Permit C ITY OF TIGARD PLUMBING PERMIT
; DEVELOPMENT SERVICES PERMIT #: PLM2004 -00488
''�'� DATE ISSUED: 11/1/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD PARCEL: 1S12600 -00300
SUBDIVISION: tOMER1156FraliE SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: S4 FLOOR DRAINS; 12 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 28
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Phase 1, South parking structure. Interior plumbing fixtures. Other fixtures: (1) sump pump, (9) hose bibs,
(17) rain drains & (1) trench drain. All fixtures drain to storm drain system, no EDU charges per CWS.
FEES
Owner:
Description Date Amount
PPR WASHINGTON SQUARE LLC
BY MACERICH COMPANY [PLUMB] Permit Fcc 11/1/2004 $664.00
9585 SW WASHINGTON SQUARE RD [TAX] 8% State Surchaq 11/1/2004 $53.12
TIGARD, OR 97223 Total $717.12
Phone:
Contractor:
KINETIC SYSTEMS INC
DBA FULLMAN /KINETICS SERVICE
5805 SW HOOD AVE REQUIRED INSPECTIONS
PORTLAND, OR 97239
Phone : 503 Rough -in Insp
Underfloor /Underslab
Reg #: LIC 32357 Top -out Insp
PLM 26 Final Inspection
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)
2 4 699.
e i • I s ued By: ' .� i Permittee Signature ., ,,, lie -' . _
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
iPlumbing Permit Application FOR OFFICE USE ONLY
City of Tigard Received ��
13125 SW Hall Blvd., Tigard, OR 97223
Date /By: 0� b �ni'/>ll'� , Dq - o g '
Plan Review
Phone: 503.639.4171 Fax 503.598.1960 D ate / B Other Permit No.
� � co 24- Hour Inspection Line: 503.639.4175 s . Date Ready /By: tug ®See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: j t 6• Supplemental information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For sped a! infornurtion use checklist
Description I_ Qty. I Ea I Total
® Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
❑ 1- and 2- family dwelling ® Commercial/industrial SFR (2) bath 350.00
ID Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 9585 SW Washington Square Rd. Catch basin or area drain 16.60
City /State /ZIP: Tigard, OR Drywell, leach line, or trench drain 16 60
Suite/bldg. /apt. no.: I Project name: South Parking Garage, Phase I Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job ste:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK p p Backflow preventer Page 2
P / urrl4,n; wOti A. 4' SS° ei( W QK, y fettpli i-* Backwater valve 16.60
Euf a3 - 7 o , , W ,5 ..lred4 I Clothes washer 16.60
insr l d .-/1/ dPProV &f' Dishwasher 16.60
® PROPERTY oWNER I ❑ TENANT Drinking fountain 16 60
Ejectors /sump 16.60 /d,, kp
Name: The Macerich Partnership, LP Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink/hub /2 16.60 M20
Phone: ( ) Fax: ( ) Garbage disposal 16.60
® APPLICANT ❑ CONTACT PERSON Hose bib 9 16.60 ly 7 yo
Ice maker 16.60
Business name: See Contractor
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) /7 16 60 2V.02o
Sink/basin /lavatory 16.60
Phone: ( ) Fax::( )
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Kinetic Systems, Inc. dba Fullman/Kinetics Service Water heater 16.60
Address: 5805 SW Hood Ave. Other: jenuf p / /64 /6.
City /State /ZIP: Portland, OR 97239 Subtotal (,(,
Minimum permit fee: $72.50
Phone: (503) 224 -5221 Fax: (503) 417 -0343 Residential backflow minimum permit fee $36.25
CCB Lie.: 32357 Plumbing Lic. no.: 26 -581 PB Plan review (25% of permit fee) _ -_
-
� State surcharge (8% of permit fee) .5
Authorized signature: ( /L�/ti TOTAL PERMIT FEE 7/7. /2
Print name: Suzanne Ellis I Date: /--,..5. o V 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.
,\Boilding\Permns\ PermnApp doc 12/03 440-4616T(10 /02/COM/WEB)