Permit ,
CITY TIGARD PLUMBING PERMIT
�I I " DEVELOPMENT SERVICES PERMIT #: P /8/200 -00665
� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/8/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD MGMT ZONING: C - G
SUBDIVISION: ehtf SQUARE LOT: JURISDICTION: TIG
Project Description: Fixtures: /_
~�Z 1
CLASS OF WORK: ALT GARBAG DISP ALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS; 2 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: 1 SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
WASHINGTON SQUARE LLC
BY THE MACERICH COMPANY Description Date Amount
9585 SW WASHINGTON SQUARE RD [TAX] 8% State Surcha 12/1/2005 $6.64
TIGARD, OR 97223 [PLUMB] Permit Fee 12/1/2005 $83.00
Phone : 503- 639 -8865 Total $89.64
Contractor:
INTERSTATE MECHANICAL INC
2609 SE SIXTH AVE
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact # : PRI 233 -7171
Reg #: LIC 00055190
PLM 26 -43PB
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 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permiftee Signature: A. )601
Call 503 -639 -4175 by 7:00 a.m. for an inspection that bu mess 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.
t
Plumbing Permir`? it ll�ca f roiz orrlcr usl: o\I.VV
City of Tigard Received
DateB
13125 SW Hall Blvd., Tigard, OR 7 j Permit No rJ . - 00 /
Phone: 503.639.4171 Fax: 503.5�> - : 1960U 1 2005 Alitb �, (rl D /By: Other Permit NoS e. -61390
24- Hour Inspection Line: 503.6394.1,75 TIGARD D n • I I� �
Date Ready/By r / ® See Page 2 for
Internet: www.ci.tigard.or.us lii�i �r Notified/Method: a Supplemental Information
BU t i , 4 1 1 1 OFCVO ' RK
FEE* SCHEDULE
❑ New construction ❑ Demolition For special information 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 (1) bath 249.20
❑ 1- and 2- family dwelling ® Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ Master builder ❑ Other: Each additional bath/kitchen 45.00
Fire sprinkler ( sq. IL) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 9585 SW Washington Square Road MGMT Office Catch basin or area drain 16.60
City/State/ZIP: Tigard Oregon 97223 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt no.: I Project name: Housekeeping Space Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Washington Square Mall I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: - -
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Intall Pluming For Sin aterheater, Washer Backwater valve 16.60
Clothes washer ' 16.60
Dishwasher 16.60
® PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Washington Square LLC Expansion tank 16.60
Address: 9585 SW Washington Square Road Fixture/sew.. 16.60
City/State/ZIP: Tigard Oregon 97223 Floor dra floor si I b I I 1 I 16.60
Phone: (503- 639 -8865) Fax: ( ) Garbage dis.'. 16.60
® APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Interstate Mechanical, Inc. Interceptor /grease trap 16.60
Contact name: Dan Osborne Medical gas (value: $ ) Page 2
Address: 2609 SE 6 Avenue Primer 16.60
-
City/State/ZIP: Portland Oregon 97202 Roof drain (commercial) 16.60
Phone: (503) 233 -7171 I Fax: : (503) 233 -2902 ink in / lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: dosborne @intermech.com Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Interstate Mechanical, Inc. Water heater 11,J ls'(`iiiis / 16.60
Address: 2609 SE 6 Avenue Other:
City/State/ZIP: Portland Oregon 97202 Subtotal
Minimum permit fee: $72.50
Phone: (503) 233 -7171 Fax: (503) 233 -2902 Residential backllow minimum permit fee: $36.25 g3. IV
CCB Lic.: 55190 //h Plumbing Lic. no.: 26-43PB �.`� lo Plan review (25 % of permit fee)
/ State surcharge (8% of permit fee) & .491
Authorized signature: �Ca-.. TOTAL PERMIT FEE
Ig9. („
Print name: Dan Osborne Date: 1 /1/05 I This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodoloav set by Tri- County Buildine Industry Service Board.
7
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: PLM2005 0066.1
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/8/2006
Phone: (503) 639 - 4171 . 1 I A
Inspection Requests (24 Hrs.): (503) 639 -4175 = n! L "'I � ..
INSPECTION WORKSHEET FOR DATE: 12119/2005 TIME: 7:01AM PAGE: 3
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD MGMv1T CLASS OF WORK:
SUBDIVISION. WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WASHINGTON SQUARE
DESCRIPTION: Fixtures:
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639 -8865
CONTRACTOR: INTERSTATE MECHANICAL INC PHONE #: 233 -7171
Inspection Request Scheduled For: Date: 12/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 023682.01 503-887 -1106 Y
Corrections /Comments/ Instructions:
O s li'l ,,,,,
I .
i
(1.ii 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
I
' Inspector: Date: V qi G__-) Phone #: (503) 718-
'_
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00665
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/8/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/12/2005 TIME: 7:02AM PAGE: 14
SITE ADDRESS: 03585 SW WASHINGTON SQUARE RD MGMT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WASHINGTON SQUARE 51°`
DESCRIPTION: Fixtures:
WI t1 - netts' e 6 c 11 - r
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503. 633.8865
CONTRACTOR: INTERSTATE MECHANICAL INC PHONE #: 233 -7171
Inspection Request Scheduled For: Date: 12/I7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 023302 -01 503.887 -1106 N
Corrections /Comments /Instructions:
i
%WI _ , 4t r
•
/PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
l l� •
Inspector: Date: Phone #: (503) 718-