Permit 'A N CITY OF TIGARD PLUMBING PERMIT
r Y�, � A ' DEVELOPMENT SERVICES PERMIT #: PLM2000 -00245
^-- „ 13125 SW Hall Blv Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/27/00
SITE ADDRESS: 10218 SW WASHINGTON SQUARE RD PARCEL: 1S1356A -00102
SUBDIVISION: 024KBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: GARBAGE DISPOSALS: 1 MOBILE HOME SPACES:
TYPE OF USE: WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: FLOOR DRAINS: 5 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 7 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Remarks: Commercial TI.
. FEES
Owner:
Type By Date Amount Receipt
PPR SQUARE TOO LLC PRMT BLD 7/27/00 $265.50 0004022
BY MACERICH COMPANY SPOT BLD 7/27/00 $21.24 0004022
ATTN: JANET FISHER, ASSET MGMT PLCK BLD 7/27/00 $66.38 0004022
SANTA MONICA, CA 90407
Phone 1: Total $353.12
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone 1: 691 -6166 Top -out Insp
Reg #: LIC 87906 RP /Backflow Preventer
g Final Inspection
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 -0080.
• You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: „ Permittee Signature: C
_,4f&
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
07/14/2000 03:26 5036916771 MODERN PLUMBING PAGE 02/04
CITY 'OF TIGARD . Plumbing Permit Application Plan Check # - /G
13125'SW'HALL BLVD. # Commercial and Residential Rec'd By DE/3
TIGARD, OR 97223 1 /La.'1 j 7 / , . J Date Recd 41.2 -
(503) 6394171 l Ps c- ie.— Date to P.E. a, Ai. •
Print or T e Date to DST - ' id
yp Permit #P , aa'aat•-00.2
lnc mplete or illegible applications will not be accepted Related swR #2o 00 - o Z01
Called 7-' - 00 L)
me CO /f' � (6'e'1 e
Name of Develo me
?Project . I E §10 i Ga! > • 4
r
. 4 :m
Job Sts+rbur�lCS Sui I Sink 9.00 43, i•
Address Street Address ' t C/ /f ,Lavatory _ 9.00 8.6;
f og1 8 S (t1 �tSh i k.3 St , Tub or Tub /Shower Comb. • "
Bldg # City /State ip Shower Only 9.00
—.- Water p�' Water Closet a• 1:10 /?• 0 •
Name i
Dishwasher i ',00 9, 0.
Owner Malting Address 1 Suite Garbage Disposal 1 • '.00 16
Washing Machine ' 0 '
City/State I Zip Phone Floor Drain/Floor Sink 2" • 0'
Name 3'
ame 900
13M1eb U 5 a 9 1 s.
Occupant Mailing Address Suite ater Heater 0 conversion • tilde kind 9 •
a (,V, ;�.i is . y_• . •i• _. as piping requires a separate mechanical permit. 1 900
City /State Zip I '' on e Laundry Room Tray 9
7 091?�4 / t Urinal • * 9 ''
" MOO - 7/ /) Other Fixtures (Specify) 9•"
Contractor Malting Address i ,• Suite / 7 .tom i _. 1,. .
, 0 (. 'r ., _ ' . 4 s. p
Prior to permit City /State Zip Phone Sewer - 100' 30. ,
issuance, a copy ' 0' ' ' ' ' et '— A. - • - - each e • • •Donal 100' 25 � 0
• . of all licenses are Oregon .nst. ont . Board Lic.# — te'" r senri� - 3o q r
required if I pt - 06 Water n . •
expired in COT Plumbing •c. # Exp. Date Water Service - each :. ditiona1200' ' 'l'
database 8g- a P A:a --Ob Storm & Rain Drain - let I I' 3
Name Storm & Rain Drain - each a • • ltional'100' 2...'
Architect i Mobile Home Space
Or Mailing Address • 4ulte Commercial Back Flow Prevenll•n Device orAntl -.00 P it t e vice I
Engineer City /Stale 1 Zip hone -esi ntial Back low Prevention Device' 5.00
1 (Irrigation timing devices require a separate
Describe work to be_deRe: 1 tit restricted energy permit.) • ,
New 0 Repair 0 Replace with ike Ind: Yes 0 No 0 Any rap or Waste Not Conne d tta a Fixture :.00
Residential 0 Commercial 0 Cat. = - - n '.00
Additional description o work* .f ,� ...ear" crisp. f Existing Plumbing 0
�C.(�t.� 1 ; error
1 / Specially Requested Ins. = ctlons 0,00
• r . er /hr
Rain Drain. single f. ily dwelling :0.00
Are you capping, moving or repl ci any fixtures?
Yes • NO Grease Traps 9.00
If yes, see back of form to indIc to work • : ormed by QUANTITY TOTAL )1 :,..1!.,0,
fixture. FAILURE TO ACCURA LY REPOR TURF i;'•:'
ometric or riser diagram Is required R ouAnNy Total is � 9 � ? �: • � •�
WORK COULD RESULT IN INCR ASED SEWER FEE .'SUBTOTAL :' x;
hereby acknowledge that I have read t :s application, that the information ' •' "; : .. 1 '• ' ir . '
given is correct. that•i am the owner or a 1 horiized agent of the owner, and 5% SURCHARGE '; ' , i•w,,� • ''� ` ;
• • ^
that p • ns submitted are in c. • ',rice •th Oregon State Laws ti . . �; = • n I
Si re of Owner/Au: Date
7-10 -PLAN REVIEW 2 5 / SUBTOTAL 'k ' rt�� k ni,ttr �
R e quired only If fixture qty. total Is > 9 rn;j ,'°f',``t`; "'■
D TOTAL s: >. ...roil .
C t Parson Name • Phone t� :. , ,i 13.Sr
/ 1 'Minimum permit fee is $25 + 5°d surcharge, except Residential Ba . • ow
Qp I f9J— / G4' Prevention Device, which is $15 +:5% surcharge
II - All New Commercial Buildings require plans with Isometric or riser diagram
and plan review
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CITY OF TIGARD Plumbing Permit Application Plan Check#
13125 SW HALL BLVD. Commercial and Residential Rec'd By
TIGARD, bR 97223 Date Rec'd
(503) 639 -4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit#
Related SWR #
Called
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Job Sink i 11.50
Address Street Address Suite Lavatory 2 11.50 i_.5, .du
Tub or Tub /Shower Comb. 11.50
Bldg # City /State Zip Shower Only 11.50
Name
Water Closet Z 11.50 13,
Urinal , 11.50
Owner Mailing Address Suite Dishwasher I 11.50 l i °
Garbage Disposal 11.50 S r7
City /State Zip Phone Laundry Tray 11.50 !
Name Washing Machine/Laundry Tray 11.50
Floor Drain/Floor Sink 2" 11.50
Occupant Mailing Address Suite 3° 5 11.50 gy V
4" 11.50
City /State Zip Phone -
Water Heater 0 conversion 0 like kind 11.50 V
Name Gas piping requires a separate mechanical permit. I (1 i
MFG Home New Water Service 32.00
Contractor Mailing Address Suite MFG Home New San/Storm Sewer 32.00
Hose Bibs 11.50
Prior to permit City /State Zip Phone Roof Drains 11.50
issuance, a copy Drinking Fountain 11.50
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if
Other Fixtures (Specify) I 15.00 (4" ea
expired in COT Plumbing Lic. # Exp. Date
database
Name
Architect Sewer- 1st 100' 38.00
' - - or Mailing Address - Suite Sewer - each additional 100' 32.00
Water Service - 1st 100' 38.00
Engineer City /State Zip Phone
Water Service - each additional 200' 32.00
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New 0 Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00
Residential 0 Commercial 0
Additional description of work: Commercial Back Flow Prevention Device ) 32.00 -2
Residential Backflow Prevention Device' 19.00
Catch Basin 11.50
Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Yes 0 No 0 Inspections per /hr
If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL c_/
I hereby acknowledge that I have read this application, that the information Isometnc or riser diagram is required . Quantity Total Is > 9 � 5 / V
given is correct, that I am the owner or authorized agent of the owner, and
that plans submitted are in compliance with Oregon State Laws. 'SUBTOTAL
Signature of Owner /Agent Date 8% SURCHARGE 2 �/ •
Contact Person Name Phone � - / I
"PLAN REVIEW 25% OF SUBTOTAL GG 3g
1 BATH'HOUSES$178A0 Required only if facture qty. total is > 9 v
•
s
HOUSE '$2 00 TOTAL
°
HOUSE $285 85 7�. 5 j. f 00;�
(() Includes Eto plumbing il dwelling'and the first *Minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention
( C11sanita (3M7Ca.a.lulaa207and water se Ice), Device, which Is $25 + 8% surcharge
"All New Commercial Buildings require plans with Isometric or nser diagram and
- plan review.
I 11/18/99
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Urinal
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
1. ldstsVormslplumapp.doc 11/18/99
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location /02./9 S w tt. Suite 7 / I MEC
Contact Person ( r bu CAc) Ph c q / CO ( fir li PLM �2 u' -00 e L(5
Contractor Ph / SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: .
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
•
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
-T _nder Slab}
op Out
Water Service
Sanitary Sewer
Rain Drains
Fin
00 05 PART FAIL
HANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk � � 6� Ext
Other Date Inspector
Final
PASS PART FAIL D NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 - - "'Business Line: 639 -4171
BUP
Date Requested ( � �/ AM PM BLD
Location /0 2/154 t J ' 4 5 Suite C-? - C. MEC
Contact Person Ph 5 - 0-4y/ -(i /G li PLM Z Y i�
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Acces
l/V
Foundation / G/� �/—
Ftg / FPS SGN
Drain 'i rJ G
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
P ASS PART FAIL
UMBIN
ost & Beam Z Q
Under Slab
Top Out
Water Service V �S,
Sanitary Sewer tA
Rai rains
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
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
- ) - 2
Other Date 0 / / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location / U 2 ( C 5 A a-4) 4. S, Suite i( MEC
Contact Person *fr7 Ph 69/ -6 /6 P)."..1,i/k-c z YJ
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear .
•
Framing
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof •
Misc: _ - - -
Final • /
RT FAIL
/'
Post & Beam
Under Slab
UU
a er Service
Sanitary Sewer .
Rain Drains .
Fi
ASS ART FAI
ANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL •
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage, •
Fire Alarm •
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
• Fire Supply Line
ADA
Approach /Sidewalk - S" / -/'
Other Date - 7/ — ° ° Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.