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Permit \ C ITY OF TIGARD PLUMBING PERMIT �� DEVELOPMENT SERVICES PERMIT #: PLM2004 -00049 °°�'� � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/10/04 SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD PARCEL: 1S12600 -00300 SUBDIVISION: t1M1gfI111.1:4 SQUARE ZONING: C -G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ADD GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: 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: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Site utilities for new parking structure. FEES Owner: Description Date Amount PPR SQUARE TOO LLC BY MACERICH COMPANY [PLUMB] Permit Fee 2/4/04 $3,376.00 ATTN: JANET FISHER, ASSET MGMT [PLMPLN] Plan Review 2/4/04 $844.00 SANTA MONICA, CA 90407 [TAX] 8% State Surcharl 2/4/04 $270.00 Phone : Total $4,490.00 Contractor: INTERSTATE MECHANICAL INC 2609 SE SIXTH AVE PORTLAND, OR 97202 REQUIRED INSPECTIONS Sewer Inspection Phone : 233 Sewer Inspection Reg #: LIC 00055190 Sewer Inspection PLM 26 -43PB Sewer Inspection Water Service Insp Storm Drain Insp Storm Drain Insp Storm Drain Insp Rain Drain Insp 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 • Issued By' ,/ /`' Permittee Signature: 7i/L�Ll Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day T ^ ' ' �) r r'• .. Site Utilities - ' D PIumbiilo'Permit Application FOR OFFICE USE ONLY 4 City of Tigard �E� 1 00 ° Received 0� Permit N •� +�� [! 13125 SW Hall Blvd., Tigard, OR 97223 Date/By o. I / �� {{ T • 503.598 1960 Ii '/ R ®I Plan Review Phone. 503 639 4171 Fax • CM _ ll'''' t, DateBv- L- O L/ Other Permit No 51 42 03'OQd f 2 I 24 Hour Inspection Line 503 639.4175 ® pp y ►1�� ,� 1� ® ° t5 �1/�KJ �p�J16r ►;_1,.� �,� Date ReaayBy E S ee P age 2 for Internet www ci tigard.or.us Notified/Method , Supplemental Information T OF WORK :FEE* SCHEDULE New construction ❑ Demolition I For special information use checklist —I ' Description 1I I I Qry � Ea I Total %Addition /alteration/replacement ❑ Other: New 1 2 family dwellings (includes 100 ft for each utility connection.)] • - ._ATEGORY "OF.�.CONSTRUCTION - 'C . I SFR (1) bath I I 249.20 ID and 2 family dwelling Commercial /industrial SFR (2) bath I 350 00 I - ❑ Accessory building ❑ Multi - family SFR (3) bath I 399.00 Each additional bath/kitchen 45 00 ❑ Master builder Other I Fire spunkier (-- sq ft) I Page 2 • JOB SITE INFORMATION A.NDD LOCATION Site utilities Job site address: e /15 -5 (..)(,(ASH/ Al 67-0A) ouARG- R Catch basin or area drain I 16.60 6,,, City/State/ZIP: 1 /6AR 0 / OR ?7,2 ?-3 A {� I Drvwell, leach line, or trench drain I --- 16.60 — Suite/bldg. /apt. no.: Project name: WA5H )6TI7� SQUARE Footing drain (no. linear ft. yDO Page 2 9 Cross street/directions to job site: dq 10 0 Manufactured home utilities I 1 10 00 /f' Manholes 16.60 , d /.t/e .SI De 4r /IA ALL .l) '7 70 yUaRVS7RoNt5 Rain drain connector 16.60 ' 1 A ,/1 U CI SWAB S. Sanitary sewer (no. linear ft. /900) Page 2 g 3, S Storm sewer (no linear ft. 3 /00 Page 2 , JP Subdivision: Lot no.' 300 Fixture or item Water service (no linear ft =) 1 Page 2 17A , , Tax map /parcel no.: /�(� /� (.� p `�i_ / I / 1 1 `✓ Absorption valve I 16 60 DESCRIPTION OF 'WORK . 111.12121 . Backflow preventer I i) /d 24) PA�k � 5 � �� 9 &k - Backwater valve 16.60 I blt - r14 0T /L! T /F5, &So OT /� J Rk of WOR Clothes washer 16 60 Sl176 pFAUPSTR0A45 iu PRE/ATO -6 Fot f//Ast-g ■ Dishwasher 16 60 g PROPERTY OWNER .. _ Drinking fountain 16.60 ❑ TENANT � Ejectors/sump 16 60 I I Name: � c C)M/AA) ! � Il I �-/c B EASOU . l _ Expansion tank 16.60 I I Address: g idJ4S/// Q E & y, , 5v,76- ' " ' " ) Fixture/sewer cap 16 60 City/State/ZIP: j'A A A4OU / 4 0090 / Floor drain /floor sinktnub 16.60 Phone: ( /3,,C) 86 7_opos Fax: ( e36 77 Garbage disposal 16 60 - . 0.APPLICATIT _ ❑ CONTACT :PERSON • Hose bib I 16.60 Ice maker I I 16 60 Business name: /,/9 ,9 PAC, r�1C Interceptor /grease trap I 16 60 Contact name: RA ! y B © �� 7 m6,0366-- Medical gas (value $ ) Page 2 -C Address: 77 �)E S ROAM Pnmer 16 60 City/State/.ZiP: p6RTLAJ f) l e e17�s Roof drain (commercial) 16.60 V Sink/basin/lavatory I 16 60 Phone: ($p j) 372 360) I Fax: : (..53)0 _ n775- Tub/shower/shower pan I 16.60 • E- mail: blep 0 1G,co Unnal I 16.60 CONTRACTOR _ Water closet I 16 60 I I Business name... „r e J ,� S77 - -7 �/7e /// ..il / CA Water heater I 16 60 // Ad...,..:. • s • (1/(- 9 � ;<., 5 ( ,cri4 Gt � L16. : � �IJ Other. ' - City, ... - � -, �� � .., Subtotal 33 76, I 7 _ •�o)( .'9 7. _ I Minimum permit fee $72 50 J Phone: f.` 50 3 ; 3 - 7i 7/ 016-713P8___, Residential backflow minimum permit fee $36.25 CCB Lic.: 56-790 1 Plumbing Lie. no.. Gj - - 0.1 I Plan review (25% of permit fee) I 9'/9 Authorized signature: � State surcharge (8% of permit fee) I s / TOTAL PERMIT FEE I'/V /p ® Print name: g � Date Lilo $ I This permit application expires if a permit is not obtained within !!! 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board :t BuddmpiPemuts \PLMU- PerrmiApp.doc i2/03 440-4616T( i 0 /02/COM/ EB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site =Utilities - • Qty.. Fee (ea) • Total Square.Footage: I Permit Fee: j Footing drain - 1' 100' / I „ L"� ' 1 0 to 2,000 $115 00 Footing dram - each additional 100' '3 46 40 2.001 to 3,600 $160 00 13 s� l 3,601 1 to 7,200 I $220 00 Sewer - 1st 100' l 55.00 5 7.201 and greater I $309 00 I Sewer - each additional 100' r7 46.40 788 Water Service - 1st 100' I ' 55.00 5-5- Medical Gas Systems: Water Service - each additional 100' g 46 40 371 Valu•ationf: Permit Fee: Storm & Rain Drain - 1st 100' I 55.00 55 $1.00 to $5,000.00 . Minimum fee $72.50 I Storm & Rain Drain - each additional 100' so 46.40 1 3.7g $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1 52 for each a additional $100.00 or fraction thereof, to and Fi%flll Qr'ItC Qty Fee: (e) 'Total. including $10.000.00. Commercial Back Flow Prevention Device — 46 40 $10,001.00 to $25,000 00 $145.50 for the first $10,000.00 and $1 54 for Residential Backfiow Prevention Device each additional $100 00 or fraction thereof, to (minimum permit fee $36.25) — 27.55 and including $25,000 00 Rain Drain, single family dwelling 65 25 $25,001.00 to $50,000.00 $379 50 for the first $25,000.00 and $1 45 for each additional $100.00 or fraction thereof, to Inspection of existing plumbing or _ and including $50,000.00 specially requested inspections - per hour 72.50 $50,001.00 and up $742 00 for the first $50,000 00 and $1 20 for Subtotal: aCi I' . each additional $100.00 or fraction thereof lf Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . : Quantity by (Fixture). Work Performed - Fixture Type: - - - 'Replace ' y Moved Existing Capped Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" - 4" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an - Industrial increase of sewer EDUs, a sewer permit will be issued and Ice Mach./Refrig. Drains Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar /Lavatory Quantity Total - Bradley Isometric or riser diagram is required if fixture quantity - Commercial Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. urinal Other Fixtures i \Buildmg\Pemuts\PLM- PemutAno doc 3/03 ` 2 C — crr 4/7 • 9755 SW Barnes Road, Suite 300 ■ Portland, Oregon 97225 PACIFIC 503.626.0455 Fax 503.526.0775 • TRANSMITTAL To: Gary Lam pella Date: February 27, 2004 Company: City of Tigard Project Number: 30773 Address: 13125 SW Hall Blvd. Project Name: Washington Square Expansion City/State: Tigard, OR 97223 Re: Request for Modification of Code For pipes under a structure Phone: 503- 639 -4171 Fax: Confidentiality Notice: This facsimile is intended only for the use of From: Monte Higbee, PE the individual and exempt from disclosure under applicable law If the reader of this message is not the intended recipient, you arc hereby Phone: (503) 372 - 3609 notified that the unauthorized dissemination, distribution or copying of this communication, or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received Fax: (503) 526 - 0775 this facsimile in error, please notify us immediately by telephone (collect). Thank you. We are sending: These Are Transmitted: Copied To: Attached ❑ For Your Info/File ❑ Facsimile ❑ As Requested # Of Pages Including Cover ® For Review & Comment Copies Description Request for Modification of Code letter and plan S I.OA Video tap of pipes to review condition - Comments Gary, Please review the attached documents for approval of existing pipe material under the proposed parking structure. Call Brady Berry or myself if you have any questions. Thank you, Monte Higbee, W &H Pacific whpacific.com planners surveyors engineers landscape architects CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 6 AM PM BUP Location T5 y . /pard Suite MEC Contact Person Ph ( ) PLItgd - — 47 d Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC 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 Firewall Fire Sprinkler Fire Alarm .1> R Ceiling fir Roof oof Other: Final PASS PART FAIL Post & Beam 411W— ' Under Slab N � . Rough -In Water Service Sanitary Sewer 7 i _ , Rain Drains Catch Basin / Manhole Storm Drain Shower P n ∎/' Other .( i /��'� S r- 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: El Unable to inspect — no access Fire Supply Line ADA 3 Ins ector G Ext Approach /Sidewalk P Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL