Permit CITY OF TIGARD
PLUMBING PERMIT
f DEVELOPMENT SERVICES PERMIT #: PLM2001 -00087
�-� ,L r�� II 13125 SW Hall B lvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/22/01
SITE ADDRESS: 09455 SW WASHINGTON SQUARE RD A -15 PARCEL: 1 S126C0 -01107
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: 2 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing tenant improvement, relocating 5 fixtures.
FEES
Owner:
Type By Date Amount Receipt
MACERICH NORTHWESTERN ASSC. PRMT CTR 3/22/01 $83.00 27200100000
401 WILSHIRE BLVD - STE 700 SPOT CTR 3/22/01 $6.64 27200100000
SANTA MONICA, CA 90401
Total $89.64
Phone 1: 800 - 421 -7237
Contractor:
JACK CORMAN PLUMBING INC
7483 SE JOHNSON CREEK BLVD
PORTLAND, OR 97206 REQUIRED INSPECTIONS
•
Phone 1: 788 -6947 Rough -in Insp
Reg #: LIC . 88311 Final Inspection
PLM 3 -198PB
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 ma • • = I copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
/ )L'/
Permittee Signature:
Call (503 639 -4175 by 7:00 P.M. for an inspection needed the next ainess day
,,09/19/00 TUE 10:16 FAX 503 598 1960 CITY OF TIGARD Z002
"ITY OF TIGARD Plumbing Permit Application Plan Ch=
131'25 SII0 HALL BLVD. Commercial and Residential Recd B W+
TIGARD, OR 97223 Date Recd A.
Date to P.E.
;503) 6394171 Date to D
Permit # 1,940! g--7
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project ' F IXTURES ; (Individual): ",:•;; : _ - ..,____ . ;.Qty_';,'; ff?nce',�_' Tota`
Job 60/411- ,/ -AA-90c Sink, 16.60
Address street Address 61/45.1/4M 2y' Suite Lavatory / 16.60 /4.40
7“ Sell s41/4 31.6-' (/fl/7 s4 -/ Tub or Tub/Shower Comb. 16.60
Bldg* City/State Zip Shower Only 16.60
77644/0 f ,alt._ 97
Water Closet / 16.60 /4,4
in wil6i G /aZ • Urinal 16.60
Owner Mailing Address Suite Dishwasher 16.60
Garbage Disposal 16.60
City /State Zip Phone • -
Laundry Tray 16.60
Name ( /j Washing Machine 16.60
4� 1-"r? - ' 1, t I - ri i fr Floor Drain/Floor Sink 2" 2 16.60
Occupant Mailing Address Suite 3' 16.60
4" 16.60
City/State Zip Phone •
Water Heater 0 conversion l( like kind 16.60
Gas piping requires a separate mechanical permit. / 14.6 .l
Name MEG Home New Water Service 46.40
Contractor Mailing Address Suite MFG Home New San /Storm Sewer 46.40
70 S'E • ./�•✓1 / 4 AL /47 Hose Bibs 16.60
Prior to permit City /State Zip Phone Roof Drains 16.60
issuance, a copy P6+4,1 at_ 9v z4 sv , - 7rP -ai ,•
of all licenses are Oregon Const. Cdf t. Board Llc.# Exp. Date Drinking Fountain 16.60
required if 6 ?1 / C TiO &/O Z. Other Fixtures (Specify) 21.75
expired in COT Plumbing Lic. # Exp. Da
. database 3- / 1 - Q'(3 01/ go a/
Name -
Architect Sewer - 1st 100' - 55.00
or Mailing Address Suite Sewer - each additional 100' 46.40
Engineer City/State Zip Phone
Water Service 1st 100' 55.00
9 Water Service - each additional 200' 46.40
Describe work to be done: Storm & Rain Drain - 1st 100' 55 00
New 0 Repair 0 Replace wi like kind: Yes No 0 Storm & Rain Drain - each additional 100' 46.40
Residential 0 Commercial O ) �-
Additional de cription of work: /`"" ' 6 .r _ (14 d �6l4,-iZ Commercial Back Flow Prevention Device 46.40
�j� Residential Backliow Prevention Device' 27.55
/' + 4•7-1-1-A ) 02•42,- - '" � ? •4M Catch Basin 16.60
Are you pping, moving or replacin fixtures? Insp. of Existing Plumbing or Specially Requested 72.50
Yes IX No 0 Inspections permu
If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 65.25
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 16.60
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information > r - 44 <:
given is correct, that I am the owner or authorized agent of the owner, and
isometric « riser diagram is required if Quantity Total is > 9 ; t _;V,,; ;:
,. ;.;;
that • . k su. itled are in mpliance with Oregon State Laws. 'SUBTOTAL !:: i'•,, ' ='_ ;. r
d' 8 00
• nature • • , Ag Date
,-,, 3 of 8% SURCHARGE '-`-=,-. - - - _...:v1.--1. -
. Y ,
Co • Person 'ame i Phone .';v . iq wi. �` _ `.L`/
Z •, c'p� / / "Ler sp1-7e -I I "PLAN REVIEW 25% OF SUBTOTAL y L,' ,;: _ - = _•r:r=i',•_
71 ' c ?2, 0 d:` r g .r . � , Required only It fixture qty. total Is ? 9 ...: c
WM > TOTAL =T T _+ / U
,ti' U k , e
A i - '• O�"1- '`uemF t`` - = .s- ; m �'~ <, _ ' _;-_.: V /-
' i.,!- - .1 9 - Elam ,,� . ±:.;s -r L&.. � r r � _ r x f f .r w i •
Minimum permit tee is $72.50 + 8% surcharge, except Residential Bacldlww Prevention
;1;;!. .. : � • 7 �d '11�J.uta't.1 '.��' `i. Z., ' .; ..�.a,.i %,. • , ; ' ,;4 Device, which is $36.25 .8% surcharge. •
"All New Commercial Buildings require plans with isometric or riser diagram end plan review.
•tdstsVormslphsnapp rev -doc 9/8100
• /r. , cry,
CITY 6F TIGARD BUILDING INSPECTION DIVISION
MST,
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
it BU
Date Requested 3. 6 AM Awry PM _ ,•t _ BL
Location ?9 5 A cr-G S k Sj / Suite MEC
Contact Perm Ph 72 G P 1 PLM 2- f 7
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing - Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
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
Post & Beam
Top Out
Water Service -
Sanitary Sewer _
Rain Drains
AS AR T 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 [ ] Unable to inspect - no access
ADA l - -�
Approach /Sidewalk
Other Date /Z �� G 1 Inspector - / ( Ext
11 •
Final
PASS PART FAIL DO NOT R MOVE this inspection record from the job site.
•
[� 3/
CaY OF TIGARD BUILDING INSPECTION DIVISION MST,
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
(�
SUP.,
Date Requested 3 3v AM PM BLD
Location 94 55 5 t--) f- $ 3 k Suite MEC
Contact Person �-` ', -° !- ` ``j Ph PLM sue/
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall _ EL
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
Fire wall /� ,e
Fire Sprinkler � .
Fire Alarm
Susp'd Ceiling _ .
Roof
Misc:
Final
I PART FAIL
Post & Beam
Under Slab •
Chop 0 P
Water Service
Sanitary Sewer
Rain D -' 4 s
Fi =
•ART FAIL
• NICAL
Pos 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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA /,11
Approach /Sidewalk ) )) V
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the-job site. -
CITY OF TIGARD BUILDING INSPECTION DIVISION M T
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
yet .BUP
Date Requested e-/-/, AM PM BLD
Location 9'/5 7 51 4' COGS Suite MEC
Contact Person gG' Id c 6� G ✓ Ph 5 7 7 $8 G f 7 PLM Zaol — d 6 e 7
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 ( CO S G, _
Susp'd Ceiling .
Roof
Misc:
Final —
"PASS - PART FAIL
•
aw
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
- ain Drains
Fina
P : T-- FAIL -
M ' 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 • [ ] 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 •
Other oach /Sidewalk Date / 3 D / Inspector 1-5 �� " Ext
Final •
PASS PART FAIL DO NOT REMOVE this inspection, record from the job site.