Permit I ,
!� a CITY OF TIGARD PLUMBING PERMIT
■
' COMMUNITY DEVELOPMENT PERMIT #: PLM2009 -00015
TIGARD DATE ISSUED: 1/29/2009
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S12600-00300
SITE ADDRESS: 09348 SW WASHINGTON SQUARE RD W14 ZONING: MUC
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: GAP KIDS /BABY GAP
Project Description: Relocate or replacement of plumbing fixtures.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQUARE RD [PLUMB] Permit Fee 1/29/2009 $83.00
TIGARD, OR 97223 [TAX] 12% State Surcha 1/29/2009 $9.96
Phone : Total $92.96
Contractor:
CASCADE PLUMBING CO.
2630 N HAYDEN ISLAND DR SP#3
PORTLAND, OR 97217 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 289 -7095
FAX 503- 283 -9514
Reg #: LIC 120893
PLM 34 -412PB
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 y: I,, J ` Permittee Signat e: _��A� ✓ r
Call 503.639.4175 by 7:00 a.m. for an inspection that 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.
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RECEIVED •
P umbi ®Q Permit Avalrclatron ,, ; 1
Dare/BY: Fort OIl l( l: I fir. O\1.1
City of Tigard JAN 2 8 2009 Received , a g 6 P ermit No : t w 9 GY b
IN
13125 SW Hall Blvd., Tigard, OR 97223
Phonic: 503.639.4171 Fax: 503.598.04Y OF TIGARD Plan Review
Date/By. Oilier Permit No.:
l t "ice ;' ■ E; i Inspection Line: 503.639.4175 [j '1.3 ; ` / r : • Da
A I re Ready/By rr .1 + Internet: www.tigard- or.gov w {!! �� v i �llt . Noiitied/veth / d s RI g lemeetal Information
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❑ New construction ❑ Demolition For special Information use checklist
Description I Qty. I Ea. 1 Total
1•t, ddrdonfalteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
xl e t �iip ,:n Pry " I tarrlr - ,;r1 .rir : 4go s 1,ii
s :" ° { '( :_";! SFR (I) bath 249.20
n� 4..T''a,__ :p::.:,JW;a.m .. .te r ^:4E....4t.� rsullfkvz,Y,7ksF'rJ :!= . �.5•.47'a•�l •,. ( )
❑ I - and 2- family dwelling ,onunercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ Master builder Each additional bat /kitchen 45.00
❑ Other: Fire sprinkler (_ sq. ft.) Page 2
>1 i "'r .�c r� n �.r 'Tir :.J 7,- Rti: F Xi r r f ri
`�tl y1 � - i� � S- 'F'. r rl`- t ': � E.;1H�"
z.. itl ilkil iTt. . � 4F1: w,':: -. T?, � s . <,r 141 Miniii.s 'r kits 4i ' "" itL. Site utilities
Job site address: q 3 &/' co i .4 4J-1 4 Catch basin or area drain 16.60
City/State/ZIP: 4,14 15-12. DryweIl, leach line, or trench drain 16.60
Suite/bldgJapt. no.: I Project name; ( 19-#9 i tit Q 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 R: _) Page 2
Storm sewer (no. linear ft.: _) Page 2
Subdivision: I Lot no.: Wal er service (no. linear ft.: I Page 2
Tex map/parcel no Fix:ure or item
�r �a : r a s"t ; +� ° �uw t?2lftcM F ?+yu " .: Abo-orptlon valve 16.60
4; ' s �.� ,F Y�„ o t ,/ , r alloy . )14.4', ' ;r, .il � ' -. a i ✓ 1,J
t l`Y:': t!w ,c „t.1kiZdi nist:lliiii .afeta curve- k .•t . f -. c . _. :� Ba&tlow preventer Page t
F 1 r v C p'n t n r C Backwater e1 ? D77 and Ba valve 16 60
.7'
1 1 ,- ol( - x• Y,eiS Clothes washer 16.60
// Disnwasher 16.60
Ys•li V. 7 ! , ?� 'z 4,•.,a tff 'r • ., _ Drinking fountain 16.60
ids ' ' . , 5'.� , f '£c ._ ' r ;� car tii4 - h i
1 ,r • T a s
z- ,�tca.�;a, .rx� t, .. •lrxr�;,r�,v,v .�'�ri,�a�� ,fir .a �,,� � - a Ejectors/sump 16.60
Name: Expansion tank 16.60
Address: Fixrure/sewer cap 16.60
City/Stale/ZIP: Floor drain/floor sink/hub I 16.60 (( , (p 0
Phone: ( ) Fax: ( ) Garbage disposal 16.60
'_ "I,a ti r „,> ' '''- +°:,6 ti, a; ��ti` f} r s T x- { w
..? -'!. . r Hose bib 16.60
a r ig 1 4 1 r a � `ra�VIMI ti, F ru g Q . 't` to . i r i
• tii.- .+�•fi?' �'AT�....,.,• .... . •, :nu+�rs5c.:1Ei5u AS.. ',A.. � ?.._ . a:ksltt;.r�l+stsY�.,�;:w�6�.•�_ s ',maker 16.60
Business name: * / 001424/1 a7
I CO lntrrceptor /grease trap 16.60
Contact name: 1 &XI Lein rte, { Medical gas (value: $ ) Page 2
Address: t,, ? /.�,rr q , / _ ( . 7i ar3 Pruner 16.60
City/State/ZIP: P�.(�0��� "" / ,9/ 7 Roof drain (commercial) 16.60
`i Si k/basin/lavatory a 16.60 `
Sink/basin/lavatory .
Phone: ( 403) ,-;cj 7*(3 I Fax:: t U3 ),:,143 ' e- 1 /4 Tuts/shower/shower pan 16.60
E-mail: i
'�• i t i s r v ,I.� •2 l fa 1 q,,, a •^ u ,� Urinal 1 16.60
` f 1$,I e S ' - } .R✓ .*-- ,aAS�, , 5J�,. [4 a, , , t' f - aa -{... 2-... '..,d: '. !•• Wsar Closet 16.60
Business name: l 4 r Pi urn k2 A Water heater 1 16.60 j 400
Address: ; 30 _ other
City /State/ZIP: C 7 L ' ''J r subtotal � '�
Minimum permit foe: $72.50
Phone: l �J 'q 7,95 Fax: (51)3 )' /4 Residential backflow minimum permit fee: $3625
CCB Lic.: J O ..,) Plumbing Lic. no.. � L+
•/ J � Plan review (259'0 of permit fee)
Authorized signature: State surcharge (12 ofpennit fee) , q t° TGC0 TOTA PERMIT FEE 9a.. ..Gj 1.
I Print name: C,1- $. t, 6Yh� D ate: 1 This permit application expires if a permit Is not obtained within
days a ft e r T y accepted ue.
/ /' / / J� "E ee methodology see b
t by Tri-County - Cotin unty Building Industry Se Sery ice Board.
I:lBui ennit PI.M•Permit .doe 6/06/ 4 40.4616T(10/02/COM/WFB)
I'd bIS6E82E0S 9NIBWflld 3Q1:13SU3 WdSb =E 6002 132 UeC
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Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: �y(? g9��, Residential Fire Su . ression S stems:
r r r''' • �k .ff'y;0� �C .r. ,
Fooling drain -1 100' 55.00 _ 0 to 2 000 $115.00
Footing drain - each additional 100' 46.40 2 001 to 3 60C $ 160.00
3 601 to 7 20( 5220.00
Sewer - let 100' 55.00 7 201 and : eater $309.00
Sewer • each additional 100' 46.40
Water Service • 1st 100' 55.00 - Medical Gas S tems:
Water Service • each additional 100' 46.40 z 3�d$ ?,'K x armii• 4 ' ;• l �} i�!YE j'
Storm Rain Drain - 1st 100' 55.00 : ' _.. _ .. 4. •
_ $1.00 to $5,0a0.00 - Minimum fee $72.50
Storm & Rain Drain -each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first 55,000.00 and $1.52 for each
a e ; i _ additional $100.00 or Fraction thereof, to and
� `� " including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or 6action thereof, to
minimum . it fee $3625 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 525,001.00 to 550,000 00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
and s . - call • . . ted - . cairns - •. c • 72.50 $74 .00 i fo t e first 55 00.
$50,001.00 cad up each additional for the $100.00 .00o fraction and thereof.
for
Subtotal:
each additional 5100.00 or fraction thereof.
ti�� ,
Fixture Work: Y . �,..,r
Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurate' re • on fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and
greater, except systems designed and stamped by licensed
f C Io, vi
+ engineer. .
�f �i ,�� Y �l� Ei ,,j , � .... ❑ Any new exterior plumbing site utilities.
B • ' !Font ❑ Medical gas and vacuum systems for health care facilities.
Bath - Tub/Shower My multipurpose fire sprinkler system.
- Jacuzzi/Whl Any complex structure as defined In OAR918.780-0040.
Car Wash -Each Stall
-Drive Thru Submit a sets of plans with any of the above,
Cus.id.-/w: - .lff ni ����� •
Dishwasher -Commercial
-Domestic MIN
Drinkin _ Fountain ❑ Isometric or riser diagram is required for new buildings
E a Wash that meet the •ualifications above.
Floor Drain/sink - 2" ���i7♦r
- 3" Comments regarding fixture work:
Car Wash Drain
Garbage -Domestic
Disposal - Commercial
- Industrial
Ice MachiRefri•. Drains
Oil - .arator Gas Station
Rec. Vehicle a . Station - - --
Shower -Gang *Note: If the fixture work under this permit results in an
• Stall r��� increase t f sewer EDUs, a sewer permit will be issued and
Sink - Bar/Lavatory 111111111111 fees assessed for the sewer increase must be paid before the
- fey plumbing permit can be Issued.
-Service 11111•111111111
Swimmin: Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet 111•=11t'
Urinal
Other Fixtures: . ,:.� . r`�� -�
2 'd bTSGEBaEOS 9NIHWlld 30UOSU3 WdSb:E 6002 82 UeC
CITY OF TIGARD `
: 1 ; U
BUILDING DIVISION PERMIT #: i�l_iYI 7L70i3 (10(11
13125 SW Hall Blvd., Tigard, OR 97223 1D DATE ISSUED: 1d g/ 1OO�
Phone: (503) 639 -4171 � i �a��i��e,
Inspection Requests (24 Hrs.): (503) 639 -4175 ! 6 // U 6
INSPECTION WORKSHEET FOR DATE: 2/6/2009 TIME: 7 :00AM PAGE: 6
SITE ADDRESS: ()9348 SW WASHINGTON SQUARE RD W14 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GAP KIDS /BABY GAP
DESCRIPTION: Relocate or replacement of plumbing fixtures.
OWNER: WASHINGTON SQUARE LLG, PHONE #:
CONTRACTOR: CASCADE PLUMBING CO_ PHONE #: 503 -2189 -7095
Inspection Request Scheduled For: Date: 7 /6/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 080382 -01 503-2897095 N
Corrections /Co ments /Instruction : 6 p
W k-4 SO
-.- &LSI Jlt Jg-e4:-._ c ....,
Leet_k
'I tu9)Z elx) (...-v.____! t.lt ‹s0----
■
1,1,1 PAS ❑ PARTIAL APPROVAL ❑ CANCEL 1 I NO ACCESS
Li FAIL _ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: VIAZ Date: 3/ (S /1) . Phone #: (503) 718- 1 D"\.
•
CITY OF TIGARD
BUILDING DIVISION 7 PERMIT #: PLIv1200 00015
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/292(109
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639-4175 ;.:.
INSPECTION WORKSHEET FOR DATE: 1/30/2009 TIME: 7 :06AM PAGE:
SITE ADDRESS: 09348 SW WASHINGTON SQUARE RD W1 1 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GAP KIDS /BABY GAP
DESCRIPTION: Relocate or replacement. of plumbing fixtures.
OWNER: WASHINGTON SQUARE LLC. PHONE #:
CONTRACTOR: CASCADE PLUMBING CO. PHONE #: 503 - 283.7095;
Inspection Request Scheduled For: Date: .1030/70013 Pour Time:
Code # Inspection Description Confirm # Contact # Message
306 Plumbing under :l; b 0F30156.01 50341?3 -3978
Corrections /Comments /Instructions:
Alf:9
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CT 1 / 4 -A10 Date: 1 3 0 -9 Phone #: (503) 718- 2g71