Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00420
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/17/2007
PARCEL: 1S12600-00300
SITE ADDRESS: 09504 SW WASHINGTON SQUARE RD J02 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: DAIRY QUEEN /ORANGE JULIUS
Project Description: TI - replace, cap and add new fixtures. Other fixtures include' (1) expansion tank, (7) caped
fixtures, (1) ice maker and (1) primer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: 1 BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: M FLOOR DRAINS; 2 TRAPS: 0
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 5 URINALS: GREASE TRAPS: 1
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
WASHINGTON SQUARE LLC Description THE MACERICH COMPANY escription Date Amount
9585 SW WASHINGTON SQUARE RD [PLUMB] Permit Fee 9/17/2007 $348.60
TIGARD, OR 97223
[TAX] 8% State Surcha 9/17/2007 $27.89
Phone : Total $376.49
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -691 -6166
FAX 503 -691 -6771
Reg #: LIC 87906
PLM 34 -250PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Iss -d By:
//L �� / Permittee Signature: r(C�N1
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
-Sep. 13. 2007 2:18PM Modern Plumbing No. 1843 P. 2
.
:
Plumbing Permit Ann 'R N
iYi i C FOR OFFICE 1_'51( ONLY
City of Tigard IA1 Poem No / ` 1l "" Si 40
III • 13125 SW halt Blvd, Tigard, OR 97$ p 1 3 20� 1 7 Plan l<s��a�r
I phone: 503.639.4171 Far 503.59. Date Sc (Vier Permed No , 7 Ile i y3 . - 2 -
Ltap«dion 1� 503,639.4 T U� i r _ /� Dj y^� � V e 2 for
Internet: `^""'v
T I ( "� .1 I: I) e't: www.ti qe o i lU ARD a te- ': Page 2 for
�d or B _ , NotificdJASethod _ _ Supplemented Ynrormprion
i t ti 1 D 1 I, . ' • lee SeltEDULE`
❑ New construction 0 Demolition For special iryformatian use checklist _
kg escYnpbon ( Qt... Es 1 Total
Addition/alteration/replacement eptacement ❑ Other. New 1- 2 -famg7 dwellings (includes 100 R for each utility connection)
'. C';iTEGORY OF cONbTYZitCTION . • ' SFR (1) bath 249.20
❑ 1- and 2-family dwelling ,r Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family
-
SFR (3) bath 399.00
❑ Master builder ❑ C)tlrcr. Each additional bathlkitehen 45.00
F i n e sprinkler L sq. ft.) Page 2
, 'a �� O 1 /� ' JOB ;SX�'E. INFORM AT Z014.._�Nlb•`X�OC.tiTR9N n ( : .. Site utilities
Job site address 3-- ash ,i r, ,s 0 1�0 Catch basin or area drain 16.60
City/State/ZIP: 9 a, r d i R CI 7 2 3 Drywell, leach line, or trench drain 16.60
Suite/bldgJapt. no 62 Project name: ,DQ I Q ,fee^ J i �s Footing drain (no. linear R: ) Page 2 La 1 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 saver (no. Novas R= __) Page 2
Subdivision: I no.; Water service (no- linear it: ) Page 2
Thrum or item
Tax map/parccl no.;
Absorption valve L 16.60 Il
a }'�.`, .: - , • , '' - ": •:DESI'1 �O1V;'OF„nORIc "` , = •e:',, , .°r' z - Backomv prevemer ' Page 2 «(D -I !. •
1 e co. ,--6- 1 I0 0 c r--� en-i- i Backwater valve 16.60
Clothes washer 1 16.60 4, (2 o
Dishwasher i 16.60 / b, (p a
;'p A,. tiFROP Ti;"Qiii'N R -. .`� ; �; main 16.60
: ' `. ' : C; T EN'_ Drinking fo Ejectors/sump 16.60
Name:
Expansion tank 1 16.60 R.,, 6 0
ma ts - ' Fixture/sewer cap 7- 16.6 . 0
City /State/ZCP: Floor drain/ loor sink/hub 2„ - 16.6 - &
Phone: ( ) Fax; ( ) Garbage disposal - 16.60
;,.,
• ..,. ,. ,,,,, ❑' Hose bib
` ' i rLic . N'r IJ CONTACT' PERSQN
Ice maker / 16.60 L (0. (m 0
Business nano: Interceptor /grease trap ', ! 16.60 /La, (v 0
Contact name: Medical gas (value: $ ) Page 2
Address: Primer i 16.60 /C.. (p O
City /Stabs/ZIP: Roof drain (commercial) 16.60
Phone: ( Sink/baain/lavatory 5 16.60
_)=ax :: ( )
Tub/shower/shower ub/shower /shower pan 16.60 $3.
Urinal 16.60
: NTRAC'xOR ,; Water closet 16.60
Business name; MODERN PLUMBING CO. Water heater / 16.60 (( 400
Address: 11120 SW INDUSTRIAL WAY Other:
Subtotal ' 3 ) 1 _ �
City /StateJ21P: TUALATIN, OR 97062 - ,
Minimum permit fee: $72.50 ��ddp
Phone: (503) 691-6166 Fax: (503) 691 -6771 Residential baoldlow minimum permit fee; $36.25 3 4L(0O
GCB Lic.: 87906 Plum.' I ic. no.: 34-2SOPB Plan review (25:yof permit fee) 2/.19
Slate aancharge (596 of permit fee) 4Gs'
Authorized signature; TOTAL PERMIT FEE b• Z
Print name: b • , . ■ - 4 . Date: 9 ®o This permit application expires if a permit is not oblatne wlthIn
180 days after It has been accepted ere complete. 3�p ,
di
*Fee methodology set by Tri•County Building Industry Service Soars.
dAsmtaingwetrair .*t,M- PamitApn.aoc 06/26r05 4e0-461dTp0 /02/cowvW6B) 4 6 KA CO t ■ e
2I F.x+urensT.ka1 X SIG. o 1 ,f 3i8. 1,0
CITY OF TR ARD
BUILDING DIVISION PERMIT #: PLIsA2007- 0t)420
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/17/2007
Phone: (503) 639 -4171 �'�
Inspection Requests (24 Hrs.): (503) 639 -4175 ..':� 'I_�..
INSPECTION WORKSHEET FOR DATE: 10/31/2007 TIME: 7:00AM PAGE: E3
SITE ADDRESS: 09504 SW WASHINGTON SQUARE RD J02 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DAIRY QUEEN /ORANGE JULIUS
DESCRIPTION: 11 - replac:e, cap and add new fixtures. Other fixtures include: (1) expansion tank, (7) taped Fixtures,
(1) ice maker and (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 603 - 691 - 6166
Inspection Request Scheduled For: Date: 10/31/2007 Pour Time:
Code # ,spection Description Confirm # Contact # Message
399 Plumbing final 058723 -01 503-691-6166 N
Corrections /Comments /Instructions:
r \
e %
[`P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �(� V Date:' a/.3 1 a Phone #: (503) 718- L�
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007- 00420
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/17/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ''IL
INSPECTION WORKSHEET FOR DATE: 10/29/2007 , TIME: 7:01AM PAGE: 27
SITE ADDRESS: 09504 SW WASHINGTON SQUARE RD J02 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DAIRY QUEEN /ORANGE JULIUS
DESCRIPTION: TI - replace, cap and add new fixtures. Other fixt.vwes include: (1) expansion tank, (7) raped fixtures,
(1) ice maker and (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: MODERN PLUMUING PHONE #: 503.691 - 6166
Inspection Request Scheduled For: Date: 10129/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 050526 -01 503-691 -6166 N
Corrections/Comments/Instructions:
2�efT 'lJ ac.LC el o w pt./ i ce ✓ 2 L cJ A
�ivr -rte l l col ilr Gt.) ✓mac r GL L I fo a of to, tip . , A-<
•
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
T' FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cn �hn -�✓��U -� Date: f 6 (2 cr/ 0 7 Phone #: (503) 718-
CITY OF TIGARD ,. ,s ,.. ..
BUILDING DIVISION PERMIT #: P[ M2007 -00420 .
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/17/2007
Phone: (503) 639 -4171 �w
Inspection Requests (24 Hrs.): (503) 639 -4175 ..':� IL.
INSPECTION WORKSHEET FOR DATE: 10/26/2007 TIME: 7:QOAM PAGE: 71
SITE ADDRESS: 09504 SW WASHINGTON SQUARE RD J02 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DAIRY QUFEN/ORANGE JULIUS
DESCRIPTION: 11 - replace, cap and add new fixtures. Other fixtures include: (1) expansion tank, (7) raped fixtures,
(1) ice maker and (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503-691 -6166
Inspection Request Scheduled For: Date: 10/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 058402 -01 503-691 -6166 Y
Corrections /Comments /Instructions:
/ al IZ12-64.-A
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: c `aw �''"'�� Date: 1'b 1/141,61 Phone #: (503) 718-
I t
CITY OF TIGARD . .. "
BUILDING DIVISION PERMIT #: PI_M2007 -00420
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/17/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/16/2007 TIME: 7 :01AM. PAGE: 28
SITE ADDRESS: O9504 SW WASHINGTON SQUARE R'■ CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE • #: TYPE OF USE:
PROJECT NAME: DAIRY QUEF_N /ORANGE JULIUS
DESCRIPTION: TI - replace, cap and add new fixtures. Other fixtures include: (1) expansion tank, (7) caped fixtures,
(1) ice maker and (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503 -691 -6166
Inspection Request Scheduled For: Date: 10/1007 Pour Time:
Code # Inspection Description Confirm # Contact # Mes • -
399 Plumbing final 057691 -01 503- 691 -6166
Corrections/Comments/Instructions:
1
■
4/1
1 10,6
❑ PASS ❑ PARTIAL APPROVAL % CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL — FEES - ASSESSED
Inspector: VZ/ Date:, l /1 �` P hone #: ( 718 - 7 4 24
CITY OF TIGARD - `
BUILDING DIVISION PERMIT #: PLM2007- 00420
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/17/7()07
Phone: (503) 639 -4171 �'�
Inspection Requests (24 Hrs.): (503) 639 -4175 °7 IL,
INSPECTION WORKSHEET FOR DATE: 10/1/2007 TIME: 7:00AM PAGE: 17
SITE ADDRESS: 09504 SW WASHINGTON SQUARE RD J02 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DAIRY QUEEN/ORANGE JULIUS
DESCRIPTION: TI - replace, cap and add new fixtures. Other fixtures include: (1) expansion tank, (7) c:aped fixtures,
(1) ice maker and (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: MODFRN PLUMBING PHONE #: 503.691
Inspection Request Scheduled For: Date: 10/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 056660 -01 503.691 -6166 Y
Corrections /Comments /Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL , ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ■r\ k)- ••--`-- Date: /0/ / I d 2 Phone #: (503) 718-
c, ( (.' .l
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007- 00420
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/17/2007
Phone: (503) 639 -4171
Avitt
Inspection Requests (24 Hrs.): (503) 639 -4175 ° ' I I ..
INSPECTION WORKSHEET FOR DATE: 9/24/2007 TIME: 7:00AM • PAGE: 38
SITE ADDRESS: 09504 SW WASHINGTON SQUARE RD J02 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DAIRY QUEEN/ORANGE JULIUS
DESCRIPTION: TI - replace, cap and add new fixtures. Other fixtures include: (1) expansion tank, (7) caped fixtures,
(1) ice maker and (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503 -691 -6166
Inspection Request Scheduled For: Date: 9/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 056169 -01 503 - 691 -6166 Y
Corrections /Comments/ Instructions:
f l
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CPA/11..n.-il Date: c3 1 1,2Ut I,0 '7 Phone #: (503) 718-