-AJ,Jeuv.
t 1 TYoF TIGARD PLUMBING PERMIT
PERMIT #: PLM2005 -00078
DEVELOPMENT SERVICES DATE ISSUED: 3/4/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10101 SW WASHINGTON SQUARE RD PARCEL: 1S135BA -01802
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 025 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 60 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace water service- emergency. 60 ft.
Owner:
FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQUARE RD [TAX] 8% State Surchan 3/4/2005 $5.80
TIGARD, OR 97223 [PLUMB] Permit Fee 3/4/2005 $72.50
Phone : Total $78.30
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Phone : 503- 691 -6166
Reg #: LIC 87906
PLM 34 -250PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 0001 -0010 through OAR 952 -0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling (503) 24.;699.
Issued By: ` ` 4 L Permittee . /7'7 412 (�j,,
Call (503) 639 -4175 by 7:00 P.M. for an inspection the next business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Ij, /2005 30 5036916771 MODERN PLUMBING PAGE 02
1 4 ,12004 ,34 FAX 5035981960 CITY OF TIGARD 0 003
RECEIVED .
Plumbiipff Permit AffiiiicailoA FOR OFFICE tisE. O \
City of Tigard JAR 0 1 2005 • 1 Y J 05 J3 / t a itrio,: �p j. -voa
13125 SW Noll Blvd.. Tigtlrl), OR Plan Review
shuns: So3.639.4171 Pax: SOS OF TIG • • .. i,..' I tannin J Odm•PImirtlta.: .
2 Hour Inspection LIM 543. IS' �! ° ' ' '' NMRsmAwBr 6s Set es far
mtrm$ waw�
c-na,eeus DIVI • marided/Method: So; •larnantatlarartasnag _
•1. ' � l "•' ' -131.• . 1 l � 1u' L q/ uwy �.� , ti' i. . i r ' �' . a ! ; � a 1 11 �,,1 t
`Jik wl :> 41. 1. 1 '.j+`'j ri91 .. .., . i :.` -1 : ,L ;•.i 9r,1 t ;.- a,O. : :: ,:I 'I - 4 .: . . • " :, 1
Q New co istuct er D Demolition For apoc al In fannadon ox cAadf,
di
.. Jadrlldvalalttrauor,/ 1)escrl on 1 Ott. J Es. I T6m1
c
roplloonment D O thnn N te�f . 3rfamity dwellings (Meted= loo A. fu+ cad) utility connection)
��', '. I,`:7 -e�Ir�;;(An, /14�T SFR(l) 149.20
❑ 1 • and 2- £atmly dwelling otsmeteial ieaiustrlal SFR (2) bath 350.00
❑ Acc ory building D Muhl-family
(3) bath 399
- Lath additi0rlat bath/kitchen 45.00
❑ Muter builder . In Other: -
}.S�' '��,i 1 r'!n!
�' �.,' tits aprinider (__^ A) 2
1, '•� p : ', ;. + yl o . . . ' u, i; , .,; 11u t ye , n � ilia` ,.;,• s :..•. C 9 0 . , : , r I I. sire
Yob she addresc • O Lei • -S I , . . • J* Catch basin or area drain 16.60 _
City/State/MP: a Dr leach tine, trench drain 1G60
■ Suite/bldg./apt no.: project name: Footing drain (no, linear ft.: _,,,) Page 2
Class oi to tiQE: ManUfauwn�l lane utiIhles 110.00
Manholes 16.60
Rain MS ootmecror 16.60
',/ /,/ A: /` / t Salitarysewer `
ft: Page 2
( , Sturm sewer (no- linear ft.: _, Page 2
War aariw Ole. linear ft., Cs e) Page 2 - j -
. Fixture or item
Tmt map'paroel co.:
ff�.I yy11}} • - � , _ Absorption valve 1 • l . II... •I 9 4 };jl,,i: i1 : 4. 1' :;'7.1 ` 4 '*V I •'rA� .i !I• .��. If . . .i,1'. BaCkcOWpllcVCnow �Z
l _' VArn Jt 77 1 /.-J 1 / _! Backwater valve _ 16.60
Cloths ew 16,60
Dlehaaalter 16.60
Drittirin fountain 16.60
;h+y i ., : sin •
�, . i ' v- ' J:di1' ^,�Td'1'• 5 ;S f IIF. Q,,a $
1.4 ' '' , ' . , �'- '9'JIIh P:ElE1b7ir, 4 . ~ • . I %y! .11 1111' , 11 :T 611 • • • �' ., . `ii :: ricactrifetirnp 16.60
Name: t3>qnmsion tank 16.60
AttAresr FixtureAme er a 16.60
aly/smteiylP; Finer dr4ltIMor atnlr/hub . I 16.60
Phone: ( ) Fax: ( )
nd 16.60
l a ' : 1 ' ,I ..1 ~ ' •nl�c 1 . .$-1 . ., 7 'r '. ' , • l ' Y f caa`a • "'' 1 I , 1 ken:11w 16.6D ..
Business Bair • In? Mr eptJx/g2sto 01141 - 16.60 •_
CO M= IN= Medical alas (value: S ) . Page 2
AB_ Primer 16.60
)soul drain (COrtlttlamt0l) 1640 _
Ciry/Statr�ZlP Siak/baainnevntorY 16.60
mac ( )' ; ( ) Tub/showedshowar pan w 16.60 T
nail: Urinal 16.60
:13;k "JV3 •l''' 1 '1r1' ,ter , • •1)'11. . g,iari 111 � ta f l I a w 'ti 'F NW IVA : w 16.60
4• )Ii �' 111 . i � n fi:' IV i l .:0 € ,r. "P , r: .. ...141 f ,y,•1, 1 : ,:; . ` . at
1 q a i / .- // / / Water hem v 16.60
J �^
Other:
• .1 6 , 6 - . Sewed - 7).�p
ari/statemp: Tv, : d ip _ Motown permit fee: 172.50
Phone: (Svc) 61 i - , , . ; Pa= ($'a it - , 77 / Resldendat bacMlowminirraim a feG $36.2
Plea review (25% of penult ibe)
• i Plannisita Lie. am JL ; Sb it State surcharge (81 of permit tie) s TO
Authorized signs.. -• / TOTAL PERM r MS 7$30
o ' . t - 0 . 'foie permit appli ation moires if a pernat is not obtained within
or
I a • r I . L ISO days after 11 hru boon lateral aS complete.
*Fee methodology eat by TriCouJnty Building blowy y Service Board.
hrhuirrasouresiumetApp.sa Was 440441Qid0 t't1PED1
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CITY OF TIGARD. ...., PLC •
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BUILDING DIVISION PERMIT #: a - -7V
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639- 4171I(
Inspection Requests (24 Hrs.): (503) 639 -4175 Ail
INSPECTION WORKSHEET FOR DATE: --- — 7 TIME: PAGE:
SITE ADDRESS: / 0 1 6 ( L0 4-SCR CLASS OF WORK: 1
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #: 6 / _
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
0 a K r / IL -.,
1,(
P OC r a .P t ir? 1/
•
4_,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: / Phone #: (503) 718 -
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