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Permit CITY OF TIGARD � C O PLUMBING PERMIT 4 COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00445 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/2/2007 PARCEL: 1512600 -00300 SITE ADDRESS: 09473 SW WASHINGTON SQUARE RD A08 ZONING: C - G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG PROJECT: JAMBA JUICE Project Description: Replace 3 p traps to floor sinks and I floor drain. 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: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 3 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES WASHINGTON SQUARE LLC D BY THE MACERICH COMPANY Description Date Amount 9585 SW WASHINGTON SQUARE RD [PLUMB] Permit Fee 10/2/2007 $72.50 TIGARD, OR 97223 [TAX] 8% State Surcha 10/2/2007 $5.80 Phone : Total $78.30 Contractor: MODERN PLUMBING 11120 SW INDUSTRIAL WAY TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS Contact # : PRI 503 -691 -6166 FAX 503 -691 -6771 Reg #: LIC 87906 PLM 34 -250PB 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: ,, � /� Permittee Signature: 7- - t rY\-- 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. Oct. 2. 2007 2:05PM Modern rnn Plumbing No. 2663 P. 2 a/3 PYumbine Permit Anplication City of Tigard 0' C .r 200 Due By 131SW HaBlvd Tigani0Q- 1 1 G s D p M•, , char p 1�� "�r� ' f ll Phone: 503.639.4171 Fax: 60 Dale B) r i t„� r; r ` �" °n ,e: Sos.639.�&sl1Ll�1 G DIVISION 1 Beady/By: row{ - lid See Page 2 for Irdemet www'.tigard- or.gov NotiGeNM, d: _ , I supplemenullnformation 1 . T1T4 dFVURK ` ' FEE' IgC'1fiEDLrI:E ❑ New construction ❑ Demolition For special information use checklist -- Deseriplam I Qtc. I Es. I Total V Addition/altefation/replacement 0 Other. New 1- 2- family dwellings (includes 100 a for each utility connection) ' • •iA'ltEGORY'OF (••'0NJ31'Rti( ION' . • , : ' SFR(1)bath 249.20 ❑ 1- and 2 -family dwelling 'CommcrciaVindustrial SFR (2) bath 350.00 1:1 Accessory building CI Multi-family Spit (3) bath 399.00 Each additional bath/kitchen 45.00 ©Nester builder ❑ Other Fire sprinkler (_sq. R.) Page 2 r' 'J OB': S� ii .' NFORl► fO� •Alm' - . 1.:66 N , • , , ; ,. .;; , _ site utilities _ - Job site address: "/73 S) 1A)e4.0 h S Catch basin or area drain 16.60 City/State/ZIP: 77 r d O JZ $ Drywall. leach line, er trench drain 16.60 SuiteibldgJapt no.; Project name: l� iU �'L Fooling draw (no. finest R: _ ) Page 2 Manufactured home utilities 110.00 , Cross street/directions to job site: / , / Manholes 16.60 I/V l s11 i /lf 18) .54 )4, -t Rain drain connector 14.60 f Sanitary sewer (no. linear ft: _____) j Page 2 Storm waver (no. linear R: ) Page 2 Subdivision: I Lot no.: Winer service (no. linear IL: _) _ Page 2 Fixture or hem Tax map/parcel no.: Absorption valve 16.60 % N i w� . . , rr" . ; ,• ... , : 1 ? F i l s E � 6 @ ON O F : *QRT�:' .. ..... '` . . , Backflow proveneer Page 2 C i . /.._% / I ,c /0 ✓ 5 A n , i+�S Backwater valve 16.60 � 4 1 Ai pL) t2 t he$ t-J .- - ~ Clothe s washer 16.60 • - O Dishwasher 16.60 ;+ ,� Drioldng fountain 16.60 ;r'Rn , • *Y'ROP ?f. : : - .. .;; . .. 7 ` .' ! -' - ' 7 `'. ' 16.60 Ejectors/sump Name: _ Expansion tank 16.60 Address; _ Future/sewer cap 16 60 /� City /StateJZIP: Floor drain/floor sink/1mb 41- _ 16.60 & 6 1 Phone: ( ) Fax. ( ) Garbage disposal 16.60 }joss bib I6.60 "',. 13 A1PPIrI lyT '• C`OTl1'_4iC'r'*V•RSON • ,• . Ice maker 16.60 Business name: ham: ptar /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State/ZIP: Roofdrain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: ( ) , Fax.: ( ) Tub/shower /shower pan 16.60 E -mail: Urinal 16.60 CONRR�C IOR ° Water closet 16.60 Business name: MODERN PLUMBING CO. M Water heater F6.60 Address : 11120 SW INbUSTRIAL WAY Other: Subtotal City /State/ZIP: TUALATIN, OR 97062 _ Minimum permit fee: 572.50 Phone: (503) 691 -6166 Fax; (S03) 691 -6771 Residential baddlow minimum permit fee: $36.25 71 CC13 Lie.: 87906 I Plumbing Lie. no.: 34 -2SOPB Plan review (25% of permit fee) L / V t,[.� Lt?..5r6 / Starts surcharge (8 °6 of permit fee) (l7 Authorized signature y 'TOTAL PERMIT FEE 76.3D Print name:Ma r ,kr I )L A os k [ Date: 1/ Q -) -p 7 This permit application expires Ira permit Is not obtained within 180 days after ft has been accepted as complete. *Pee methodology set by Tn - County Building Industry Service Board. L-\ Bmlaite\PQadaWi.M- PemniNap.doc 06126/06 448.46tsr(►otovcoMVWEB) CITY OF TIGARD BUILDING DIVISION PERMIT #: P1.M2007- 004'15 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1002007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 . ' "'I L INSPECTION WORKSHEET FOR DATE: 10/4/2007 TIME: 7 :02AM PAGE: 35 SITE ADDRESS Q0473 SW WASHINGTON SQUARE RD A08 CLASS OF WORK: SUBDIVISION WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME JAMBA JUICE DESCRIPTION Replace 3 p traps to floor sinks and I floor drain. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: MODERN PLUMBING PHONE #: 503 -691 -6166 Inspection Request Scheduled For: Date: 10/4/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 056966 -01 503 - 691 -6166 Y Corrections /Comments/ Instructions: Ca PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CrtAti. 1..)% Date: 10/ Phone #: (503) 718-